Improving urinary comfort without major surgery
Introduction
Urinary problems can severely impair quality of life — nighttime awakenings, frequent urges, discomfort when moving around… When symptoms do not warrant major surgery or the patient wishes to delay an intervention, there are effective conservative solutions to improve urinary comfort , limit risks and preserve bladder function.
It is not a question of letting evolution take its course, but of acting intelligently with appropriate means, often progressive and less invasive.
The approach must be personalized, progressive and reassessed regularly.
Why aim for non-aggressive solutions?
- To delay or avoid major interventions, if symptoms are moderate
- To minimize risks and convalescence, especially in more fragile patients
- To optimize your daily urinary comfort, with control over side effects
- To test the effectiveness of conservative options before considering surgery
Difficulty urinating: consider prostate adenoma
Non-surgical solutions are not suitable for all cases (e.g., severe obstruction with renal impact), but are often a good compromise in many situations.
When to consider conservative treatments?
These strategies are generally indicated when:
- Urinary symptoms are moderate to moderately severe, but not disabling
- The patient wishes to avoid immediate intervention
- There is comorbidity or high surgical risk
- Prostatic volume is not excessive or anatomy does not contraindicate alternatives
- No serious complications (acute retention, renal failure, recurrent infection) are present
On the other hand, surgery will be preferred in the event of significant obstruction, complications or failure of conservative treatments.
Tools to improve urinary comfort without major surgery
1️⃣ Hygiene of life and adaptation of habits
- Drink gradually throughout the day, avoid large amounts in the evening
- Reduce stimulant or diuretic drinks (coffee, tea, alcohol)
- Avoid prolonged retention; urinate as soon as you feel the urge
- Limit exposure to intense cold and urination stress
- Limit exposure to intense cold and urination stress
- Promote physical activity, fight obesity and metabolic factors
- Adapt the intake of certain medications (diuretics, decongestants, etc.) in consultation
These simple measures can have a significant effect in addition to treatments.
2️⃣ Appropriate drug treatments
Medications can effectively relieve urinary symptoms depending on their nature:
- Alpha-blockers: relax muscle fibers around the prostate and bladder neck, improving flow
- 5α-reductase inhibitors: to gradually reduce prostate volume if it is moderately enlarged
- Anticholinergics or muscarinic modulators: useful for irritative symptoms (urgency, frequency)
- Combination drugs: in certain situations, a combination may be considered
- Complementary therapies: some herbal therapies, but with moderate effectiveness and to be discussed with the urologist
The choice of treatment depends on the intensity of the symptoms, the prostate, and the patient’s profile.
3️⃣ Minimal or minimally invasive procedures
When medication is not enough but one wishes to avoid major surgery, intermediate techniques can be proposed:
- Laser vaporization/photovaporization: reduction of prostate volume by “evaporation”
- Water vapor therapies (REZUM, etc.): less invasive method to “reduce” the adenoma
- Micro thermal ablation, microwaves, radiofrequency, etc.
- Prostatic stents (in selected special cases)
- Focal cryotherapy or HIFU (in certain well-chosen contexts), as localized treatments
Advantages, limitations and selection criteria
Benefits
- Fewer immediate operative risks
- Better tolerance in the postoperative phase
- Faster return to daily activities
- Possibility of retrying interventions if necessary
- Good compromise in suitable cases
Boundaries
- Effect sometimes less spectacular or slower than surgery
- Risk of failure if the obstruction is too severe
- Need for close monitoring
- Some treatments are not suitable depending on the anatomy or morphology of the prostate
- Possible side effects (transient bladder irritation, temporary discomfort when urinating)
The choice depends on the balance between the discomfort felt, the risks, and the patient’s adherence to follow-up.
Why choose a specialized urologist?
- To accurately assess the nature and severity of urinary disorders
- To determine if you are eligible for non-aggressive treatments
- To select the gentle technique best suited to your anatomy
- To anticipate results, risks and limitations
- To guide you towards a personalized and shared approach, taking into account your priorities
Dr. Olivier Dumonceau offers a progressive and flexible treatment plan, respectful of your choices and your physiology.
Urinary disorders in men
Do you suspect a prostate adenoma?
Requirements
Expertise
- Prostate surveillance after age 50
- Prostate cancer screening
- REZUM (steam thermotherapy)
- UroLift (trans-urethral implants)
- Holmium laser / ThuLEP
- Robotic-assisted radical prostatectomy
Patient pathway
Let me introduce you to the classic patient journey, my approach to urology and the way I work.
Do you want to improve your urinary comfort without resorting to major surgery?
Discover innovative, effective treatments tailored to your situation.
Urology Practice Paris Opéra – Paris 17th
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