Benign Prostatic Hyperplasia (BPH)

Benign prostatic hyperplasia (BPH) is an enlarged prostate. It is the non cancerous enlargement of the prostate that occurs as a man ages. The prostate grows to its normal adult size in male’s early 20’s and then enters into a second growth phase in a male’s mid 40’s. Benign prostatic hyperplasia often occurs with the second growth phase. BPH is common in aging men. About half of all men between the ages of 51 and 60 have BPH. Up to 90% of men over age 80 have BPH.

As the prostate enlarges, it can cause pressure on the urethra. The pressure on the urethra make it harder to urinate and lead to lower urinary tract symptoms (LUTS).

Lower urinary tract symptoms include:

  • frequency of urination
  • urgency
  • painful urination
  • weak urinary flow
  • inability to urinate
  • waking up at night to urinate
  • trouble starting and stopping urine flow


  • Medical History
  • Physical Examination
    • Prostate exam (Digit Rectal Examination)
  • Self Evaluations of Symptoms
    • American Urologic Association Symptom Index ( AUA- SI)
    • International Prostate Symptom Score (IPSS)
    • Quality of Life (QoL) Questionaire
  • Urinalysis (urine test)
  • PSA blood test to screen for prostate cancer
  • Post-void residual volume (PVR) to measure urine left in the bladder after urinating
  • Uroflowmetry to measure how fast urine flows
  • Cystoscopy to look at the urethra or bladder with a scope
  • Urodynamic pressure to test pressure in the bladder during urinating
  • Ultrasound of the prostate
Normal Prostate - BPH

Normal Prostate

Severe Enlarged Prostate - BPH

Enlarged Prostate


Watchful Waiting

  • Best for men with mild symptoms
  • Yearly examination
  • Lifestyle modification- adjusting diet, evening fluid intake, medication use and exercise patterns.

Medical Therapy

  • Alpha Blocker
    • Intended for men with mild to severe symptoms
    • Provides relief of BPH symptoms
    • Work almost immediately
  • 5-Alpha Reductase Inhibitor
    • intended for men with demonstrable enlarged prostate
    • reduces the need for surgery
    • relieves the symptoms of BPH
  • Minimally Invasive Surgery

    • Transurethral Resection of the Prostate
    • GreenLight TM Laser Therapy
    • Urolift