Benign Prostatic Hyperplasia

The prostate is a walnut-sized gland that is located in men beneath the bladder, between it and the urethra. The prostate produces fluid that nourishes and transports sperm.

Enlargement of the prostate, or benign prostatic hyperplasia (BPH), means that the prostate has become bigger than normal over time. This is a common condition in men over 40. It is not related to prostate cancer and does not seem to put a man at greater risk for developing prostate cancer.

Most cases of BPH are not serious but they can cause urinary issues. As the prostate enlarges, it can seriously block the flow of urine and cause urinary tract infections, a weakened bladder, bladder stones and even kidney damage. 

A wide range of medical and surgical treatments for BPH is offered at UMass, including but not limited to the following.

Non-Surgical Treatments

BPH is often treated with medication. There are two types of medications typically used, and they may be used individually or together:

• Medications that relax the muscles and fibers of the bladder and prostate within days of starting treatment, making it easier to urinate; these medications are in a class called "alpha-blockers"

• Medications that slowly shrink the prostate over the course of weeks or months; these medications are called "5-alpha reductase inhibitors"

Both medications are effective but they can cause "retrograde ejaculation," in which semen harmlessly goes into the bladder at the moment of ejaculation instead of out the tip of the penis. Medications that shrink the prostate can also cause impotence and decreases sexual desire.

UMass is proud to offer Prostatic Arterial Embolization, or PAE. This is an experimental procedure in which radiologists, in conjunction with urologists, use CT-scan guidance to place small particles that block the blood supply to the prostate and cause it to shrink.

Surgical Treatments

Medication is often the first line of treatment for an enlarged prostate. When medication doesn't work or when the prostate is severely enlarged, there are a number of surgical treatments:

• Transurethral surgery involves inserting tiny instruments into the tip of the penis and down the urethra to reach the prostate, then cutting part of it away or making incisions in it to make more room for the flow of urine

• Laser surgery is also done with tiny instruments guided through the tip of the penis and the urethra; depending on the procedure, the surgeon may use laser to burn away or cut away part of the prostate

• Surgeons may use microwaves or radio waves to heat up the prostate, which causes it to shrink; these procedures are also done with tiny instruments inserted through the tip of the penis and the urethra

• In open surgery, the surgeon makes an incision in the belly to reach the abdomen and then cuts away some of the prostate to relieve blockage

These procedures require different levels of anesthesia and recovery and have different side effects and potential complications.  Your surgeon will help you determine the best treatment option based on your individual case and circumstances.