The latest treatments for an enlarged prostate may help reduce prostate size or reduce symptoms. Treatments include water vapor thermal therapy, prostatic urethral lift, and prostate artery embolization.

A doctor and patient.Share on Pinterest
Studio Firma/Stocksy

Because it presses against the bladder and urethra, an enlarged prostate can cause uncomfortable symptoms such as frequent urination, nocturia — needing to urinate in the night — and strenuous urination.

Many males develop an enlarged prostate. It is common in older adults.

This article outlines some of the latest treatment options for an enlarged prostate. It will also cover older pharmaceutical, surgical, and noninvasive treatments for this condition.

Water vapor thermal therapy (WVTT) involves using a special steam-creating device to reduce the size of the prostate. The hot steam travels through a tube in the urethra and damages excess prostate tissue.

Over time, the body reabsorbs this tissue. After multiple sessions, the prostate should decrease in size and put less pressure on the urethra.

Outcome and success rates

Some evidence suggests that WVTT is effective.

According to a 2020 review, WVTT may improve symptoms by up to 54% in people with moderate to severe symptoms of an enlarged prostate. Adverse effects are usually temporary and relatively unserious. However, further research is necessary to evaluate this treatment.

Prostatic urethral lift (UroLift) uses implants to hold the prostate back and reduce pressure on the urethra.

Doctors begin the UroLift procedure by inserting a device into the urethra. This device can hook tiny stainless-steel implants onto the prostate. Once these implants are secure, they move the prostate away from the urethra.

Outcome and success rates

Research suggests that UroLift may be an effective treatment for an enlarged prostate.

According to a 2021 analysis of real-world UroLift procedure outcomes in hospitals across England, the complication rate tends to be relatively low. Within 2 years of undergoing UroLift treatment, only 11.9% of people required further retreatment for enlarged prostate.

Prostate artery embolization (PAE) aims to restrict blood flow to the prostate, causing it to shrink.

During the procedure, a medical professional enters a thin tube into an artery in the groin or wrist. Using imaging technology, they guide the tube into the prostate arteries and inject tiny round particles that help restrict blood flow.

Outcome and success rates

Results on the effectiveness of PAE are unclear.

Some research suggests that symptoms of enlarged prostate recur in 23% of cases post-PAE. Additionally, the complication rate for PAE is around 32.9%, although 99% of these are minor.

However, the same analysis suggests it can significantly reduce symptoms.

Several pharmacological treatments for an enlarged prostate include alpha-blockers and 5-alpha-reductase inhibitors.

Some pharmacological treatments can be quite effective. For example, some 5-alpha-reductase inhibitors can reduce prostate volume by up to 25%.

The goal of surgery for enlarged prostate is to remove prostate tissue. Procedures include transurethral resection of the prostate (TURP) and open prostatectomy.

With TURP, surgeons pass a small device known as a resectoscope through the urethra. It allows surgeons to remove parts of the prostate.

Open prostatectomy involves removing the whole prostate. This procedure may be necessary for people with a very enlarged prostate.

When less invasive treatments do not work, doctors may consider other procedures that aim to reduce the symptoms of an enlarged prostate by operating on other parts of the body, such as the urinary tract.

However, these procedures are extreme and carry significant risks. Such operations include:

  • Cystoplasty: This procedure increases the size of the bladder. Surgeons perform a cystoplasty by removing a piece of the intestine. They then sew this piece of the intestine into the bladder.
  • Implanted sacral nerve root stimulation: Doctors insert a small device under a person’s skin during this procedure. This device creates electrical stimulation, affecting the bladder and urine system. It allows for better control when urinating.
  • Urinary diversion: This involves diverting the tubes that normally travel from the kidneys to the bladder. It allows urine to collect without traveling through the bladder.

Lifestyle changes for managing the symptoms of an enlarged prostate may include:

  • drinking less in the evening
  • drinking fewer alcoholic, caffeinated, and artificially sweetened drinks
  • double voiding

Some people may also benefit from bladder training, which involves postponing urination for increasing stretches of time and learning various muscle and relaxation techniques.

Enlarged prostates can cause problems with urination. The enlarged prostate pushes against the urethra, making it difficult for urine to leave the body.

Some new techniques for treating an enlarged prostate include WVTT, PAE, and UroLift. Other treatment options for an enlarged prostate include surgical procedures. Lifestyle changes and bladder training may also help people cope with the symptoms of an enlarged prostate.