Benign prostatic hyperplasia, also called prostate gland enlargement or BPH, is a common condition as men get older. Approximately 70% of men experience symptoms by age 60 – and as men age the risk of benign prostatic hyperplasia increases.

Mayo Clinic Health System in Austin offers a wide variety of treatments for enlarged prostate. There are several effective treatments for benign prostatic hyperplasia, including medications, minimally invasive in-office therapies, and surgery.

Causes of BPH

The prostate gland is located beneath your bladder and behind the pubic bone. The tube that transports urine from the bladder passes through the center of the prostate. When the prostate enlarges, it may block urine flow.

Most men have continued prostate growth throughout life. In many men, this continued growth enlarges the prostate enough to cause urinary symptoms or even urinary retention.

The cause of prostate enlargement is unclear. However, it might be due to changes in the balance of sex hormones as men grow older.

Symptoms of BPH

An enlarged prostate gland can cause uncomfortable urinary symptoms, such as blocking the flow of urine out of the bladder, difficulty starting the urinary strain, as well as daytime and nighttime frequency. It also can cause bladder, urinary tract, or kidney problems.

The best treatment choice for you depends on several factors, including:

• The size of your prostate.
• Your age.
• Your overall health.
• The amount of discomfort or bother you are experiencing.

If you and your health care provider decide that in-office therapies or surgery would be the best treatment options* for you, your options may include:

• Laser PVP
• Simple prostatectomy
• Steam therapy
• Transurethral resection of the prostate (TURP)

Laser PVP

Laser PVP surgery is a minimally invasive treatment for an enlarged prostate. The procedure uses a laser to perform photoselective vaporization of the prostate (PVP). During laser PVP surgery, a tube with an imaging system (cystoscope) allows the surgeon to place the laser through the cystoscope to burn away excess tissue blocking urine flow through the prostate.

Unlike traditional prostate surgery, laser PVP surgery doesn’t cut or scrape tissue which results in less blood less. This makes laser PVP surgery a good option for people who have blood-clotting conditions or who take blood thinners. Like other minimally invasive treatment options for an enlarged prostate, PVP can offer faster recovery compared with traditional prostate surgery.

Simple prostatectomy

Prostatectomy is a surgery to remove the part of the prostate gland that is blocking the flow of urine. The surgery eases urinary symptoms and complications resulting from blocked urine flow. Simple prostatectomy is usually performed as a minimally invasive procedure with robotic assistance. It’s not often done as an open procedure anymore.

Two types of prostatectomy are available: 

• Robot-assisted prostatectomy. The surgeon makes five to six small incisions in your lower abdomen to remove parts of the prostate. He or she sits at a console using instruments attached to a computer-assisted mechanical device (robot). The robot device allows a more precise response to movement of the surgeon’s hands.
• Open prostatectomy. The surgeon typically makes an incision in your lower abdomen to remove the prostate.

Steam therapy

Steam therapy is an in-office, minimally invasive therapy using steam to reduce the size of the prostate and alleviate symptoms. This treatment has been shown to effectively eliminate excess prostate tissue, while carrying a low risk of side effects. The procedure takes about 20 minutes, and patients go home immediately after. During the treatment, a tiny needle is inserted into the urethra and positioned within the prostate gland. In nine seconds, the needle produces a steam ball within the prostate that is about 2 centimeters wide. All the tissue the steam touches is shrunk and reabsorbed by the body within 30 to 45 days. The treatment eliminates the extra prostate tissue causing benign prostatic hyperplasia symptoms.

Transurethral resection of the prostate (TURP)

During the TURP procedure, a lighted scope is inserted into the urethra, and the surgeon removes all but the outer part of the prostate. TURP generally relieves symptoms quickly, and most men have a stronger urine flow soon after the procedure. After TURP you might temporarily need a catheter to drain your bladder.

*Some of the treatments listed may not be available at the location of your consultation.