Benign prostate hyperplasia (BPH) is an enlarged prostate gland. The condition is an inevitable part of aging and the symptoms associated with BPH are common in men over 50.  

Signs and symptoms
  • Frequent urination
  • Urgent urination
  • Waking up at night to urinate
  • Slow stream
  • Feeling unable to empty your bladder

The prostate is downstream from the bladder and urine must pass through the prostate during normal urination. When the prostate grows it can cause blockage of the urination. Usually the symptoms develop gradually over time. Left untreated, men’s symptoms will steadily worsen leading to urinary tract infections, need for catheter to drain the bladder or kidney problems.  

Many men have their symptoms by their primary care provider, using medications that either relax the prostate (alpha blockers) and / or shrink the prostate (5 alpha reductase inhibitors).  These medications are effective in up to 85% of men, and in general are safe. Each type of medication, of course, has side effects that are usually mild. If the medications are helpful in reducing a man’s symptoms, it is important to continue to take them.  Stopping the medications will result in rebound symptoms (they come back), especially with alpha blockers (terazosin, alfuzosin, doxazosin, tamsulosin, silodosin).  

For men who prefer not to take medication, whose symptoms aren’t controlled by pills or who develop infection or urinary retention (unable to urinate) we need to consider an alternate approach.  I offer two approaches:


  • Prostate Needle Ablation (REZUM)


  • Minimally invasive
  • Performed in office with local anesthesia
  • Procedure time <10 minutes; mild to moderate discomfort
  • Takes 6-8 weeks to notice significant symptom improvement
  • Does not affect sexual function
  • Allows men to discontinue medication


  • Transurethral Resection of the Prostate (TURP)


  • Gold standard procedure that has been used for years
  • Performed in operating room with anesthetic
  • Physically removes prostate tissue
  • Men spend one night in hospital
  • Prompt improvement in flow and reduced irritation over 1-2 months

“These symptoms creep up on you and unfortunately are a part of normal aging.”

To prevent complications associated with BPH, seek medical assistance if you’re experiencing trouble urinating or suspect that you have an enlarged prostate.

Schedule an appointment with Dr. Kuan

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