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Pharmacotherapy and Surgical Treatment for (BPH) Benign Prostatic Hyperplasia



Benign prostatic hyperplasia, or BPH, is a non-cancer pathology that affects men’s quality of life significantly. Depending on the patient’s complaints, BPH may require active therapy or watchful waiting (i.e. regular medical supervision).

Treatment options also include non-invasive pharmacotherapy, minimally invasive surgical interventions, and open surgeries. Scope of therapeutic techniques depends on the availability of updated equipment for minimally invasive procedures, modern drugs and qualified healthcare professionals.

Thus, many patients choose treatment abroad for achieving better functional results.

Administration of medicines

Pharmacotherapy is mentioned among the first-line treatment methods due to simplicity of the preceding diagnostic tests, cost-effectiveness and minimal risks and side effects compared to surgery. Typically, it is applied in patients with mild to moderate complaints and moderate prostate enlargement. Also approved therapeutic schemes include:

  1. 5-alpha reductase inhibitors that reduce the prostate volume by blocking conversion of testosterone to a more active dihydrotestosterone. Medications from this pharmacological group are consequently finasteride and dutasteride. In addition to fighting the prostatic hypertrophy, they steadily increase the maximum flow rate of urine.
  2. Alpha-adrenergic blocking agents that relax smooth muscles of bladder neck and prostate. Due to this, they reduce external pressure on the urethra and facilitate urination. Medications from this pharmacological group are alfuzosin, tamsulosin, doxazosin, and silodosin. Alpha-adrenergic blocking agents are the most efficient in patients with mild prostatic enlargement.
  3. Combination drug therapy is administered in the majority of cases and includes simultaneous taking 5-alpha reductase inhibitor and alpha blocker. The cumulative effect of both drugs provides patients with prostatic hyperplasia syndrome with additional benefits.

Phosphodiesterase-5 inhibitors are also relatively new drugs in the BPH treatment. Their first indication is improving sexual activity in men with erectile dysfunction. Nevertheless, relaxation of the smooth muscles of the prostate gland and bladder eases symptoms of the BPH as well. Consequently Tadalafil is now the only medication from this group that has received the FDA approval.

Minimally invasive and open surgical interventions

Interventional treatment of BPH in Germany is aimed at improving patient’s state and restoring normal urine flow with maximally sparing techniques. Surgery is considered only when BPH causes moderate to severe symptoms that do not respond to medications intake. Other possible indications include the blood in urine, bladder stones, urinary tract obstruction, etc.

Healthcare systems of Germany and other developed countries offer a number of targeted procedures that are performed under the constant visual guidance (ultrasound or tomography control):

  1. (TUIP)Transurethral incision of the prostate .
  2. (TURP)Transurethral resection of the prostate
  3. (TUMT)Transurethral microwave thermotherapy.
  4. (TUNA)Transurethral needle ablation.
  5. Laser therapy, including HoLAP and HoLEP.
  6. Prostatic urethral lift (PUL).
  7. Embolization of prostate vessels.
  8. Prostatectomy (open or robot-assisted).

Minimally invasive procedures are also typically associated with shorter hospital stay, faster functional recovery, minimal pain syndrome, more favorable overall cost, etc. Thus, patients also prefer such interventions to open surgeries.

Efficient BPH treatment abroad with Booking Health

Patients from all over the globe can undergo treatment of BPH in Germany due to assistance of Booking Health. The certified medical tourism provider Booking Health facilitates the following:

  • Choosing the right healthcare institution according to the hospitals ranking.
  • Booking the appointment, communicating with the chosen physician.
  • Preparing the complex medical program in advance and discussing it with the patient.
  • Monitoring of medical program implementation.
  • Providing favorable costs, without additional fees for foreigners (saving up to 50%).
  • Control of the final calculation.
  • Help in buying the required medical products.
  • Communication with the hospital after therapy completion.
  • Organization of additional and follow-up tests, distant consultations.
  • Booking hotels and tickets, transfer organization.

Please, leave your request on the Booking Health website, and a patient case manager or medical advisor will contact you the same day.



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