Benign prostatic hyperplasia, or BPH, is a very common condition that occurs as men get older. It refers to the enlargement of the prostate gland, which sits just below the bladder and surrounds the urethra. As the prostate grows, it can press against the urethra and interfere with the normal flow of urine.

This enlargement can lead to a variety of lower urinary tract symptoms (LUTS), such as difficulty starting urination, a weak urine stream, or the feeling that the bladder has not completely emptied. Some men also experience the need to urinate more frequently, a sudden and urgent need to go, or waking up several times at night to urinate.

BPH symptoms can have a significant impact on a man’s daily life and overall quality of sleep and health. Fortunately, there are many effective diagnostic tools and treatment options available to manage BPH and provide relief.

Benign Prostatic Hyperplasia (BPH)

MICHAEL FICAZZOLA, MD, FACS

The signs of BPH vary from mild to severe. Common enlarged prostate symptoms include:

  • Urgency – sudden, strong need to urinate

  • Frequency – urinating more often than usual

  • Incomplete emptying – feeling as if the bladder doesn’t fully empty

  • Nocturia – waking up multiple times during the night to urinate

If you are experiencing these urinary symptoms, you are not alone. At Advanced Urology Centers of New York (AUCNY), we have helped thousands of men find lasting relief from BPH and enlarged prostate problems.

  • Blood tests– including Prostate-specific antigen (PSA) and other tests to determine the cause of BPH symptoms
  • UroCuff Test– a noninvasive test that measures bladder pressure and urine flow to help determine whether BPH symptoms are caused by an enlarged prostate or bladder function issues.
  • Digital Rectal Exam (DRE)– checks to see if the prostate is enlarged, whether there is cancer, or if other health issues exist.
  • Transrectal Ultrasound– provides images and measurements of the size and shape of the prostate. It can find abnormal growths in the prostate.
  • Urine Test– used to rule out infection as the reason for existing symptoms
  • 24-hour Voiding Diary– provides the AUCNY caregivers with urine output information, including the amounts and time of day of bathroom trips
  • Postvoid Residual Volume Test– Shows whether you can completely empty your bladder
  • Urinalysis– checks for infections, blood, proteins, and other issues that can give information about your symptoms
  • Urinary Flow Study– Checks the strength and volume of your urine flow
  • Cystoscopy– a procedure that allows your doctor to inspect your urinary tract, including the bladder and urethra
  • MRI’s and CT’s– if surgery is needed, these tests may be ordered to see the prostate and the surrounding areas around it.
  • Prostate Biopsy– a procedure that uses a needle to remove a small sample from the prostate gland to check for prostate cancer. This is done if there is a high PSA blood test result or an abnormal digital rectal exam.

BPH Treatment Options

For men with mild to moderate BPH symptoms, medications are often the first line of treatment. Alpha-blockers such as:

  • Alfuzosin (Uroxatral)
  • Doxazosin (Cardura)
  • Silodosin (Rapaflo)
  • Tamsulosin (Flomax)
  • Terazosin (Hytrin)

These medications work by relaxing the muscles around the prostate and bladder, allowing urine to flow more freely.

If medications are not effective, or if symptoms are more severe, your urologist may recommend a minimally invasive enlarged prostate procedure:

  • Aquablation® Therapy – a robotic, waterjet-based treatment that uses a combination of heat-free water pressure and real-time imaging to precisely remove excess prostate tissue while preserving surrounding structures. Aquablation is designed to provide lasting symptom relief with a lower risk of sexual side effects.
  • Prostatic Artery Embolization (PAE) – a non-surgical procedure performed by an interventional radiologist that works by blocking blood flow to parts of the prostate, causing it to shrink over time. PAE can help relieve urinary symptoms in men who may not be ideal candidates for surgery.
  • UroLift® System – tiny implants reposition prostate tissue to open the urethra. This office-based procedure requires no cutting or heating.
  • Rezum™ Water Vapor Therapy – steam shrinks excess prostate tissue. This in-office treatment typically improves symptoms within 2 weeks.
  • iTind™ –This outpatient procedure gently reshapes the prostate through a folded device implanted in the prostatic urethra. Over the course of 5-7 days, the device unfolds, creating new channels through which urine can flow. The device is then removed.                                                                                                          
  • Greenlight™ Laser Therapy – laser energy vaporizes prostate tissue, usually providing quick relief.
  • Transurethral Microwave Therapy (TUMT) – microwave energy destroys enlarged prostate tissue.
  • Transurethral Needle Ablation (TUNA) – radiofrequency waves shrink prostate tissue to improve urine flow.
  • Transurethral Resection of the Prostate (TURP) – surgical removal of excess tissue using electric current or laser, typically for more severe BPH cases.

For men with severe BPH or when other therapies are unsuccessful:

  • Prostatectomy – This is the surgical removal of part or all of the prostate gland that is blocking the flow of urine. A prostatectomy is typically considered for men with very large prostates or severe urinary problems that significantly affect daily life. The procedure can be performed in different ways, including traditional open surgery or minimally invasive techniques such as laparoscopic or robotic-assisted surgery.

    The goal of a prostatectomy is to relieve obstruction, restore normal urine flow, and prevent complications such as bladder damage, recurrent infections, or kidney problems. While recovery takes longer than with other BPH treatments, many men experience significant and lasting improvement in their symptoms after surgery.

Take the First Step Toward Relief

At Advanced Urology Centers of New York, our board-certified urologists specialize in diagnosing and treating BPH using the latest technology and individualized care. From medications to advanced minimally invasive procedures and surgery, we are committed to finding the best treatment to restore your comfort, health, and quality of life.

Don’t let urinary symptoms disrupt your daily life. If you’re struggling with an enlarged prostate or BPH symptoms, schedule a consultation with the specialists at AUCNY today—your trusted choice for enlarged prostate care in the New York Metropolitan area.

Take the First Step Toward Relief

At Advanced Urology Centers of New York, our board-certified urologists specialize in diagnosing and treating BPH using the latest technology and individualized care. From medications to advanced minimally invasive procedures and surgery, we are committed to finding the best treatment to restore your comfort, health, and quality of life.

Don’t let urinary symptoms disrupt your daily life. If you’re struggling with an enlarged prostate or BPH symptoms, schedule a consultation with the specialists at AUCNY today—your trusted choice for enlarged prostate care in the New York Metropolitan area.