Prostate normal & enlarged.

Medication that relaxes the muscles that surround the prostate channel

The anatomy of the bladder and prostate is such that a special muscle surrounds the urinary channel in

its course from the bladder into the prostate. These muscles are controlled by special nerves called

“alpha sympathetics”. In many men, increased tone of this muscle occurs with aging and can be a cause

of significant blockage of urinary flow without significant prostate growth. This muscle that runs

around the prostate channel can be relaxed by taking specific medications known as “alpha blockers”.

These drugs, Hytrin, Cardura or Flomax (terazosin, doxasin or tamsulosin), also are used to lower blood

pressure in some patients with hypertension. The smooth muscles around the neck of the bladder and

prostate are relaxed by these medications, and many men have both subjective and objective

improvement of their urinary flow. These improvement usually occur within the first few weeks of

taking these medications. These medications seem to work best in patients with smaller prostates, but

work in larger glands as well.

SURGICAL or PROCEDURES TREATMENTS FOR BPH

Transurethral RESECTION of the Prostate (TURP)

Transurethral resection of the prostate (TURP) has been the primary choice of treatment for the past 50

years for BPH that is causing obstruction of the bladder outlet

Approximately 400,000 transurethral resections of the prostate are performed annually in the United

States. TURP is a safe procedure with four out of five patients experiencing resolution of their voiding

symptoms with improvement of all of their urinary flow measurements. Essentially, TURP is the

removal of the obstructing portions of the prostate with a telescopic electric knife. The TURP requires

an anesthetic and takes about 30-60 minutes to perform. A tube or catheter is inserted into the bladder

and is left in place for 24 to 48 hours. The hospitalization lasts from 1-3 days and requires two weeks of

severe activity restrictions and another two weeks of modest restrictions. No treatment to date has

bettered the long term effectiveness of TUFT in alleviating obstruction caused by benign prostatic

hyperplasia.

But because TURP is a surgical procedure with some risks, and because of the costs and time off work,

other methods of therapy are being looked at intensively by the medical community. These include

medical treatments and alternative surgical treatments which are less complicated than transurethral

resection of the prostate