Condition
Prostate Enlargement (BPH)
Benign prostatic hyperplasia is a common, non-cancerous growth of the prostate that can cause urinary symptoms.
Common symptoms
- Weak urinary stream
- Difficulty starting urination
- Urgency or frequency
- Incomplete emptying
Benign prostatic hyperplasia — BPH for short — is a non-cancerous enlargement of the prostate that affects most men as they age. It can cause weak urinary stream, getting up at night, urgency, and incomplete emptying. It is bothersome, but it is highly treatable.
How we diagnose
A focused history (using a symptom score), exam, urinalysis, and PSA test are usually all that is needed. For more bothersome symptoms or before procedures, we may add a urinary flow study, post-void residual measurement, and a bladder/prostate ultrasound.
A graduated treatment approach
- Watchful waiting — for mild symptoms that are not bothersome
- Lifestyle changes — fluid timing, alcohol, caffeine
- Medications — alpha blockers, 5-alpha reductase inhibitors, or both
- Minimally invasive procedures — UroLift, Rezum, prostate artery embolization
- Surgical options — TURP or robotic simple prostatectomy for very large prostates
Choosing the right treatment
The right treatment depends on prostate size, symptom severity, your priorities (especially around sexual function), and whether you have already tried medication. We map out the trade-offs of each option so the choice fits your life.