Benign Prostatic Hyperplasia

Benign prostatic hyperplasia (BPH) is a condition in which the prostate gland becomes enlarged. Though non-cancerous, this condition can cause significant lower urinary tract symptoms and discomfort.

As a man gets older, the prostate goes through two growth phases — the first phase occurs in early puberty when the prostate doubles in size and the second phase begins in early adulthood and continues through much of a man’s life. As the prostate enlarges, it presses against the urethra causing the bladder wall to thicken.

Over time, the bladder may weaken, and you may lose the ability to empty it completely. The narrowing of the urethra and the inability to empty the bladder causes many of the problems associated with benign prostatic hyperplasia.

Our Approach to Treating BPH

Benign prostatic hyperplasia is the most common prostate problem for men over 50, and for the vast majority of men, not serious. However, if the symptoms associated with BPH are affecting your quality of life, the BPH specialists at NewYork-Presbyterian will work with you to create a treatment plan that is right for you.

With multiple outpatient facilities located throughout New York City and the surrounding counties, our patients can receive the same caliber of care close to home or work. We have two urologic centers — the Center for Prostate Health and Male Voiding Dysfunction at NewYork-Presbyterian/Columbia University Medical Center and the Iris Cantor Men’s Health Center/ Brady Prostate Center at NewYork-Presbyterian/Weill Cornell Medical Center — dedicated to treating men with urinary dysfunction disorders, including benign prostatic hyperplasia. Our clinicians follow the American Urological Association symptom index to help guide your treatment plan in synergy with their clinical evaluation of your condition.

Diagnosing BPH

Many urinary conditions have symptoms typically associated with benign prostatic hyperplasia. That’s why it is essential to seek medical care from a highly trained urologist. The urologists at NewYork-Presbyterian perform non- or minimally-invasive diagnostic procedures to determine your exact condition.

  • Non-invasive urine testing. Whenever possible, we perform urine tests to help determine if a prostate is enlarged. Urine tests also help rule out an infection or other conditions that have similar symptoms.
  • Urodynamic testing. Using sophisticated instruments, we can measure the pressure in the bladder and flow of urine past the urethra. It also assesses the bladder capacity and strength, and over all function of the bladder muscle.
  • Cystoscopy. Using a small flexible telescope called a cystoscope, we can evaluate the size of the prostate, examine the bladder, and help plan potential treatment options in patients where medication alone does not alleviate symptoms.
  • Transrectal ultrasound of the prostate (TRUS). Using an ultrasound transducer about the size of a finger inserted into the rectum, our urologists can visualize an image of the prostate gland and the surrounding tissue in three dimensions to accurately measure its size and assess its anatomy, vasculature and tissue compositions. It is a tool that also guides a biopsy needle to identify prostate cancer. The transducer sends high-frequency sound waves, which generates an image of the prostate gland on a monitor.

Therapeutic Approaches

At NewYork-Presbyterian, we offer several treatment options for prostate gland enlargement, including medications, minimally invasive therapies, and surgery. We evaluate your level of discomfort, symptoms, the size of your prostate, and other health conditions to find the right treatment option for you.

BPH and complications associated with the condition are unpredictable. The first line of treatment is often to monitor your progress over the course of a year. If pain and discomfort intensifies, one of the following treatment measures may be prescribed.

Medication Management. Medications have been developed to relieve the symptoms of benign prostatic hyperplasia, or stop prostate growth and shrink the size of the gland. There are several categories of medicines to help relax or shrink the prostate and improve your quality of life.

Photoselective vaporization of the prostate (PVP). Our urologists use the GreenLight XPS™ Laser Therapy System that vaporizes prostatic tissue. Patients avoid or have a short hospital stay and recover quickly with excellent relief of their BPH symptoms. The GreenLight can be done for most prostate shapes and sizes and offers a quicker recovery than the TURP procedure with the expertise of NYP urologist who have almost 2 decades of experience and who have refined the procedure and technology since its commercial availability.

Open Prostatectomy. Rarely, open prostatectomy involves an open surgical procedure to remove the central enlarged inner prostate gland. This is typically reserved for very large prostate glands that cannot be removed with other approaches.

Rezum procedure. Rezūm applies radiofrequency thermal energy to safely and effectively treat lower urinary tract symptoms secondary to BPH. Each treatment uses radiofrequency heated sterile water vapor, which over time, ablates tissue and reduces the volume of tissue allowing the urethra to open relieving LUTS.

Transurethral microwave therapy (TUMT). An outpatient procedure, in which a small microwave antenna that emits a dose of microwave energy is inserted into the urethra. Our urologists use the antenna to heat and destroy excess prostate tissue blocking urine flow.

Transurethral needle ablation (TUNA). Our urologists insert a catheter into the urethra that sends out small needles into the obstructing prostate tissue. The needles give off high-frequency radio waves that heat and destroy the tissue. Clinical studies have shown that TUNA provides excellent relief of symptoms and minimal side effects.

Transurethral resection of the prostate (TURP). Considered the old fashion "gold standard" of urologic surgical care, our urologist uses a cystoscope with a loop with radiofrequency high thermal energy to cut and remove the prostate tissue that is blocking the urine from exiting the bladder Potential complications include bleeding, fluid absorption, incontinence, and rarely erectile dysfunction.. However, this approach is safer today with the evolution of advance techniques and technology.

Urolift procedure. Urologist places tiny implants to pull and hold the prostate lobes apart, like to relieve compression on the urethra. This allows urine to flow normally again. This can be done as an office or ambulatory surgery procedure and avoids risk of ejaculatory or erectile dysfunction.

Next Generation Therapeutic Care through Research

Thanks to continuing advancements in science and technology, our physicians can offer patients innovative therapies and use novel technologies to treat conditions like benign prostatic hyperplasia. Through laboratory research and clinical trial programs, we have expert clinicians at the forefront of new innovations that evaluate promising technology. They tested the safety and efficacy of several technologies in clinical trials . To learn more about how our research is advancing your care, visit our clinical trials page.

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At NewYork-Presbyterian, we treat a diverse patient population with conditions ranging from the most common to the rarest and most complex. Clinicians in private practice or at other hospitals are welcome to refer their patient to NewYork-Presbyterian. Please call 212-305-0114 or 646-962-4811 to arrange a referral.

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