One of the most common reasons men visit a urologist is for lower urinary tract symptoms (LUTS). These symptoms can include:
- Difficulty starting or maintaining a urine stream
- Waking up multiple times at night to urinate
- Sudden urgency to urinate
- Frequent urination
- A constant feeling that the bladder is never fully emptied
Understandably, many patients initially worry that these symptoms could indicate prostate cancer. Our brains tend to jump to the worst-case scenario. However, the good news is that most cases of prostate cancer do not present with urinary symptoms in their early stages. In reality, the vast majority of men experiencing LUTS are dealing with benign prostatic hyperplasia (BPH) – a completely normal part of aging.
BPH is Ubiquitous:
- 50% of men over 50 experience symptoms.
- By age 80, that number jumps to 90%.
- It is a normal part of aging.
It’s Not Cancer—So Why Should You Treat It?
After receiving a negative prostate cancer diagnosis, many men feel such a sense of relief that they delay addressing their BPH symptoms. While that relief is understandable, ignoring BPH can lead to significant lifestyle compromises. Left untreated, symptoms will worsen over time, often leading men to unconsciously modify their daily habits—whether it’s avoiding long trips, planning their days around restroom availability, or waking up multiple times at night. In very rare cases and when left untreated, BPH can lead to an emergency known as urinary retention, where the blockage prevents any urine from draining.
Treat BPH Early and Aggressively for the Best Outcomes
Many patients first visit their primary care physician for BPH and are prescribed Flomax (Tamsulosin), a common medication that relieves urinary symptoms. While Flomax can be effective, it does not treat the root cause—the gradual enlargement of the prostate that squeezes the urethra. Additionally, Flomax can have side effects, including dizziness, fatigue, and even sexual dysfunction, making it an undesirable long-term solution for many men.
The good news? Minimally invasive, highly effective BPH treatments are available, regardless of prostate size or symptom severity.
BPH Treatment Options: Minimally Invasive to Surgical Solutions
Rezūm Therapy
A 5-Minute, In-Office Procedure for Mild to Moderate BPH – a steam-based treatment that eliminates excess prostate tissue using targeted steam injections.
- Procedure Time: 5 minutes
- Best For: Men with straightforward prostate anatomy and mild enlargement
- Benefits: Non-surgical, effective, and minimal downtime
Surgery Center Procedures for Moderate to Severe BPH
GreenLight Laser Therapy
This procedure vaporizes excess prostate tissue using a high-energy laser (yes, a green one!) deployed via the urethra in a minimally invasive, non-surgical manner.
- Procedure time: ~ 1 hour
- Best for: moderate to severe BPH and patients with bleeding disorders.
- Key Consideration: Effective but carries significant risk of retrograde ejaculation
Transurethral Resection of the Prostate (TURP)
TURP is a surgical procedure that involves inserting a resectoscope through the urethra to remove excess prostate tissue, relieving urinary obstruction. TURP is the standard treatment for moderate to severe BPH symptoms, offering significant symptom relief and improved urine flow. While effective, it carries risks such as bleeding, urinary incontinence, and retrograde ejaculation. Recovery typically requires a short hospital stay with catheterization. Though newer techniques are emerging, TURP remains widely performed due to its proven effectiveness in treating BPH.
Hospital-Based Procedures for Large Prostates
Robotic Simple Prostatectomy: The “Orange Peel” Approach
For men with very large prostates, robotic prostatectomy may be an option. This technique removes the central “pulp” of the prostate while preserving the outer capsule—like peeling an orange and keeping the skin intact. This procedure is often best for men with significantly enlarged prostates who need long-lasting relief and are comfortable with having a surgical procedure.
HoLEP
Holmium Laser Enucleation of the Prostate (HoLEP) is a minimally invasive surgical procedure that uses a holmium laser to precisely remove excess prostate tissue, relieving urinary obstruction while preserving the surrounding structures. It is highly effective for men with large prostates, offering long-term relief with minimal bleeding and a lower risk of recurrence. The procedure also allows for rapid recovery, shorter hospital stays, and a lower likelihood of needing retreatment. HoLEP is a gold-standard treatment, particularly for patients with significant urinary symptoms.
Why Wait? Improve Your Quality of Life Today
BPH symptoms only worsen over time. Fortunately, modern BPH treatments’ simplicity and low-risk nature mean there’s no reason to suffer unnecessarily. If you’ve recently had a negative prostate cancer diagnosis but were told you have an enlarged prostate, now is the perfect time to act. The best part is that if needed, BPH procedures can be repeated years later. You can continue enjoying an active lifestyle if you need another treatment in five, seven, or even ten years.
