New Surgical Treatments For Bpe

New surgical treatments for BPE

 

The following surgical procedures have been more recently developed. The EAU currently considers these techniques to require further assessment and to show strong scientific evidence of benefit before they can be approved, so they are currently under evaluation.

Fewer doctors are trained in these techniques, so they may not be available in your local hospital.
 

Prostatic urethral lift

During this procedure, a surgeon uses a thin device to insert implants into both sides of the prostate to force it away from the urethra, so it is no longer blocked. This helps to relieve symptoms such as pain or difficulty when urinating. It is usually done under sedation .

Aquablation

This is a new treatment for BPE. Water is injected into the prostate using a probe passed into the urethra. The pressure of the water is used to destroy some of the prostate tissue, making it smaller.

Water ablation is less likely to cause side effects, however not all surgeons are trained to do this procedure.

Prostatic artery embolisation

A vascular catheter is inserted into an artery in your groin. Using X-ray guidance, it is passed into the blood vessels that supply the prostate gland. Tiny plastic particles are injected into these vessels to reduce the prostate gland’s blood supply, which shrinks it. This procedure can be done under a local anaesthetic as an outpatient.

Convective water vapour energy (WAVE) ablation, or the Rezum system

The surgeon passes a tool into the urethra and forces sterile water vapour or steam through it, into targeted parts of the prostate tissue. When the steam turns back into water, it causes the treated prostate cells to die. Over time, the body’s natural healing response removes the dead cells, thereby shrinking the prostate and enabling the urethra to open.

iTind

iTind is a folded medical device which is inserted into the urethra, where it makes contact with the prostate. iTind stays in place for up to a week, during which time it unfolds, expands, and re-widens the urethra. The device is then removed, but the urethra stays re-shaped even after iTind has been taken out. This means that normal urine flow is restored and remains.
iTind is usually inserted under sedation and local anaesthetic.

What are the most common side-effects of BPE treatments?

It is important to discuss the side-effects of any treatment recommended to treat your BPE. It is likely that you will have a number of treatment options and your doctor will be happy to discuss what each involves, the benefits and the risks and side-effects of each. It is important to be fully informed so that you and your medical team make decisions that you are comfortable with.

This section covers some of the common side-effects of BPE treatments so that you can read and consider these before speaking to your medical team for advice relating to your own personal circumstances.

Medicines

Medicines to treat BPE generally do not have many side effects, but for those few medicines that do, the side effects are usually mild and disappear shortly after the medicine is stopped.

Side-effects of BPE medicines include:

  • Dizziness
  • Blood pressure changes
  • Headache
  • Indigestion
  • Dry eyes
  • Dry mouth
  • Constipation

Additionally, some medicines can cause side-effects related to sexual dysfunction, such as decreased sexual drive, erectile dysfunction, or problems with ejaculation. Although it may feel uncomfortable, it is important to discuss these side-effects with your doctor if you experience them.

It is important to note that just because a side-effect is listed for a medicine, it does not mean that you will necessarily experience it. Some people do not notice any side-effects at all when taking medicines for BPE.

The advantage of medication is that if it doesn’t suit you, you can stop taking it and try something else.

Surgery

The most common temporary side-effects of surgery for BPE include:

  • Infections
  • Risk of bleeding
  • Being unable to pass urine
  • Scarring that narrows the urethra
  • Temporary pain when urinating

If you experience any of the above side-effects, they should resolve a short time after surgery but please speak to your doctor if you are concerned, or if the effects seem to be lasting for longer than a few days post-surgery.

Permanent retrograde ejaculation (where semen enters the bladder instead of emerging through the penis) is a possible long-term to permanent side-effect of surgery and this should be discussed with your doctor.
 

What is it like living with BPE?

Effects on your social life

The symptoms of BPE, such as needing to urinate urgently or very often, can be difficult to deal with. You may be worried about carrying out your usual social activities due to fear that there may not be a toilet nearby. It is important that you do not avoid social activities that you enjoy. Instead, go to your doctor, who will be able to give you advice and discuss possible treatment options that can help you manage your symptoms.

Effects on your personal relationships and sex life

BPE symptoms can have a negative effect on your personal relationships and sex life. It can be difficult to feel confident when you do not always feel in control of your body. Episodes of leaking or needing to find a toilet quickly can be embarrassing and lower your self-esteem. Side-effects of drug treatments, such as lack of sexual drive or erectile dysfunction, can add to these feelings.

These changes can be difficult to deal with and some men can suffer from depression as a result. That is why the effect of BPE on a person’s quality of life should not be underestimated. Living with BPE can be challenging for yourself and your partner, so it’s very important that you talk together and discuss the best way to cope with this condition. Together with your partner and your doctor, you can identify what is important in both your everyday life and your sex life and choose the best treatment option, to make it easier for you to live with BPE.

Seeking help

It may feel difficult to talk to your doctor about problems with urinating or about your sexual activity. Or perhaps you are afraid that you have an incurable disease or will receive the wrong diagnosis. These concerns are understandable, but your doctor will have helped many patients like you.

Do not let a prostate condition rule your life, arrange an appointment with your doctor today.

What happens if BPE comes back?

BPE cannot be completely cured and all medical and surgical treatments that are available focus on reducing the symptoms as far as possible. BPE symptoms and how bothersome they are can change over time. You may or may not decide to have further or more invasive treatment depending on your circumstances or how much the symptoms affect your daily life.

Your doctor will help you to make informed decisions about how you decide to treat your BPE and advise you of any new treatment options available so that your BPE is as well-managed as it can be, and you are able to enjoy your relationships and participate in all aspects of your life.