An enlarged prostate won’t shrink on its own. Fortunately, several treatment options are available. Our urologists can help identify the one that’s best for you.
If your symptoms are mild, you may not need treatment. You can choose “watchful waiting.” With this approach, you have regular visits with your doctor to track your condition. But, our urologists can provide a wide variety of therapies if you need treatment.
Non-Surgical Treatments
Our urologists may recommend medication as a first therapy option.
- Prescription medication: If you have moderate to severe symptoms, our urologists may recommend prescription medication. Alpha-blockers relax the smooth muscles in your prostate gland. This makes it easier for you to urinate. If you have a large prostate (over 40 cubic centimeters), 5-alpha reductase inhibitors can shrink the gland. This improvement can take between six to 12 months.
- Herbal medication: Some research shows that saw palmetto, an over-the-counter herbal medication, can help relieve some symptoms. These include difficulty urinating, frequency and getting up at night to urinate. Always talk with your doctor before taking any herbal medication. They may interfere with other prescription medications.
- Urethral catheter: If you can’t urinate or empty your bladder completely, you may need a urethral catheter. It can help your bladder drain until you can get further treatment. Our urologists can place one for you or teach you how to self-catheterize.
Surgical Treatments
If medication isn’t enough to control your symptoms, you need surgery. Our urologists offer the full range of procedures to help you. They can perform minimally invasive techniques in the clinic. Or they can perform traditional techniques in the operating room.
- Clinic-based procedures: Our urologists offer REZUM. This sterile water vapor therapy uses an endoscope (a long, thin tube). The endoscope delivers several nine-second steam injections. The energy from the steam destroys diseased prostate tissue. Urologists perform this minimally invasive procedure in the office with local anesthesia.
- Scope-based operating room surgery: If you have a larger prostate, you may need a transurethral procedure. These surgeries are done under general anesthesia in the operating room. During this operation, our urologists pass a cystoscope through your urethra with no incision on the skin. Then, they use special tools to remove diseased prostate tissue. You’ll stay in the hospital overnight and have a catheter for a few days.
The transurethral resection of the prostate (TURP) is the most common endoscopic procedure to treat enlarged prostate. This technique uses heat from electricity to cut away diseased prostate tissue.
- Aquablation: This treatment for enlarged prostate is performed in the operating room and includes the use of general anesthesia. The prostate is mapped with real-time ultrasound to identify the boundaries of the prostate. A high-pressure water jet is used to destroy tissue within those boundaries.
- Laser surgery: Emory is the first urology practice in Georgia to offer a procedure specifically for patients with very large prostates (over 80 cubic centimeters). This endoscopic procedure is called Holmium Laser Enucleation of Prostate (HoLEP). Urologists use a laser to cut away large amounts of obstructing prostate tissue.
- Robotic surgery: If you have a very large prostate, our urologists can remove it using the da Vinci robotic surgical platform. In this procedure, they use special tools to reach and remove your prostate through a small cut in your abdomen. This approach can reduce the size of your prostate and remove bladder stones, and treat other bladder abnormalities at the same time.
