BPH Treatment Comparison
|Laser Focal Therapy||TULSA-PRO®||TURP/GreenLight||UroLift||Rezum|
|Low blood loss||1, 2|
|Relatively low risk of retrograde ejaculation||3||4|
|Get to keep the prostatic urethra|
|Requires general anesthesia|
|Results in the removal of excess tissue|
|Requires a surgical device to be inserted into the penis|
|Real time image guidance during ablation||N/A||N/A|
|Learn More||Learn More|
 Descazeaud, A., Azzousi, A.R., Ballereau, C. et al. (2010). Blood loss during transurethral resection of the prostate as measured by the chromium-51 method. National Library of Medicine, 24(11), 1813-1816. doi: 10.1089
 Bruyère F, Huglo D, Challacombe B, Haillot O, Valat C, Brichart N. Blood loss comparison during transurethral resection of prostate and high power GreenLight(™) laser therapy using isotopic measure of red blood cells volume. J Endourol. 2011 Oct;25(10):1655-9. doi: 10.1089/end.2011.0104. Epub 2011 Aug 11. PMID: 21834657.
3 Preserving ejaculatory function in young patients with lower urinary tract symptoms: medium- to long-term follow-up of prostatic urethral lift at a single center https://pubmed.ncbi.nlm.nih.gov/34377154/
4 Rezūm Water Vapor Thermal Therapy for Lower Urinary Tract Symptoms Associated With Benign Prostatic Hyperplasia: 4-Year Results From Randomized Controlled Study https://pubmed.ncbi.nlm.nih.gov/30677455/
There are four main options for treating benign prostatic hyperplasia (BPH): from mild diagnoses suggesting no intervention to patients with significant, multiple symptoms requiring medication or surgery.
If your symptoms are mild or you’re not bothered by the effects of BPH, you and your doctor may choose to watch, monitor, and wait. A yearly exam is common and personal awareness of any change in urination is important to understand if your BPH status has changed.
BPH is usually treated first with a medication called an alpha-blocker (e.g., Flomax, alfuzosin, Rapaflo). These medications help to relax the muscles in the prostate, taking some of the pressure off the urethra. Unfortunately, these medications often have side effects, including dizziness, decreased energy, and/or retrograde ejaculation.
Another class of medications is 5α-reductase inhibitors (e.g., finasteride or dutasteride). These medications block the body’s production of a version of testosterone that causes the prostate to enlarge. As a result, they can also decrease erectile function, energy, and libido.
If you cannot or do not want to tolerate the side effects of BPH medications (or if they are not effective), a BPH treatment procedure may be the next step.
Transurethral Incision of the Prostate (TUIP)
The surgeon makes small cuts in the bladder neck, where the urethra joins the bladder and in the prostate. This widens the urethra and reduces the pressure of the prostate on the urethra, making urination easier. The hospital stay is one-to-three days. A catheter is left in your bladder for one-to-three days after surgery.
Photoselective Vaporization (PVP)
PVP (such as GreenLight laser) is a way to vaporize prostate tissue with a high-powered laser. It is an outpatient procedure. The procedure takes place at the hospital or sometimes in the doctor’s office. There are a few side effects, and PVP is not recommended for men with the largest prostates.
Transurethral Resection of the Prostate (TURP)
A common surgery for men with BPH, TURP uses a laser to cut and remove tissue. Anesthesia and a tool called a resectoscope inserted through the penis are used. Men with moderate-to-severe BPH symptoms may be good candidates for TURP.
The entire prostate gland is removed via laparoscopic or robotic-assisted surgery. This treatment is generally only offered to men with the largest prostate glands.
For those with BPH, laser focal therapy (LFT) / focal laser ablation (FLA) or transurethral ultrasound ablation (TULSA-PRO) may be worth considering.
After using an MRI to map the prostate gland, the physician targets the areas of enlargement which are then destroyed with a laser (LFT/FLA) or ultrasound (TULSA-PRO).