Get treatment for a benign enlarged prostate | Cleveland Clinic

Benign Prostate Enlargement

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Who knew something as natural as peeing could become such a problem?

If you’re 50+, you might notice that it’s difficult to get anything out no matter how hard you try. And when you do, you have a weak stream that dribbles even when you think you’re done. These are signs of an enlarged prostate, a common but treatable problem. Also known as benign prostatic hyperplasia, its symptoms can be tough to ignore. But there’s good news — we can help make it easier to go when you need to.

At Cleveland Clinic, our skilled healthcare providers understand what you’re going through and can help you feel better. We treat many people who have enlarged prostates. And our treatments are very successful — even for the most complicated cases. We’re here to help you find lasting relief.

Why Choose Cleveland Clinic for Enlarged Prostate Care?

Demonstrated expertise:

Because we treat so many people with BPH, our experience leads to an exceptional level of care. You’ll receive effective, personalized treatments aimed at helping you avoid surgery and catheters (tubes to drain pee from your bladder).

Personalized care:

Our providers will take time to get to know you so we can better understand your health, lifestyle and goals. We make sure you understand all your options and any potential side effects so you can make good decisions about the next steps. Meet our team.

Specialized knowledge:

We do a complete evaluation to find out how severe your prostate enlargement is. This may include tests to rule out internal bleeding and other conditions that cause symptoms similar to BPH.

Comprehensive treatment:

We offer procedures for symptoms that don’t respond to BPH medications. Options may include transurethral procedures that use slim instruments and real-time imaging to deliver treatments. People often go home the same day.

Convenient care:

Some services, including second opinions, are available via virtual visits. You’ll get the same great care, but from the comfort of your home using your smartphone, tablet or computer. We welcome the opportunity to review your case and provide expert recommendations.

National recognition

Cleveland Clinic is a trusted healthcare leader. We're recognized in the U.S. and throughout the world for our expertise and care.

Enlarged Prostate Diagnosis at Cleveland Clinic

There are certain things we need to do to make sure that you have an enlarged prostate. At your appointment, we’ll look over your medical history and ask about any other medical conditions. We’ll also ask you to describe your BPH symptoms and if they’re getting worse.

You will fill out a short questionnaire called the International Prostate System Score (IPPS). Your answers will help us know how to best care for you.

Here are a few other things to expect:

Physical exam: We’ll check your prostate with a digital rectal exam. Your urologist carefully slides a gloved, lubricated finger past your anus to feel your prostate and check to see if it’s enlarged.
Prostate-specific antigen (PSA) test: This test checks for an elevated level of prostate-specific antigen, which can be a sign of prostate cancer. In rare cases, an enlarged prostate is due to cancer.

Advanced tests for an enlarged prostate

If your condition is complex, we might do more testing, including:

Cystoscopy, which uses a slim, lubricated tube with a camera at the tip to look inside your prostate and nearby organs. Anesthesia (pain control) helps you stay comfortable during the procedure.
Ultrasound, which measures your prostate using soundwaves to check for unusual bleeding or bladder issues.

Providers Who Treat Enlarged Prostates

Locations

Our healthcare providers see patients at convenient locations throughout Northeast Ohio, Florida and London.

Enlarged Prostate Treatment at Cleveland Clinic

There are several different ways to treat an enlarged prostate. They include:

Medications

In many cases, BPH medications are the only treatment you’ll need. These include alpha-blockers, which relax muscle tissue around your prostate, reducing pressure on your urethra (the hollow tube where pee leaves your body). Alpha-blockers are a trusted option, but they don’t work for everyone.

Another option is 5-alpha-reductase inhibitors. These BPH medications block the hormone that makes your prostate grow. It can take up to six months to start working, though, and can sometimes make sex difficult.

Transurethral procedures

If BPH medications don’t work, or the side effects are too much, a transurethral procedure might help. Instead of making large cuts (incisions), we slide slim instruments and a camera into your urethra. We’ll give you medicine to keep you comfortable — and possibly even sleep — during the procedure. There are three different types of transurethral procedures:

Transurethral resection of the prostate (TURP) removes sections of tissue blocking your urethra.
Transurethral incision of the prostate (TUIP) makes two small cuts in the bladder neck, where your urethra and bladder connect. This widens your urethra and helps your pee to flow better.
Transurethral electrovaporization sends electrical energy to targeted areas of your prostate tissue. Special sensors at the tip quickly heat up the area until cells turn into steam.

Other enlarged prostate procedures

Depending on your condition, your provider may recommend one of these procedures instead:

GreenLight™ laser removes prostate tissue using a laser, which helps control bleeding. This technique isn’t used as often as others.
Holmium laser prostate surgery (HoLEP) also uses a laser to remove extra prostate tissue.
Prostatic artery embolization sends substances that block blood flow to your prostate, shrinking enlarged tissue.
Rezum™ is a form of water vapor therapy. It sends targeted bursts of steam to get rid of extra prostate tissue.
Robotic simple prostatectomy lets surgeons take out a section of your prostate through a tiny cut. This option is for severe cases where your enlarged prostate completely blocks your urethra.
UroLift® inserts tiny clips that spread your prostate so it doesn’t block your urethra.

Taking the Next Step

If you have an enlarged prostate, you’ve probably started dreading going to the bathroom. It’s not easy struggling to pee. Or talking about something that feels so personal. Cleveland Clinic’s team of trusted experts will help you feel comfortable talking about this issue. We’ll work with you to design a personalized treatment plan that meets your unique needs. And if you have any issues after treatment, our care team is here to help you get things figured out so you can feel good about going again.