There are various medicines for BPH starting from Ayurvedic, Homeopathic and Allopathic, now various users all over the world. Generally the symptomatic patients are initially started with medical management. They are generally two categories. They are called as alpha blockers and 5 alpha reductase inhibitors or ination of these two there can be given wither in single or in ination based on the size of the prostate or based on the severity of the symptoms and depending upon the age of the patients. Some older age group does not tolerate these medications because of its postural hypotension side effects. So generally they do not prefer these medications after 75 to 80 years. Coming to the surgical options, if the medication is not working in a patient, and if they are refractory to management, then the surgical treatment comes into picture There are various surgical modalities starting form open surgery, laparoscopic surgery to endoscopic surgery. Commonly 95% of the surgeries done for the prostate are endoscopic procedures. Among the endoscopic procedures, we have got a monopolar TURP, we have got a bipolar TURP procedures and lasers. Among these lasers there are various lasers like KTP laser, Thulium laser, Holmium laser. So depending on the size of the prostate, depending on the risk of the patient, we classify them and we offer them a choice of approach which patient requires what type of treatment, for example, if the young guy is 65 year old who has a 35 gram prostate, without no comorbidity, without any blood thinners, he can be a fit candidate for bipolar TURP. At the same time, if the patient is about 85 year to 90 year old main with a large prostate, 120 to 130 gram prostate, and if the patient is having a high risk of cardiac risk factors, and he will be taking blood thinners, then he will be preferably be operated on a laser procedure, especially the Holmium Laser Enucleation of the prostate where it can clear the prostate at one shot and which also helps the prevention of recurrence, especially in those cases where the larger prostate. At the other hand, if thee prostate is very small and the patient is under high risk where the patient cannot undergo anaesthesia, then in such cases can be treated under local anaesthesia using a vaporising lasers called as KTP lasers can be used to treat them. So there are various treatment options, it is suitable to the patient, depending upon the patient safety, we can chose the treatment and we offer them.
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