The prostate grows slowly throughout life because of testosterone. If the prostate can’t expand outwards, it expands inwards and put pressure on the urinary tract, causing problems with emptying the bladder. Retaining more and more urine will eventually stretch and destroy the bladder muscle function. Eventually you can’t urinate at all, which will kill you, unless you get immediate treatment.
There is no way to reduce the prostate size without medicine or operation.
Medicines, like a type of alpha blockers, can relax the prostate and mitigate the symptoms somewhat, but just for a couple of years. They also come with side effects that can be problematic.
Other medicines reduce the testosterone level, which will shrink the prostate. It’s the same medicine that is used to stop men from losing their hair. It also has side effects.
Then there are various operations to reduce the prostate size.
In some cases, open surgery is done, but is avoided if possible.
The oldest and ,most common by tradition is the TURP, where a rather thick tube is inserted in to the urinary tract and the prostate is shaved off in slices using a heated wire. If the tube doesn't go in, the urinary can be sliced open lengthwise to permit the tube to go in. Obviously, this treatment comes with a lot of temporary side effects. But many doctors seem to prefer this as it’s more difficult, and a bit of a challenge like golf, according to my urologist.
Then there are other versions where parts of the prostate are killed by steam or microwaves, where the body slowly absorbs the dead material afterward. Green laser is another version where parts of the prostate is vaporized. These use a not so thick tube, so if the thick TURP tube can’t go in then this is a backup treatment.
Common to all of them is that a tube is inserted through the urinary tract and the procedure is done from there.
I had the steam version, with the Rezûm system, which worked excellent. It takes a bit longer than TURP to get the wanted effect after the procedure, but the side effects are much lighter. It’s performed with local anasthesia and takes a few minutes, and you can walk home afterwards. You can continue with sports, and don’t need sick leave afterward.
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