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Enlarged Prostate

Benign prostatic hyperplasia (BPH), commonly referred to as enlarged prostate, is when the prostate gland becomes very large and may cause problems passing urine. BPH is not cancer, and is a common part of aging.

What causes BPH?

What are the symptoms of BPH?

As the prostate grows, it presses against the urethra, the tube that carries urine out of the body. This interferes with urination. At the same time, the bladder wall becomes thicker and irritated, and begins to contract, even when it contains only small amounts of urine. This can cause more frequent urination. These changes cause the bladder muscle to weaken. It may not empty fully and can leave some urine behind. This leads to symptoms.

The following are the most common symptoms of BPH:

  • Leaking or dribbling of urine
  • Trouble starting urine stream
  • More frequent urination, especially at night
  • Urgency to urinate
  • Holding urine (can't pass urine)
  • An interrupted, weak stream of urine

These problems may lead to one or more of the following if BPH is not treated:

  • Loss of urine control
  • Blood in the urine
  • Urinary tract infections
  • Bladder stones
  • Inability to pass urine at all
  • Kidney damage
  • Bladder damage

The symptoms of BPH may look like other conditions or health problems. Always talk with a healthcare provider for a diagnosis.

How is BPH diagnosed?

How is BPH treated?

With time, BPH symptoms often need some kind of treatment. When the prostate is just mildly enlarged, treatment may not be needed. In fact, research has shown that, in some mild cases, some of the symptoms of BPH get better without treatment.

The need to start treatment will be decided by you and your healthcare provider after careful evaluation of your symptoms. Regular check-ups are important, and they’re needed to watch for developing problems.

Treatment for BPH may include:


To remove only the enlarged tissue that is pressing against the urethra (the tube that carries urine out of the body), with the rest of the inside prostate left intact. Types of surgery often include:

  • Transurethral resection of the prostate (TURP). A thin, narrow tube (resectoscope) is put into the urethra through the penis. The surgeon uses tools through the resectoscope to remove the prostate tissue blocking the urethra one piece at a time. The pieces of tissue are carried into the bladder. They are flushed out at the end of the surgery.

    This surgery option may be recommended if symptoms are severe or have not responded to other, less invasive treatments. You may be put to sleep with general anesthesia, or local anesthesia may be used.
  • Holmium Laser Enucleation of the Prostate (HoLEP). This is a minimally invasive procedure using laser tools to cut away the prostate tissue blocking the urethra. The laser fiber is passed through the urethra to the prostate. This procedure is similar to open prostate surgery, but it doesn’t require incisions. Therefore, recovery is often faster, and symptom relief occurs sooner.

    Typically, general anesthesia is administered to put you to sleep during the procedure.

Nonsurgical treatments

These may include:

  • Medicines. These are used to shrink or at least stop the growth of the prostate without using surgery. Or to make the muscles around the urethra looser so urine flows more easily.
  • For men who experience unwanted side effects to medication or do not see a major improvement in symptoms and do not want to have surgery, other non-surgical treatment options may be appropriate:
    • iTind (Temporarily Implanted Nitinol Device). The iTind procedure reshapes the anatomy of the prostatic urethra, by insert a temporary implant to gently create a wider opening for urine to flow freely, without burning or cutting out tissue. Light sedation and a local anesthetic will be used. Watch how it works.
    • Urolift. Small stitches are placed into the sides of the prostate through a camera and device inserted into the urethra, pulling the blocking prostate tissue open. Local or general anesthesia may be used. Watch how it works.

Making Lifestyle Changes Can Also Help

Not all treatments are a good fit for every patient. If you’ve been diagnosed with BPH, our highly experienced, trained specialists would be happy to discuss the benefits and any risks of each option so you can make the decision that is right for you.

Call Atlantic General Urology at 410-629-6277 to make an appointment.