Treatment of Prostate disease

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In benign prostate enlargement, if symptoms are mild to moderate then no treatment and watchful waiting may be the best option.

Medication does not cure the problem, although it might help to ease some of the problems:

Alpha-blockers â€“ these relax the muscle tissue of the prostate and the outlet of the bladder.
Finasteride - blocks the conversion of the hormone testosterone to dihydrotestosterone in the prostate.

Surgical treatment involves part or complete removal of the gland.This is most commonly done through the urethra, using a special viewing and cutting instrument called a resectoscope.

The procedure is called a trans-urethral resection of prostate, or TURP. This operation gives good improvement in symptoms in most cases. If the enlargement is considerable, a direct surgical approach through the lower part of the wall of the abdomen and the wall of the bladder may be necessary.

There are various alternatives to TURP. Â·

The urethral part of the gland can be stretched with a balloon catheter.
The gland can be treated with Cryotherapy (freezing), a microwave heat method, or a laser.
Bladder neck incisions can be made in the bladder neck to reduce the outflow resistance.
A permanent widening device called a stent can be inserted.

To date, TURP still appears to be the most reliable form of surgery. A simpler alternative is intermittent catheterisation. This relieves the obstruction to the flow of urine by passing a urinary catheter to empty the bladder. Men with urinary-outflow difficulties can be trained to perform the procedure themselves.

In an emergency, when prostate enlargement has completely blocked urinary outflow, a procedure known as suprapubic catheterisation may be necessary. Suprapubic catheters are inserted directly into the bladder through an incision in the lower abdomen.

Treatments for bacterial prostatitis are:

Antibiotics - a 4-6 week course is needed. The bacteria present can be identified from the urine test so the most suitable antibiotic can be used.Â·
Painkillers- Paracetamol or ibuprofen to ease the pain and reduce fever. Stronger painkillers are sometimes needed.

Treatments for non- bacterial prostatitis are:

Painkillers - paracetamol or ibuprofen to ease the pain
Antibiotics - a 4-6 week course of antibiotics may be advised. To be sure that no infection is present even though urine tests for infection are negative.