Understanding your BPH treatment options at HCA Healthcare UK

Mr Marc Laniado, Consultant Urological Surgeon at The Princess Grace Hospital, discusses the treatments available for benign prostatic hyperplasia (BPH) and how you can choose the best option for you, including the benefits and any side-effects.

Male patient with consultant

1) What is benign prostatic hyperplasia, and how common is it?

BPH is a non-cancerous (benign) enlargement of the prostate gland which tends to affect men as they get older. It can make men feel the need to pass urine far more frequently, particularly at night, and with a slower flow of urine.

2) How can you tell the difference between BPH and prostate cancer?

Understandably, most men will worry that they have prostate cancer if they experience unusual or different urinary symptoms. In the majority of cases, any change in situation will be due to a common and benign overgrowth of the prostate. The best way to be sure and confirm is by doing a prostate-specific antigen (PSA) test to see this the level is higher than usual. If it is, an MRI scan will then be done to look for indications of cancer. Sometimes, biopsies are needed after to be sure also, and if anything is found, you’ll be booked in to see an urological oncologist as soon as possible to explore treatment options.

3) What are the main medications for BPH?

There are three main treatment and medication groups that can improve urinary symptoms associated with BPH:

  1. Herbs – Such as carbon dioxide extracted of saw palmetto
  2. Alpha blockers – There are medicines like tamsulosin that relax the valve between the bladder and the prostate
  3. 5-ARIs – Medications like Finasteride can shrink the prostate slowly over one to two years by about 25%

4) What are the pros and cons of the various BPH treatments?

At HCA UK, we provide an extensive range of treatments for BPH, featuring options not available elsewhere in the private sector. We’ll provide each patient with a clear understanding of their available options, emphasising the importance of crafting a plan that puts them and their needs - not just the diagnosis - at the centre of care.

BPH affects men differently, so tailoring treatments will be crucial for achieving the best outcomes. Whether this is through lifestyle changes, medication, minimally invasive procedures, or more complex surgery, we can maximise effectiveness, minimise side effects, and improve overall quality of life.

Treatment  Best for  Key benefits 
Aquablation Large prostates with BPH Fast, precise, maximum bladder control, and enables normal ejaculation for most men
HoLEP Very large prostates with BPH Considerable urinary relief and minimal bleeding 
TPLA Small to moderate prostates Minimally invasive, local anaesthesia, normal ejaculation for most men 
Greenlight Patients on blood thinners with moderate BPH Minimal bleeding, immediate relief, often a day case procedure
Rezum Younger men with mild to moderate BPH Outpatient procedure with the preservation of ejaculation in most men

Prostate artery embolisation

High-risk surgical patients Minimally invasive, no anaesthesia

UroLift

Those with mild to moderate BPH symptoms Preserves sexual function in all men, fast recovery, day case procedure

5) How do you choose the best treatment for BPH?

Choosing your treatment is an entirely personal decision. If the most important goal of treatment is to get maximum relief from urinary symptoms then HoLEP is likely to offer the most durable and longer-lasting treatment for any prostate size with minimal bleeding – however, there may be a slight impact on ejaculation. If a dry orgasm is unacceptable, then men should choose a procedure such as UroLift or Rezum. If the thought of any urinary leakage is unacceptable, then Aquablation is very safe and a chance of urinary leakage almost none, as the treatment is robotically under direct visual and ultrasound control.

6) What is the latest advancement in BPH treatments?

One of the latest treatments for BPH is Aquablation. Offering similar symptoms relief to HoLEP, it has the potential to preserve and offer better sexual function and excellent bladder control. It does this through state-of-the-art imaging, robotic control of the equipment and computerised guidance to choose the area of the prostate to treat in minute detail.

 

To find out more about our Urology services at HCA please click here.
To book an appointment with Mr Marc Laniado please visit his profile here.