Noncancerous Prostate Disorders
Up to 90 percent of men over age 80 have some symptoms of the condition known as
benign prostatic hyperplasia (BPH). Half of men over 50 have it.
BPH is not cancer, but it can display similar symptoms:
prostate specific antigen (PSA) levels may be elevated, and the prostate gland itself is enlarged. The condition is rarely dangerous, but it can be aggravating for men because of the prostate's proximity to the urethra, which runs through the gland. When the prostate becomes enlarged, it chokes off the flow of urine, and strain may be necessary to start the flow. Men may have frequent urges to urinate, especially at night, or they may have a lingering sensation that the bladder isn't empty.
Treatment options include:
Heat treatments- These are minimally invasive and generate heat within the prostate by microwave, radio-frequency (RF), or laser energy. FDA approved the first microwave device, the Prostatron, in 1996, and since has approved the Targis and Urowave systems. Transurethral Needle Ablation (TUNA) was cleared in 1996 and uses RF needles inserted into the prostate to heat the tissue. FDA has cleared three types of lasers for treating BPH: a side-firing device that delivers laser energy from a fiber in the urethra; contact systems, which come in direct contact with the prostate; and the interstitial laser, which heats the prostate from probes placed within the gland.
Surgery- Transurethral resection of the prostate (TURP) removes excess prostate tissue with special instruments inserted into the urethra. For smaller prostates, the less invasive transurethral incision of the prostate (TUIP) involves one or two cuts made in the gland.
Stents- In 1997, FDA approved the Urolume, a tube to hold open the urethra and relieve obstruction due to BPH.
Alpha blockers- These oral drugs relax the prostate muscles, easing pressure on the urethra. FDA has approved Hytrin (terazosin), Cardura (doxazosin), and Flomax (tamsulosin hydrochloride).
Proscar (finasteride)- This drug shrinks the prostate by reducing the body's conversion of testosterone to the hormone DHT. FDA approved Proscar in 1992, and in 1998 allowed the drug to be labeled as the first medication to reduce the need for prostate surgery and to lower the risk of developing acute urinary retention, a serious and painful complication of BPH. Proscar also is being tested as a prostate cancer preventive in a massive clinical trial sponsored by the National Cancer Institute.
Another noncancerous condition, prostatitis, can be a bacterial infection of the prostate occurring in men of any age. Doctors typically prescribe antibiotics for the condition, which may occur only once (acute prostatitis) or several times (chronic prostatitis). Sometimes the condition clears up on its own, but men should always seek treatment, say health professionals.
