An enlarged prostate, medically known as benign prostatic hyperplasia (BPH), is one of the most common conditions affecting men as they age. While BPH is not cancer, it can cause frustrating urinary symptoms such as weak flow, frequent nighttime urination, or difficulty starting and stopping urination. If left untreated, it may lead to bladder damage or urinary retention.
At Advanced Urology, we specialize in providing modern, minimally invasive, and surgical treatments for BPH. The right solution depends largely on the size of your prostate gland, your overall health, and your personal goals for recovery and long-term results.
Treatments for Small Prostates (<40cc)
1. UroLift®
How it works:
The UroLift system places small implants to gently hold back prostate tissue that is blocking the urethra. Unlike traditional surgery, no cutting or heating is required.
Benefits:
Quick recovery, often returning to normal activity within days.
Preserves sexual function.
No tissue is removed, reducing complications.
Risks:
Temporary urinary discomfort.
Rare bleeding or infection.
Some patients may require additional treatment in the future.
Setting & Recovery:
Performed in our outpatient Advanced Urology Ambulatory Surgery Center, most men do not need a catheter. If used, it is typically removed the same day or the next morning.
Ideal for: Men looking for a rapid, minimally invasive BPH treatment with little downtime.
2. Prostate Artery Embolization (PAE)
How it works:
Performed by our interventional radiologists, PAE involves inserting tiny particles into the arteries supplying the prostate to reduce blood flow. Over weeks to months, the prostate shrinks and symptoms improve.
Benefits:
Non-surgical, done through a small puncture in the wrist or groin.
Effective for small to large prostate sizes.
Very low risk of sexual side effects.
Highly effective for men with catheter-dependent urinary retention.
Risks:
Mild bruising or discomfort at the puncture site.
Rare chance of urinary retention or non-target embolization.
Setting & Recovery:
Done in our Advanced Urology Interventional Radiology Lab, usually without the need for a catheter.
Ideal for: Men seeking a non-invasive treatment for BPH without anesthesia or a hospital stay.
Treatments for Medium Prostates (40-80cc)
1. Aquablation®
How it works:
Aquablation uses a robotic, high-velocity water jet under ultrasound guidance to precisely remove prostate tissue.
Benefits:
Highly accurate, uniform tissue removal.
Preserves urinary and sexual function better than older techniques.
Shorter operating time compared to TURP.
Risks:
Temporary bleeding or urinary retention.
Rare risk of stricture or sexual side effects.
Setting & Recovery:
Requires an overnight hospital stay for bladder irrigation. The catheter is usually in place for 2-5 days.
Ideal for: Men who want effective symptom relief with less impact on sexual function.
2. Transurethral Resection of the Prostate (TURP)
How it works:
One of the oldest and most common BPH surgeries, TURP removes prostate tissue using a heated loop inserted through the urethra.
Benefits:
Proven, long-lasting results.
Widely available and well-studied.
Risks:
Temporary bleeding and discomfort.
Risk of erectile dysfunction, urinary incontinence, or retrograde ejaculation.
Setting & Recovery:
Performed in our ambulatory surgery center. A Foley catheter typically remains 1-3 days.
Ideal for: Men seeking a traditional, well-established BPH surgery.
3. UroLift®
As noted earlier, UroLift® can also be an excellent choice for men with medium-sized prostates (up to 80cc). It offers quick recovery, preserves sexual function, and provides a minimally invasive alternative to surgery.
Ideal for: Men with small to medium prostates who want a rapid, non-surgical option and minimal downtime.
Treatments for Large Prostates (>80cc)
1. Holmium Laser Enucleation of the Prostate (HoLEP)
How it works:
A laser removes large amounts of prostate tissue, which is then flushed out through the urethra.
Benefits:
Highly effective for very large prostates.
Minimal bleeding.
Durable, long-term symptom relief.
Risks:
Temporary urinary retention or bleeding.
Retrograde ejaculation is possible.
Setting & Recovery:
Done in the hospital with a 1-night stay. A catheter is needed for 1-3 days.
Ideal for: Men with very large prostates who want a definitive, minimally invasive solution.
2. Prostate Artery Embolization (PAE)
As noted earlier, PAE is also an excellent choice for large prostates. It avoids surgery and anesthesia while effectively reducing gland size over time.
Ideal for: Men with large prostates who prefer a non-surgical option.
3. Robotic Simple Prostatectomy
How it works:
Using robotic-assisted precision, surgeons remove the inner portion of the prostate causing blockage.
Benefits:
Best suited for very large glands.
Provides long-term symptom relief.
Robotic technology enhances accuracy and reduces complications.
Risks:
Surgical risks include bleeding or infection.
Temporary incontinence or retrograde ejaculation is possible.
Setting & Recovery:
Performed in the hospital. The catheter typically stays in for 7 days.
Ideal for: Men with extremely enlarged prostates who need a definitive surgical solution.
Choosing the Right BPH Treatment
When deciding on the best treatment for an enlarged prostate, several factors matter:
Prostate size: Determines whether you're better suited for UroLift, Aquablation, HoLEP, or another procedure.
Your lifestyle: Some men prefer fast recovery and minimal downtime, while others want the most durable, long-term solution.
Other health conditions: Certain treatments may be safer if you have heart disease, are on blood thinners, or wish to avoid anesthesia.
Symptom severity: The degree of your urinary symptoms will guide whether a minimally invasive or surgical approach is best.
At Advanced Urology, our urologists and interventional radiologists will evaluate your prostate size, review your medical history, and walk you through the risks and benefits of each option. We are one of the few practices in Georgia offering the full spectrum of BPH treatments, from UroLift to robotic surgery, ensuring care is truly tailored to your needs.
Take the Next Step Toward Relief
Living with the symptoms of an enlarged prostate does not have to be your "new normal." Modern medicine offers safe, effective, and customizable treatments that restore comfort and quality of life.
If you're struggling with urinary symptoms from BPH, schedule a consultation with Advanced Urology today. Our team will provide a thorough evaluation and help you choose the best treatment option for your specific situation.
