From the Guidelines
Prostatic hydrotherapy is not considered an effective evidence-based treatment for benign prostatic hyperplasia (BPH). Current standard medical treatments for BPH include alpha-blockers (such as tamsulosin, alfuzosin, or silodosin), 5-alpha reductase inhibitors (finasteride or dutasteride), and in some cases, phosphodiesterase-5 inhibitors like tadalafil. These medications work by either relaxing the prostate and bladder neck muscles to improve urine flow, reducing prostate size by blocking hormones that promote prostate growth, or improving lower urinary tract symptoms through other mechanisms.
Key Points to Consider
- Prostatic hydrotherapy, which typically involves directing water at the prostate area, lacks robust clinical evidence supporting its effectiveness for BPH management.
- The proposed mechanism that water pressure might somehow reduce prostate inflammation or size is not supported by scientific research.
- Patients with BPH should consult healthcare providers for evidence-based treatments rather than pursuing hydrotherapy, which could potentially delay effective treatment and allow the condition to worsen over time.
Available Treatment Options
- Alpha-blockers: tamsulosin, alfuzosin, or silodosin
- 5-alpha reductase inhibitors: finasteride or dutasteride
- Phosphodiesterase-5 inhibitors: tadalafil
Recent Guidelines and Recommendations
According to the most recent guidelines, such as those from the American Urological Association (AUA) 1, water vapor thermal therapy may be offered to patients with LUTS/BPH provided prostate volume <80g. However, patients should be informed that evidence of efficacy, including longer-term retreatment rates, remains limited.
Conclusion Not Applicable
Instead, the focus is on the most recent and highest quality evidence available, which does not support prostatic hydrotherapy as an effective treatment for BPH. Therefore, patients with BPH should prioritize evidence-based treatments over unproven methods like hydrotherapy to ensure the best possible outcomes in terms of morbidity, mortality, and quality of life.
From the Research
Prostatic Hydrotherapy for Benign Prostatic Hyperplasia (BPH)
There is limited information available on prostatic hydrotherapy as a treatment for BPH. However, we can discuss the available treatments for BPH and their effectiveness.
Available Treatments for BPH
- Medical therapy: includes alpha-blockers, 5-alpha reductase inhibitors, and combination therapy 2, 3, 4
- Minimally invasive procedures: such as transurethral microwave thermotherapy, interstitial ablation using radiofrequency or laser, and transurethral needle ablation 2, 3, 5, 6
- Surgical procedures: such as transurethral resection of the prostate (TURP) and open prostatectomy 2, 3, 5
Effectiveness of Available Treatments
- Medical therapy: can improve symptoms and reduce prostate volume, but may have side effects and may not be effective for all patients 2, 3, 4
- Minimally invasive procedures: can improve symptoms and reduce prostate volume, but may have a higher risk of retreatment and may not be as effective as TURP 3, 5, 6
- Surgical procedures: can provide significant improvement in symptoms and urinary flow, but may have a higher risk of complications and side effects 2, 3, 5
Conclusion on Prostatic Hydrotherapy
There is no direct evidence available on the effectiveness of prostatic hydrotherapy for BPH. However, the available treatments for BPH have shown varying degrees of effectiveness, and the choice of treatment depends on the individual patient's symptoms, prostate size, and medical history. Further research is needed to determine the effectiveness of prostatic hydrotherapy as a treatment for BPH.