Prostate problems? Consider using steam to banish your urinary woes

By DR ALLEN SIM

Water vapour therapy allows for steam to be distributed across the targeted prostate area, reducing the size of the       enlarged prostate and allowing urine to flow easily. — Images: Handout

A healthy prostate is an important aspect of a man’s overall health, as this walnut-sized gland plays an integral role in the reproductive system.

As men age, so does their prostate.

For some men, this can pose a problem as an ageing prostate could affect their quality of life and restrict their time spent outside of their homes with friends and family.

An enlarged prostate could cause various issues such as benign prostatic hyperplasia (BPH), a relatively common condition faced by older men.

BPH can be treated in various ways such as medication, surgery, or minimally invasive procedures such as water vapour therapy.

Water vapour therapy is a treatment option available for patients suffering from BPH conditions, especially those who want to avoid surgery or are worried about the side effects of medications.

Before delving more into what water vapour therapy is, let’s krst understand what is BPH.

A male problem

As its name says, BPH is a non-cancerous condition often faced by men aged 50 and above.

It is a condition where a man’s prostate enlarges, squeezing the urethra which is a narrow tube that runs through the centre of the prostate, making urination uncomfortable or difficult.

Globally, about 30 million men have symptoms related to BPH.

Caused by ageing and prolonged exposure to testosterone, maintaining a healthy lifestyle including regular exercise and a good diet may help with BPH.

According to the 2019 National Health and Morbidity Survey, about 16.3 % of Malaysian men aged 40 and above probably have BPH with moderate to severe symptoms.

This includes urinary retention, frequent urination, a slow flow or dribbling urine, the need to urinate urgently, difficulty in starting to urinate, and blood in the urine.

To understand the severity of the condition, men must consult their physician to determine the kind of treatment required.

This will help in better managing BPH, which may be restricting them from living a normal life.

An early diagnosis is vital, because if left untreated, it can lead to urinary tract infections (UTI), bladder or kidney damage, bladder stones, and in some cases, incontinence.

                                    If you answered yes to all the questions, you probably have an enlarged prostate.

How is BPH treated?

The treatment for BPH depends on the severity of the symptoms and the size of the enlarged prostate.

Treatment options to manage this condition include medication, laser treatment, surgery and minimally invasive procedures, such as microwave thermodilatation, or water vapour therapy.

Medication is considered the primary care treatment and it is commonly prescribed for patients with mild to moderate symptoms.

Examples of medication are alpha-blockers, 5-alpha reductase inhibitors (5-ARIs), and Phosphodiesterase-5 Inhibitors (PDE5).

Alpha-blockers help to relax the muscles of the urinary tract, bladder and prostate to allow urine to flow more freely while 5-ARIs help block the hormone that can cause prostate growth.

Another medication that may be prescribed is PDE5 inhibitors to regulate smooth muscle tone in the prostate.

Meanwhile, patients who do not want to take medications can instead opt for surgical treatments such as the transurethral resection of the prostate (TURP) or minimally invasive procedures such as water vapour therapy.

Without proper treatment, BPH could cause further blockage in the urethra and lead to possible worsening of symptoms.

For some, it may cause UTI, bladder stones, blood in urine and kidney damage due to urine backflow from the bladder to the kidney, which increases pressure on the kidney.

Using water vapour

Water vapour therapy is a minimally invasive procedure that uses water vapour to reduce the size of the prostate; it is safe and effective.

It is a treatment option provided for patients who do not want to do surgery or take BPH medication.

Water vapour therapy can be performed quickly under local or regional anaesthesia during the doctor’s appointment.

During each nine-second treatment, sterile water vapour is released throughout the targeted prostate tissue.

When the steam comes into contact with the prostate tissue, all the stored energy is released into the tissue, causing spontaneous cell death in the prostate transitional zone.

The number of treatments needed will be determined by the doctor based on the size of a patient’s prostate.

What will happen is, over time, the body’s natural healing response will reabsorb the treated tissue or dead tissues, slowly shrinking the prostate.

With the extra tissue being removed, the urethra opens and relieves the symptoms of BPH.

According to the American Urological Association, water vapour therapy significantly reduces the symptoms of BPH such as lower urinary tract symptoms (LUTS) and improves urinary flow rate.

These improvements can be sustained up to five years after treatment.

                                                   An image of an enlarged prostate, often known as benign prostatic hyperplasia (BPH).

The image after water vapour therapy.

Preparing for the procedure

Patients undergoing this procedure are advised to stop taking anticoagulants (blood thinners) or antiplatelet drugs; some patients may also be prescribed antibiotics.

Upon completing the procedure, the patient will be advised to continue taking oral antibiotics prescribed by the doctor.

Patients are advised to consult their doctor on their ability to drive, and also refrain from activities that may irritate the prostate, after the procedure.

If a patient experiences discomfort following the procedure, they can take mild pain medication, as recommended by their doctor.

For some patients, a warm bath or using a hot water bottle can help alleviate pain symptoms.

Avoiding caffeine, chocolate and alcohol temporarily, can also help manage or reduce post-procedural symptoms.

Treatment risks

Every treatment comes with its own risks.

For water vapour therapy, the potential risks may arise several weeks after the procedure including burning or stinging sensation when passing urine.

This is due to the swelling effect after the treatment.

However, these are temporary and resolves after a few days.

Many advantages

Water vapour therapy has many benefits which include lasting symptom relief from BPH without any invasive surgery, minimising its potential complications or side effects of prescription drugs.

While most patients can experience noticeable symptom relief after two weeks, the maximum symptom relief will be seen optimally within one to three months of the procedure.

Patients may likely be able to resume normal activities within a few days after treatment.

It provides significant, sustained improvement of LUTS and quality of life.

Water vapour therapy is effective and can be considered a viable treatment option for men suffering from BPH.

This treatment option is able to give BPH patients the ability to live like a normal man again – no more pit stops during road trips and/or waking up frequently at night.

Credit: TheStar