Comparing Enlarged Prostate (BPH) Treatments
An enlarged prostate (benign prostatic hyperplasia, or BPH) is common as men age. It can cause a weak stream, frequent urination and getting up at night. There are many ways to treat it, and the right choice depends on your prostate's size and shape, your symptoms, your other health conditions and what matters most to you.
Step one: an evaluation
Before comparing treatments, a urologist confirms that BPH is the cause of your symptoms. This may include a symptom questionnaire, a urine test, a PSA blood test, measuring urine flow and how well the bladder empties, and sometimes imaging of the prostate. Some of these tests, such as urodynamics, help rule out bladder problems that can look like BPH.
The main options at a glance
| Option | How it works | Often considered when |
|---|---|---|
| Watchful waiting and lifestyle changes | Monitoring, plus habits like limiting evening fluids, caffeine and alcohol | Symptoms are mild and not bothersome |
| Medication | Daily pills that relax the prostate or slowly shrink it | A first treatment for many men; ongoing use is needed |
| UroLift | Small implants hold the enlarged tissue out of the way | Men who want a minimally invasive option without removing tissue |
| Rezum | Water vapor treats excess prostate tissue, which the body then absorbs | Men looking for an in-office, minimally invasive option |
| iTind | A temporary device reshapes the channel, then is removed | Men who prefer nothing left behind permanently |
| Optilume | A drug-coated balloon widens the channel | Selected prostate shapes and sizes |
| Aquablation | A robot-guided waterjet removes tissue, done in the hospital | Larger prostates or more severe blockage |
| GreenLight laser | A laser vaporizes the blocking tissue | Men who need tissue removed, including some on blood thinners |
| Prostate artery embolization (PAE) | Blood flow to the prostate is reduced so it shrinks | Men who want to avoid surgery through the urethra |
Questions that help narrow the choice
- How large is my prostate, and is there a middle lobe? Some procedures suit certain sizes and shapes better than others.
- How important is protecting ejaculation and erections? Treatments differ in their effect on sexual function, and your urologist can explain the trade-offs.
- Do I want to stop daily medication? Procedures may reduce or remove the need for pills.
- How much recovery time can I take? In-office options and hospital procedures have different recovery periods, and some involve a temporary catheter.
- How long should results last? Some men may need another treatment years later. Ask how likely that is for each option.
- Do I take blood thinners or have other health conditions? These can make one approach safer than another.
When not to wait
Contact a doctor promptly if you cannot urinate, see blood in your urine, have repeated urinary infections, or have pain or fever with urinary symptoms.
Learn more
Read more on our enlarged prostate and BPH pages, or the patient article GreenLight after UroLift.
This article is general education, not medical or financial advice. Your urologist and insurance plan can tell you what applies to you.