An Overview on Enlarged Prostate (BPH) and One New Minimally Invasive Treatment

Enlarged prostate, also called benign prostatic hyperplasia (BPH), is one of the most common diseases affecting older men, specifically those older than 50. According to the National Institute of Diabetes and Digestive and Kidney Diseases, BPH affects about 50% of men between the ages of 51 to 60 and affects up to 90% of men older than 80. The condition refers to a rapid increase of cells, causing the prostate to expand. As the prostate grows, it can place pressure on the urethra resulting in various urinary problems including the decreased force of stream, hesitancy, straining, incomplete bladder emptying, and waking up to urinate several times at night.

When to Seek Medical Care for BPH

Symptoms of BPH could signal a more serious condition, such as prostate cancer. If you are experiencing any of the following symptoms, you should contact your primary care provider immediately.

  • Inability to urinate
  • Painful, frequent, and urgent need to urinate, with fever and chills
  • Blood in urine
  • Discomfort or pain in the lower abdomen and urinary tract


Early detection is imperative. If left untreated, this condition can lead to kidney damage, bladder stones, bladder deterioration, or retention of urine. There are varying tests depending on the patient’s severity to determine BPH. These include a urine flow study, digital rectal exam, prostate-specific antigen (PSA) blood test, transrectal ultrasound, and cystoscopy.

Risk Factors

  • Aging – a third of men experience moderate to severe symptoms by age 60 and about half do by age 80.
  • Family History – a blood relative such as brother or father increases your likelihood for the development of this condition.
  • Diabetes and Heart Disease – diabetes as well as heart disease and the use of beta blockers may increase the risk of BPH.
  • Lifestyle – obesity increases the risk of BPH, while exercise can lower your risk.

Treatment for Enlarged Prostate

“Every treatment has its niche, what’s fitting for one patient may not be ideal for another patient,” said TPMG board certified urologist, David M. Hartke, MD.


Alpha blockers or 5-alpha inhibitors are often the first lines of treatment before surgery. These medications are used to relax or reduce the size of the prostate. For many patients, taking medications is an excellent alternative to undergoing surgery. Other benefits are its affordability and ability to stop if any side effects occur.

Drawbacks with medications include having to take medication daily, the potential of side effects (lowered sexual drive, erection problems, lack of energy) and over time, they may stop working. In cases where medications are not sufficient and further treatment is needed, there is a range of surgical procedures including less invasive procedures that have proven to show positive results.

Minimally Invasive Surgery

One new minimally invasive surgery known as Rezum uses water vapor energy to remove the obstructive tissue causing BPH. “Basically, we’re injecting water vapor into the prostate and the heat from the steam kills a lot of the bad prostate cells and denatures the protein, over time your body reabsorbs those proteins,” said Dr. Hartke.

This in-office procedure takes about 5 minutes and patients can expect a 2-hour office visit from start to finish. One benefit compared to other procedures is in the name; patients can “Rezum” normal activity within 2-3 days. Over the course of 1 to 3 months, patients will see continued improvements in their condition.

If you suffer from BPH and are interested in alternative therapies, consult a urologist to discuss the best option for you.

David M. Hartke, MD

About David M. Hartke, MD

David M. Hartke, MD, is a board certified urologist and is experienced in the treatment and care of enlarged prostate, overactive bladder, kidney stones, urinary incontinence, erectile dysfunction, and a variety of cancers. Dr. Hartke is fellowship trained in Urology, Laparoscopy, and Oncology. He sees patients at TPMG Urology – Newport News.

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