How to decide between surgery and medication for benign prostatic hyperplasia (BPH)?
If a man opts for treatment, there are a number of choices. Most experts recommend a staged approach as follows: • Medications are the best choice for patients with mild symptoms who decide to have their condition treated. Such men have the same risks for surgical complications as patients with more severe symptoms, but they usually experience only a slight benefit. The major drug groups are alpha-blockers (which are usually the better choice) and anti-androgens (nearly always finasteride). • Men with moderate to severe symptoms still have good choices among drugs and surgeries. If a man chooses surgery, there are many choices. Transurethral resection of the prostate (TURP) is the standard procedure, but less invasive procedures, particularly those using heat to destroy prostate tissue, are gaining prominence. Drugs versus Surgery. Recent developments in drug therapy have reduced the number of surgical procedures needed and delayed their use. In men with severe symptoms, however, surge
