Treatment
Benign Prostate Hyperplasia

The latest treatments in Benign Prostatic Hyperplasia with the most pioneering technology to achieve the best results and quality of life for patients.

The treatment of prostatic hyperplasia depends largely on three factors: the degree of symptoms, the presence of complications and patient preference.

What do we offer you?
  • Super-specialized urologists
  • Personalized treatment
  • Minimally invasive approach
  • More than 16,000 patients successfully treated

Benign Prostatic Hyperplasia Treatment and Technology

We can distinguish between medical and surgical treatment:

Medical treatment

It is the treatment for most men with mild to moderate urinary symptoms. The risk of progression of prostate problems, which can reach up to 30% in large prostates, must be taken into account, as well as the efficacy and safety profile. Some prostate drug treatments cause sexual problems such as impotence, anejaculation or decreased sexual desire.

  • Phytotherapy. It consists of plant extracts that improve urinary symptoms. It is indicated in mild and moderate symptoms without complications. It does not produce side effects in the sexual sphere.
  • Alpha blockers. These are drugs that "open" the bladder neck and reduce symptoms, facilitating urination. They do not alter the natural history of the disease, so they could be considered "prostate analgesics". They have two side effects to be taken into account: arterial hypotension and the decrease, even elimination, of sperm with orgasm.
  • 5-alpha-reductase inhibitors. These are drugs indicated in prostates larger than 40cc to reduce their size and improve urine flow by blocking an enzyme that the body needs to make dihydrotestosterone.

Its effects take some time to react, but this treatment reduces the risk of complications and the need for surgery in the long term. The main drawbacks are decreased sexual desire and possible erection problems.

 

Surgical treatment

When there are important symptoms or complications, the best alternative is surgery. Among the surgical options, there are minimally invasive ones that allow very short admissions and minimize the risk of complications.

Classic techniques

  • Transurethral resection of the prostate (TURP). Classically, benign prostatic hyperplasia of less than 60cc has been treated by transurethral resection of the prostate (TURP). It consists of removing the prostatic adenoma little by little with a classic scalpel through the urethra, without incisions. This technique can lead to a series of complications such as bleeding, fluid absorption or the need for reoperation in the medium to long term.
  • Open surgery. When the adenoma is larger than 60cc, classically open surgery was required, since it was not possible to remove all the tissue through the urethra. This technique is much more aggressive, but it manages to remove the entire prostatic adenoma, preventing the recurrence of the disease, there are no recurrences. Although it is effective and definitive, it has a lot of associated morbidity and mortality: bleeding, high percentage of blood transfusion, surgical wound, requires hospital admission and prolonged bladder catheterization, recovery and reintegration to our daily life is slower.

Modern techniques

  • Holmium Laser (HoLEP). The most powerful deobstructive treatment with the best safety profile is prostatic enucleation with Holmium Laser. It is indicated for all prostate sizes and has the same efficacy as open surgery but with much less aggression and many fewer complications. In ROC Clinic we have more than 15 years of experience in this technique and we have performed more than 3,500 interventions with holmium laser.

SEE HOLMIUM LASER

 

  • Tulium laser (ThuLEP). The Tulium laser prostatic vapoenucleation technique allows the vaporization of prostate tissue through energy emitted continuously, unlike the Holmium laser, which does it in the form of pulses.

SEE TULIUM LASER

 

  • AquaBeam. This is a robotic treatment that vaporizes the prostate tissue using water. It is a very safe procedure with virtually no incontinence, erection problems or ejaculation disturbances. It is effective in medium to large prostates.

SEE AQUABEAM

 

  • Rezum. It consists of the injection of water vapor into the prostate producing the unblocking of the lower urinary tract and improvement of symptoms. It does not cause side effects such as incontinence, erectile dysfunction or anejaculation. It is effective in small or medium sized prostates. It is a treatment valid only for patients strictly selected on the basis of a series of personal, clinical and anatomical parameters, with a mild condition and for prostates no larger than 80cc in size. It is usually presented as an alternative to medication.

SEE REZUM

 

  • Green laser. This treatment is indicated for prostates smaller than 60-80gr. It consists of vaporizing the prostate tissue through the urethra, making it disappear and thus eliminating the bladder obstruction. The functional results are similar to those obtained with classic transurethral resection of the prostate, but inferior to open surgery or prostatic enucleation.

SEE GREEN LASER

Find out more about
Benign Prostate Hyperplasia

They ask us
in the Consultation

What are the symptoms of an enlarged prostate?

There are many, but some of the most common are: getting up to urinate at night, urinating many times when getting up in the morning, dropping a few drops at the end of urination, weak urinary stream, having to strain to start urinating.

I urinate badly... What tests do I have to undergo?

We may only need to do an ultrasound of the prostate, bladder and kidneys, along with a blood test.

Can prostate pills cause sexual problems?

Yes, some prostate medications worsen erection, sexual desire and ejaculation, but there are alternatives to improve symptoms without side effects.

Does prostate hyperplasia surgery cause sexual problems? Is it very aggressive?

Not at all. In recent years we have more and more technology that allows us to perform minimally invasive prostate surgery without causing sexual side effects.

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Team
of the Benign Prostatic Hyperplasia Unit

Dr. Javier Romero-Otero

Dr. Javier Romero-Otero

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Dr. Juan Justo Quintas

Dr. Juan Justo Quintas

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Dr. Esther García Rojo

Dr. Esther García Rojo

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Dr. Alfredo Rodríguez-Antolín

Dr. Alfredo Rodríguez-Antolín

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Dr. Mario Domínguez Esteban

Dr. Mario Domínguez Esteban

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Dr. Gino Marcelo Espinales Castro

Dr. Gino Marcelo Espinales Castro

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Dr. Diego Torres Perez

Dr. Diego Torres Perez

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Dr. Cristina Calzas Montalvo

Dr. Cristina Calzas Montalvo

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Dr. Elena Peña

Dr. Elena Peña

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News
of ROC Clinic on Benign Prostatic Hyperplasia

Research

Initial experience with thulium fiber laser for prostate enucleation: Analysis of the intraoperative and short-term outcomes in a prospective, multicenter cohort.

Training

Programming of the 2022 courses in Holmium laser prostatic enucleation.

The media talk about
of Roc Clinic
Dr. Romero
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