Prostate Gland Shrinkage Procedures

As men age, the prostate, a small gland below the bladder that produces most of the fluid in semen, continues to grow and can impinge on the urethra (the tube that carries urine). In cases where an enlarged prostate (also known as benign prostatic hyperplasia, or BPH) causes troubling urinary symptoms, men can benefit from treatment to reduce the size of the prostate and relieve pressure on the urethra. Options include medications called 5-alpha reductase inhibitors, traditional surgery or minimally invasive surgery.

Medication

The prostate grows under the influence of particular male hormones. An enzyme called 5-alpha reductase enhances the production of those hormones, and inhibiting the enzyme can slow or reverse the benign growth of a man’s prostate. Medications such as finasteride (Proscar) and dutasteride (Avodart) shrink an enlarged prostate by targeting 5-alpha reductase activity. According to the Mayo Clinic, these medications work best for men who have a very enlarged prostate. They are usually used in combination with another medication that relaxes bladder muscles for optimal effect on urinary symptoms.

While effective, 5-alpha reductase inhibitors can take several weeks to relieve urinary symptoms, and they can cause sexual side effects.

Traditional Surgery

Traditional surgery can be an option for men who have severe urinary symptoms that medications cannot control. To relieve pressure on the urethra, which runs through an opening in the center of the prostate, the surgeon removes a ring of prostate tissue around the center and leaves the outer core.

The surgeon can access the prostate through the urethra in a procedure called transurethral resection of the prostate or TURP, or he could work through a surgical slit in your lower abdomen in a procedure called an open prostatectomy. According to the Mayo Clinic, TURP works best for men who have a slightly enlarged prostate. An open prostatectomy involves more risk and a longer hospital stay than TURP, but it might be the best option for men with very large prostates or men who have bladder problems. Both procedures relieve urinary symptoms quickly but require a longer recovery time than the minimally invasive options.

Minimally Invasive Surgery

For men with conditions that make surgery too risky, minimally invasive techniques to remove part of the prostate can be an effective option. For example, men who take blood thinners might opt for a minimally invasive procedure because they cause less blood loss than traditional surgery. However, these options are not appropriate for all men. They do not work as reliably or effectively as traditional surgery, and they can take several weeks to provide relief from urinary symptoms.

Options include laser surgery to vaporize or cut out part of the prostate (enucleation) and prevent it from growing back, or transurethral approaches to heat and destroy part of the prostate. In transurethral microwave therapy, energy from an electrode shrinks the prostate, while in transurethral needle ablation, radio waves passed through special needles heat and destroy the excess tissue.

About this Author

In 20 years as a biologist, Susan T. McClure has contributed articles to scientific journals such as “Nature Genetics” and “American Journal of Physiology.” She earned her Ph.D. from the University of Maryland. She enjoys educating people about science and the challenge of making complex information accessible.