Understanding Enlarged Prostate and How We Can Help

Benign Prostatic Hyperplasia (BPH)—also known as an enlarged prostate—is a common condition affecting men as they age. While not cancerous, BPH can lead to bothersome urinary symptoms that impact quality of life. Our team is committed to providing up-to-date diagnostics and personalized treatment plans so you can regain comfort and urinary health.

What Is BPH?

BPH occurs when prostate cells multiply, causing the gland to grow. As the prostate enlarges, it can squeeze the urethra and restrict urine flow. Although the exact cause remains unclear, hormonal changes and aging play major roles. BPH affects roughly half of men in their 60s and up to 90% of men over 70.

Common Symptoms

Men with BPH often experience one or more of the following:

  • Frequent urination, especially at night (nocturia)
  • Weak urine stream or hesitancy when starting to urinate
  • Dribbling at the end of urination
  • Urgency—a sudden, strong need to urinate
  • Incomplete bladder emptying (feeling that the bladder isn’t fully drained)
  • Straining to begin or maintain flow

If you notice these symptoms regularly, early evaluation can prevent complications such as urinary tract infections, bladder stones, or kidney damage.

Causes & Risk Factors

  • Age: Prostate enlargement is rare before age 40 but becomes increasingly common after 50.
  • Hormonal changes: Shifts in testosterone and dihydrotestosterone (DHT) levels can stimulate prostate cell growth.
  • Family history: Genetics may predispose certain men to develop BPH.
  • Lifestyle factors: Obesity, lack of exercise, and metabolic syndrome may contribute to severity.

 

Diagnosis

Our approach to diagnosing BPH includes:

  • Medical history & symptom questionnaire (e.g., International Prostate Symptom Score)
  • Physical exam including a digital rectal exam (DRE) to assess prostate size and texture
  • Urinalysis to rule out infection or blood in the urine
  • Post-void residual (PVR) measurement to quantify how much urine remains in the bladder after urinating
  • Blood tests (e.g., prostate-specific antigen or PSA) to screen for prostate conditions
  • Ultrasound or Uroflowmetry if detailed imaging or flow analysis is needed.

 

Early evaluation helps determine whether lifestyle modifications, medications, or procedural interventions are the best path forward.

Treatment Options

1. Lifestyle & Behavioral Changes

  • Fluid management: Limiting caffeine and alcohol, especially in the evening
  • Timed voiding: Establishing scheduled bathroom breaks
  • Pelvic floor exercises: Strengthening muscles to improve bladder control
  • Weight management & exercise: Addressing metabolic risk factors

These steps can ease mild symptoms and often serve as the first line of management.

2. Medications

  • Alpha-blockers (e.g., tamsulosin, alfuzosin)
    • Relax smooth muscle in the prostate and bladder neck
    • Provide fairly rapid relief—often within days to weeks
  • 5-alpha-reductase inhibitors (e.g., finasteride, dutasteride)
    • Shrink prostate tissue over months by blocking DHT production
    • Particularly helpful when prostate volume is significantly enlarged
  • Combination therapy
    • For moderate to severe symptoms, combining both classes can improve outcomes

Our urologists will review side-effect profiles and medical history to tailor medication choices.

3. Minimally Invasive Procedures

  • UroLift System
    • Implants small permanent suture-like devices to retract prostate lobes and open the urethra
    • Preserves sexual function and often performed in-office under local anesthesia
  • Rezūm® Water Vapor Therapy
    • Uses steam to ablate excess prostate tissue, relieving urethral compression
    • Office-based, with minimal downtime and little impact on erectile or ejaculatory function
  • Prostatic Artery Embolization (PAE)
    • Interventional radiology technique that reduces blood flow to prostate, causing it to shrink
    • Often performed under sedation, reducing hospital stay and recovery time

4. Surgical Options

  • Transurethral Resection of the Prostate (TURP)
    • Gold-standard for moderate to severe BPH; removes obstructing tissue through the urethra
    • Typically requires 1–2 days in the hospital with catheter placement for a short period
  • Holmium Laser Enucleation of the Prostate (HoLEP)
    • Uses a laser to enucleate (cut and remove) enlarged prostate tissue
    • Effective for very large prostates; less bleeding and quicker recovery than open surgery
  • Open or Robotic Simple Prostatectomy
    • Reserved for extremely large glands (> 100 g) when endoscopic approaches aren’t ideal
    • Performed under general anesthesia with hospital stay of several days.

Our multidisciplinary team will explain risks, benefits, and expected recovery for each option.

What to Expect: From Evaluation to Recovery

  1. Initial Consultation
    • In-depth review of symptoms, medical history, and lifestyle factors
    • Digital rectal exam (DRE) and symptom scoring
  2. Diagnostic Testing
    • Urinalysis, blood work (PSA), and PVR measurement
    • Imaging (ultrasound) or uroflowmetry if indicated
  3. Customized Treatment Plan
    • Starts with lifestyle amendments and/or medication for mild to moderate cases
    • Reassessment at 4–6 weeks to gauge response
    • If symptoms persist or worsen, discuss minimally invasive or surgical intervention
  4. Procedure Day (if applicable)
    • Most office-based therapies take less than an hour under local or light sedation
    • Surgical cases (TURP, HoLEP) require general or spinal anesthesia and a short hospital stay
  5. Recovery & Follow-Up
    • Office-based procedures: Return to normal activities within 1–3 days
    • TURP/HoLEP: Catheter typically removed within 1–3 days; full recovery by 4–6 weeks
    • Regular follow-up visits (every 3–6 months initially) to monitor symptom improvement and PSA levels

Schedule a Consultation Today

Don’t let urinary symptoms control your life. Take the first step toward better prostate health by scheduling a consultation with our urology team.