Men who suffer from a benign enlargement of the prostate know the annoying symptoms all too well: a weak urinary stream with delayed and prolonged urination, a strong urge to urinate, frequent urination during the day and at night and dribbling of urine after urination. At the USZ, modern and gentle procedures are available for the successful treatment of these complaints.
What is HIFU therapy?
Benign prostate enlargement, also known as benign prostatic hyperplasia (BPH), is a common disease in men. Around 40% of all men over the age of 50 in Switzerland are affected, and among men over 80 the rate is as high as 80%.
As the prostate lies below the bladder and surrounds the urethra, increasing prostate enlargement increases the pressure on the urethra and bladder. Problems with urination are the result. Thanks to modern technology, prostate enlargement can now be treated gently and tailored to your personal situation.
“Many older men believe that urinary problems are an inevitable part of getting older – but that’s not true. Benign prostatic hyperplasia is easily treatable, and with the right therapy a good quality of life can be maintained into old age”
Treatment options
The treatment of benign prostate enlargement often depends on the degree of suffering. If the symptoms of prostate enlargement are mild and do not severely affect everyday life, active treatment may not be necessary. Treatment is usually recommended if the symptoms become stressful for the patient or if serious health problems develop. Initially, drug treatment is usually initiated. If this does not bring the desired success, surgical intervention may be considered. Various, mostly minimally invasive procedures are available for this purpose, which are generally gentle and well tolerated.
Therapy without surgery
Patients with a low level of symptoms are primarily checked regularly during urological consultations. Symptoms can be positively influenced by lifestyle changes (regular fluid intake, avoidance of excessive coffee and alcohol, pelvic floor exercises).
Drug therapy is usually recommended as the first therapeutic approach. Various medications are available for this: These include alpha-blockers, which relax the muscles around the prostate and urethra and make urination easier, and 5-alpha-reductase inhibitors, which can inhibit the growth of prostate tissue. Combination therapies with different preparations are also possible. In some cases, however, medical treatment is not sufficient and surgery is necessary.
Operative procedures
According to current recommendations, surgery is particularly useful in the following cases:
If a significant deterioration in bladder function is detected (e.g. due to increased residual urine formation)
If complications of prostate enlargement occur, such as repeated urinary retention or frequent urinary tract infections
If bladder stones or bladder diverticula have formed
In case of dilation of the urinary tract above the bladder and corresponding impairment of kidney function.
Insufficient effect of drug treatment.
Personal reasons, such as a high level of suffering or the desire for a permanent solution.
Minimally invasive surgical procedures
The minimally invasive (endoscopic) procedures aim to gently remove or destroy excess prostate tissue in order to reduce the pressure on the bladder and urethra and improve urine flow. The inner zone of the prostate, which causes the enlargement of the prostate and thus the symptoms, is treated. The minimally invasive procedures are performed using endoscopy. This means that a thin instrument with an integrated camera (endoscope) is inserted through the urethra to the prostate without the need for an external incision.
In recent years, various innovative treatment methods have been developed to treat benign prostate enlargement. We offer many of these modern methods at the USZ. Laser procedures in which the superfluous prostate tissue is specifically removed or vaporized are of particular importance.
Transurethral resection of prostate tissue (TUR-P) using an electric snare: TUR-P has been the standard surgical procedure for the treatment of BPH for decades. An electric snare is used to remove the excess tissue and seal the blood vessels. TUR-P is particularly suitable for small to medium-sized prostate volumes. Thanks to our surgical team’s many years of experience and sophisticated technology, this surgical procedure is still used reliably and effectively to relieve BPH symptoms.
REZUMTM water vaporization of prostate tissue:
In this procedure, short pulses of water vapor are emitted via a thin probe. The hot steam heats the surrounding tissue and thus leads to a controlled destruction of the superfluous prostate tissue. In the weeks that follow, the treated tissue is broken down naturally by the body.
A particular advantage of REZUM™ therapy is that it is gentle on the entire organism: it is therefore also suitable for older patients or patients with pre-existing conditions for whom other procedures would be too risky.
ThuFLEP(Thulium Fiber Laser Enucleation of the Prostate): The thulium fiber laser is a highly modern and very versatile laser. Since 2020, the Department of Urology has been the first center in Switzerland to offer this laser for the treatment of BPH. The laser is characterized by high power and low heat generation, which protects the surrounding tissue. During laser enucleation, the excess prostate tissue is peeled out from the inside – comparable to removing the flesh from an orange. The method is particularly thorough and is also suitable for larger prostate glands (>80 ml), which previously often required open surgery. More information
Greenlight laser vaporizationof prostate tissue In this procedure, a greenlight laser is used to vaporize the prostate tissue in a targeted manner (vaporization). The Greenlight laser generates high-energy green light that is strongly absorbed by the red prostate tissue without damaging the surrounding tissue. The procedure causes very little bleeding and has a fast recovery time. More information
The choice of treatment depends on several factors, such as the size of the prostate, the symptoms, the patient’s age and health, and their personal preferences. We will be happy to discuss with you which therapy is right for you.
Innovative lasers in urology
The Department of Urology is one of Switzerland’s pioneers in the use of laser technology. The Greenlight laser and the Thulium fiber laser are among the innovative medical lasers that we use for the gentle treatment of benign prostate enlargement.
Get active! Symptom relief through lifestyle changes
You can also do something to improve BPH yourself. Various lifestyle changes can help to alleviate the symptoms of prostate enlargement. These include avoiding caffeinated drinks and alcohol, limiting fluid consumption before bedtime, regular physical activity and training in bladder emptying techniques. Losing weight if you are overweight can also help to alleviate symptoms.
