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BPH TREATMENT:LESS INVASIVE PROCEDURES. BALLOON DILATION
For more than a century, doctors have tried to find mechanical means—using catheters, for example—of opening up the urethra constricted by BPH. In this technique, originally designed for expanding clogged arteries, a balloon is passed into the narrowest part of the urethra and then inflated to stretch the opening, and thus improve urine flow. This procedure has a lot of advantages: It’s safe and simple, can be done on an outpatient basis using a local anesthetic, and so far has shown no signs of causing impotence or retrograde ejaculation. Even the most high-risk patients, those in precarious health, are eligible and can get immediate relief of symptoms.
But does it work, and for how long? The answer is, symptoms may improve at first, but the results don’t last. One study found a 50 percent improvement in urinary flow at one month; however, this improvement disappeared after one year. Current studies suggest that balloon dilation is not a long-term cure, that the urethra does not stay open for years, as it does with prostatectomy. (As one urology textbook puts it, “It would appear that the objective, long-term results will be measured in months, rather than years.”) Much more research is needed. Also, not everyone is a good candidate for this procedure; for example, it’s not recommended in men with a decompensated bladder, middle lobe enlargement, or an active urinary tract infection. Finally, the procedure does not yield any tissue samples for a pathologist to inspect for prostate cancer, so a digital rectal examination and PSA blood test are as important now as ever.
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