Villa Stuart Private Clinic

Benign Prostatic Hyperplasia (BPH) and Treatment

Benign prostatic hyperplasia (BPH) is a non-cancerous enlargement of the prostate caused by aging, hormonal changes, and genetic factors.

SYMPTOMS
  • Sensation of incomplete emptying.
  • Increased urinary frequency during the day (pollakiuria) and at night (nocturia)
  • Difficulty initiating urination (urinary hesitancy)
  • Weak or intermittent urinary flow
  • Urinary urgency
  • Post-void dribbling
  • Burning sensation during and after urination
  • Sexual problems: erectile difficulties, painful ejaculation or reduced ejaculate volume
  • Specialist consultation and medical history
  • Digital rectal examination (DRE)
  • Post-void residual assessment
  • Transrectal prostate ultrasound
  • PSA (Prostate-Specific Antigen) test
  • Uroflowmetry
  • Cystoscopy
  • Suprapubic ultrasound
  • Multiparametric magnetic resonance imaging (mpMRI)

The treatment of benign prostatic hyperplasia (BPH) can be pharmacological or surgical. Surgery includes minimally invasive procedures, such as TURP (transurethral resection of the prostate), and laser techniques (HOLEP/TULEP, GreenLaser, …). Other options include water vapor ablation (Rezum) or open surgery for specific cases.

  • Open Prostatic Adenomectomy
  • Type of procedure: removal of enlarged prostatic adenoma
  • Technique: open technique with abdominal incision
  • Surgical approach: access through the bladder (transvesical adenomectomy) or direct access to the prostatic capsule (retropubic adenomectomy)
  • Anesthesia: general anesthesia
  • Indication: for greatly enlarged prostate
  • TURP (transurethral resection of the prostate)
  • Type of procedure: removal of the inner part of the prostate gland by shredding the excess tissue with a resectoscope, then transporting it to the bladder via an irrigation fluid until removal
  • Technique: endoscopic technique with resectoscope
  • Surgical access: transurethral without skin incisions
  • Anesthesia: general or spinal anesthesia
  • Indication: for benign prostatic hyperplasia with moderate or severe urinary problems
  • HoLEP Treatment (Holmium Laser Enucleation of the Prostate)
  • Type of procedure: removal of the enlarged prostatic adenoma using a laser to shred and remove the excess tissue
  • Technique: endoscopic technique with laser
  • Surgical access: transurethral without skin incisions
  • Anesthesia: general or spinal anesthesia
  • Indication: for very enlarged prostate volume to avoid open surgery technique
  • GREEN LASER Treatment
  • Type of procedure: photoselective vaporization of the prostate with green light laser (PVP). The green laser releases energy towards the targeted area and cuts the tissue to be treated with great precision. It interacts very specifically with the hemoglobin contained in the tissue, efficiently vaporizing the highly vascularized enlarged prostate tissues, while simultaneously coagulating and quickly sealing the blood vessels.
  • Technique: endoscopic technique with green laser
  • Surgical access: transurethral without skin incisions
  • Anesthesia: local anesthesia
  • Indication: for benign prostatic hyperplasia for prostates of various sizes
  • ITIND Treatment
  • Type of intervention: outpatient procedure or day hospital for implantation of a temporary nitinol device in the prostate. The implanted iTind expands and applies gentle pressure that reshapes the prostate tissue and creates a wider channel through which urine flows. The device is removed after 5-7 days and there is no need for catheterization.
  • Technique: endoscopic technique with cystoscope
  • Surgical access: transurethral without skin incisions
  • Anesthesia: local anesthesia or light sedation
  • Indication: for benign prostatic hyperplasia in moderately sized prostates
  • REZUM Treatment
  • Type of procedure: outpatient or day hospital procedure (duration 10-15 min) involving the use of a very thin needle to inject steam into the enlarged prostate adenoma, selectively destroying excess tissue to reduce prostate volume
  • Technique: endoscopic technique with cystoscope
  • Surgical access: transurethral without skin incisions
  • Anesthesia: local anesthesia or light sedation
  • Indication: for benign prostatic hyperplasia in case of desire to discontinue drug therapy
  • UROLIFT Treatment
  • Type of procedure: placement of clip-shaped implants (small prostheses) to lift and separate the prostate tissue from the urethra to open the channel and relieve urinary symptoms. It does not involve resection or removal of prostate tissue.
  • Technique: endoscopic technique with prostheses
  • Surgical access: transurethral without skin incisions
  • Anesthesia: local anesthesia, spinal anesthesia, or light sedation
  • Indication: for benign prostatic hyperplasia for small to medium-sized prostates
  • TPLA Treatment (Transperineal Ultrasound-Guided Laser Ablation)
  • Type of procedure: insertion of very thin needles into the perineum, under ultrasound guidance, to reach the prostate where, through the optical fibers inserted into the needles, low-power laser light is delivered, causing coagulative necrosis of the enlarged prostate tissue, damaging and destroying it. Subsequently, the body will absorb the tissue, leading to a reduction in prostate volume.
  • Technique: small punctures in the perineum through which laser fibers are inserted
  • Surgical access: percutaneous with ultrasound guidance
  • Anesthesia: local anesthesia
  • Indication: for benign prostatic hyperplasia for medium-sized prostate (with significant urinary symptoms and/or on anticoagulant therapy and/or not eligible for other techniques)
  • AQUABLATION Treatment
  • Type of procedure: use of a high-pressure, heat-free water jet controlled by a robot to remove excess prostate tissue. The robotic system and the cystoscope with camera, together with the transrectal ultrasound, allow the surgeon to view the entire prostate in real time, ensuring a more precise and personalized treatment.
  • Technique: minimally invasive ultrasound-guided robotic technique
  • Surgical access: transurethral without skin incisions for cystoscope and robot, transrectal for ultrasound
  • Anesthesia: general or spinal anesthesia
  • Indication: for benign prostatic hyperplasia for prostates of all sizes and shapes
  • Prostatic Artery Embolization (PAE) Treatment
  • Type of procedure: radiological procedure that involves permanently and irreversibly occluding the arteries supplying the prostate by injecting micro-particles. By cutting off the nourishment to the prostate tissues, a reduction in gland volume is achieved.
  • Technique: interventional radiology
  • Surgical access: femoral or brachial arterial catheter
  • Anesthesia: local anesthesia at the arterial access point
  • Indication: for benign prostatic hyperplasia for prostates of various sizes, including very large ones

The Villa Stuart Clinic is affiliated with major insurance companies and supplementary health care funds.

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Monday / Friday 8:00 AM – 8:00 PM / Saturday 8:00 AM – 7:30 PM

06 35528500

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Service available 24 hours a day

800.118.166

Andrology and Andrological Surgery

Dr. Cindolo's Team

Dr. Luca Cindolo

Surgeon

Specialist in Urology - Andrology

Dr. Roberto Castellucci

Surgeon

Specialist in Urology

Dr. Marco Domenico Salvaggio

Surgeon

Specialist in Urology - Andrology

Surgical team

Dr. Matteo Vittori

Surgeon

Specialist in Urology and Andrology

Dr. Antonio Nazzaro

Surgeon

Specialist in Urology - Andrology

Nursing home service

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