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Overview

An enlarged prostate is a common and unavoidable aspect of aging for most men that causes difficulty with urination. The medical name for this condition, which affects half of men by age 50 and still more in the decades that follow, is benign prostatic hyperplasia, or BPH.

The good news, though, is an enlarged prostate is not cancerous and is not life-threatening. But there is no question that living with a swollen prostate, which frequently causes a feeling of pressure when seated, is both inconvenient and uncomfortable. BPH slows the urine stream, so it takes longer to empty the bladder. Men with BPH tend to awaken often at night to use the bathroom. Another complaint voiced by many men with BPH is having to make frequent pit spots on road trips, which can impede their ability to travel or live normal, active lives.

There are a number of treatments for this condition that all aim to reduce or eliminate swollen prostate tissues. One new, minimally invasive procedure urologists are now performing is called UroLift. It’s an outpatient procedure performed that can be performed right in the doctor’s office.

“It is a minimally invasive procedure, which is really easy to perform with a quick recovery, and it works better than medication,” says Daniel Kellner, MD, a Yale Medicine urologist. Importantly, he adds, “There are no sexual side effects—which tends to be a priority for many men.”

What is UroLift?

The UroLift system is a non-invasive way of addressing BPH. It helps reduce the prostate swelling that inhibits the flow of urine from the urethra.

During the procedure, which takes less than an hour, the patient is given mild sedation. The urologist inserts tiny implants through the urethra that move the enlarged prostate out of the way. They are left in place to lift or hold the enlarged prostate tissue out of the way. Because the urethra is no longer blocked by swollen tissues, urine can be released without obstruction.

“UroLift has no sexual side effects (such as erectile dysfunction or lack of interest) which unfortunately are an issue found with medications for BPH,” he says.

What is recovery like after UroLift?

You can return to work within two to three days after the procedure. During recovery, men may experience temporary symptoms such as blood in the urine or a burning sensation during urination, which may last for a few days or longer in some cases.

What are the benefits of UroLift?

Clinical data shows that UroLift helps reduce obstructive prostate tissue and is considered a safe and effective for many men. It helps relieve lower urinary tract symptoms related to BPH, and it does not compromise a man’s sexual function. Having UroLift does not preclude a man from trying other treatment options in the future.

What other treatment methods are available?

If you’re diagnosed with BPH, there are a number of options your urologist may discuss with you.

Because men are affected by BPH in varying degrees and some approaches work better for particular men than others, the treatment decision is not always straightforward. Your urologist can help sift through the pluses and minuses of each option, including UroLift and others, to identify the one likeliest to achieve a good outcome for you. Here are other available treatments for BPH:

  • Lifestyle changes: These can include reducing liquid intake, bladder training (a program of urinating on schedule), abstaining from alcohol and caffeinated beverages and regularly exercising the pelvic muscles.
  • Medication: Many patients will take a combination of two types of medication: Alpha blockers are a type of medication often used to relax muscle fibers in the prostate and bladder. This allows increased urine flow and reduces the need for frequent urination. Alpha reductase inhibitors work to block the hormones that cause the prostate to swell.
  • GreenLight laser treatment: One procedure that is commonly done by Yale Medicine urologists is GreenLight laser vaporization. A laser is used to shrink prostate tissue that restricts urine flow. It’s an option you should discuss with your urologist.
  • Prostatic arterial embolization (PAE): Using mild sedation, the doctor makes a small incision into the patient’s wrist or groin and releases tiny beads into the arteries that supply the prostate gland. The beads travel through the body to the patient's prostatic arteries. Once there, they permanently block blood flow to the swollen prostate, so that the prostate gland shrinks over time.
  • Transurethral resection of the prostate surgery (TURP): “For cases of obstruction due to BPH, TURP surgery has a long history of being one of the most successful treatments for BPH,” says Dr. Kellner. While it’s considered the gold standard treatment, some men experience sexual side effects.

Why consult a Yale Medicine urologist about prostate issues?

We have one of the largest and most distinguished Urology departments in the region, with specialists trained in all aspects of prostate health.

“At Yale Medicine, there are so many treatments available for BPH, so you’re not limited by our ability to offer solutions,” says Dr. Kellner. “We offer comprehensive care and more options for our patients with prostate issues.” That’s good news for men with enlarged prostates who may need to try more than one option to get the results they’re looking for.

“The good news is with UroLift, you haven’t burned any bridges,” he says. “You can always go on and try other treatments if needed.”