Enlarged Prostate

The expert urologists in UT Southwestern Medical Center’s Prostate Diseases Program are dedicated to delivering the best possible care for diagnosing and treating enlarged prostate (benign prostatic hyperplasia). Our team has extensive experience with the latest techniques and was the first in North Texas to use steam therapy to shrink an enlarged prostate.

Experts in Treating Benign Prostatic Hyperplasia

An enlarged prostate, also called benign prostatic hyperplasia (BPH), is the most common noncancerous prostate disease. The enlarged prostate pushes against the urethra and bladder and can block the flow of urine.

UT Southwestern’s urologists are experts in treating male urology problems and prostate diseases, including diagnosing and treating BPH. Because our physicians are studying a number of promising treatments, we can also offer eligible patients opportunities to participate in clinical trials. 

Symptoms of Benign Prostatic Hyperplasia

The most common symptoms of enlarged prostate are:

• Frequent urination
• Hesitancy or difficulty getting the urine stream going
• Intermittent urination, when the stream is interrupted
• Nighttime urination, when sleep is interrupted by the need to urinate
• Urgency or inability to suppress the need to urinate
• Weak urinary stream while voiding

Certain over-the-counter cold, sinus, or allergy medications can also cause the same symptoms.

Diagnosis of Benign Prostatic Hyperplasia

Patients who suspect they have an enlarged prostate should see a doctor. There are other conditions that can mimic BPH, including certain kinds of bladder or prostate cancer, stones in the urinary tract, and abnormal bladder muscle function caused by a neurological disorder.

It is very important that prostate cancer is ruled out as the cause of symptoms.

Tests the doctor might perform include:

• Digital rectal examination, in which the doctor inserts a finger into the rectum to check for prostate enlargement
• Urine tests, including possibly a urinary flow study and/or urodynamic testing (a procedure focused on determining the bladder’s ability to hold urine and empty it steadily and completely)
• Prostate-specific antigen (PSA) test, a blood test that looks for increased PSA levels
• Transrectal ultrasound (TRUS), which uses sound waves to create an image of the prostate, enabling urologists to visually check the gland

Our physicians might also conduct a cystoscopy (examining the lining of the bladder and the urethra) or a post-void residual volume test (examining how much urine stays in the bladder after urinating) to evaluate the prostate gland.

Treating Benign Prostatic Hyperplasia

Receiving a BPH diagnosis does not necessarily mean that a patient has to be treated. Sometimes symptoms wax and wane or actually improve over time. In other cases, symptoms get worse year after year, and patients will want to seek treatment.

Twenty years ago, the only treatment doctors could offer was a surgical intervention called transurethral resection of the prostate, or TURP.

Now, patients can choose from a host of different interventions. Medication, minimally invasive surgery, nonsurgical therapies, thermotherapy, traditional surgery, and "watchful waiting" are all treatments offered by UT Southwestern physicians to treat BPH. 

Rezum

Rezum is a minimally invasive procedure that uses steam to shrink an enlarged prostate without the use of needles or scalpels. The procedure works by inserting sterile water vapor (steam) into the prostate gland during nine-second treatments. UT Southwestern Medical Center’s Kenneth Goldberg, M.D., was the first urologist in North Texas certified to perform the Rezum treatment, and he has done more than 350 of the procedures.

Prostate Artery Embolization

UT Southwestern is among a select number of medical centers in the U.S. to offer a minimally invasive treatment called prostate artery embolization, or PAE, as an alternative to surgical procedures like TURP.

PAE involves making a small incision in the groin or upper thigh and navigating a tiny catheter (tube) under imaging guidance into the blood vessels of the prostate, where tiny microparticles are injected to decrease the blood supply, thus reducing the prostate’s size and offering men lasting relief from BPH symptoms. 

PAE can be performed for patients under full anesthesia or partial sedation. The procedure usually takes three to four hours and involves a one-night stay in the hospital. Learn more about PAE.