Bothered by Symptoms of an Enlarged Prostate?

John used to sleep like a baby. Now a nagging urge “to go” wakes him up at least twice every night. He’s not alone. As men age, the prostate grows. As the prostate grows, it often causes problems with urination known commonly as “lower urinary tract symptoms.” Men may experience a weakened urinary stream, have difficulty starting the urinary stream, feel an urgent need to urinate, urinate more frequently than normal—including more than twice a night. Not all men will develop an enlarged prostate, also known as benign prostatic hyperplasia (BPH), but it is quite common. More than half of all men will have some degree of BPH by the time they turn 50, and nearly 90 percent of men in their 80s will have the condition.


The prostate is a gland located below the bladder that produces the vast majority of fluid secreted during ejaculation. A normal prostate is about the size of a walnut. Although it is not completely understood why the prostate grows as men age, it is known that age and genetics play a large role in the development of BPH.


“As the prostate grows, it can press on the urethra and cause urination and bladder problems,” say Dr. Geoffrey Nuss, a urologist with USMD Men’s Health Center. “Fortunately, there are many treatment options, including medication and minimally invasive surgery. Only a doctor can diagnose BPH and ensure that it is not a more serious condition such as prostate cancer. If you are experiencing symptoms related to an enlarged prostate, you should see a physician.”


Proper diagnosis and evaluation of benign prostatic hyperplasia requires a physical exam. During the exam, your doctor will perform a digital rectal exam to feel the prostate gland. Blood and urine tests will also be performed—including a prostate-specific antigen (PSA) blood test to screen for prostate cancer.


There are several treatment options for BPH. For men with mild symptoms, “watchful waiting” and proactive lifestyle changes may be enough to relieve symptoms, including:

  • Urinate when you first get the urge
  • Avoid alcohol and caffeine, especially after dinner.
  • Don't drink a lot of fluid at one time. Spread your fluid in-take throughout the day.
  • Skip drinking anything within two hours of bedtime.
  • Avoid decongestants and antihistamines—they can increase BPH symptoms.
  • Exercise regularly. Inactivity can aggravate symptoms.
  • Reduce stress—it can trigger an increase in the urge to urinate.

“For men who experience more bothersome symptoms, your physician can prescribe oral medications to help shrink the prostate or improve the flow of urine from the prostate,” Dr. Nuss explains.

If medications do not provide relief, a minimally invasive procedure may be appropriate. One such procedure—transurethral microwave therapy (TUMT)—can often be performed right in the doctor’s office. During the procedure, a small microwave antenna is inserted through the tip of the penis and up into the urethra until it reaches the part of the urethra surrounded by the prostate. The antenna emits a low dose of microwave energy that warms and destroys the excess prostate tissue that is blocking urine flow.

Minimally invasive laser surgery is another “no incision” outpatient treatment option. During the procedure, a scope is inserted through the tip of the penis into the urethra until it reaches the part that is surrounded by the prostate. A laser is passed through the scope. The laser delivers energy that is used to vaporize the excess tissue that is impeding the flow of urine.

“Treatment depends on the size of the patient’s prostate, severity of symptoms and the individual’s overall health,” Dr. Nuss says. “The most important step is the first step—visit a physician so BPH can be properly diagnosed and the best course of treatment can be determined.”


Don’t let an enlarged prostate cramp your lifestyle. A urologist with USMD Men’s Health Center has the tools and expertise to relieve your symptoms so you can feel better and live better. To schedule an appointment, call the USMD/UANT Men’s Health Center at (817)784-UANT (0818).


Physicians are independent providers and not employed by USMD Hospital at Arlington, LP.

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