Benign Prostatic Hyperplasia (BPH) is a common, benign condition, generally found in older men in which the prostate gland enlarges. The prostate is normally a walnut-sized gland that produces semen, the fluid that transports sperm. It is located below the bladder and surrounds the urethra (the tube carrying urine out of the body). When the prostate enlarges it can compress the urethra and cause obstruction of the urinary outlet. This can result in a slow stream, incomplete emptying, and frequent urination.

With over 30 experienced urologist office locations in Kansas and Missouri, the doctors at KCUC proudly offer local treatment for enlarged prostates and Benign Prostatic Hyperplasia in Kansas City, Overland Park, Lee’s Summit, Belton, North Kansas City, Merriam, Independence, Warrensburg, Chillicothe, Lexington, Richmond, Emporia, Leavenworth, Clinton, Butler, Harrisonville, Sedalia, Bethany, Excelsior Springs, Nevada, Ottawa, Garnett, Paola, and Iola.

Causes of Benign Prostatic Hyperplasia (BPH)

Benign Prostatic Hyperplasia is believed to be related to the aging process and the presence of the male hormone testosterone. More than half of men age 50 and older and 90 percent of men age 80 and older have BPH.  About one in every four men require treatment for BPH.

Symptoms of BPH

An enlarged prostate or BPH can cause a variety of urinary symptoms including:

  • Urgency – sudden need to urinate
  • Frequent urination, daytime or night
  • Weak or interrupted urine stream
  • Difficulty starting urination
  • Urine leakage (incontinence)
  • Inability to completely empty the bladder
  • Blood in the urine (hematuria)

Caffeine, alcohol, spicy or acidic foods, certain cold medications, and constipation can make symptoms worse. Left untreated, symptoms may worsen over time and can cause complications that may include the inability to urinate (urinary retention), bladder or kidney damage, bladder stones, permanent bladder injury or urinary infections.

Getting a BPH Diagnosis in Kansas City

Your Kansas City BPH doctor will take a medical history and do a physical exam. A digital rectal exam (DRE) and AUA urinary symptom score will be performed. An examination of your urine is performed. Other tests may include:

After that, you might need other tests that can help confirm an enlarged prostate. These tests include:

  • Prostate-specific antigen (PSA) blood test. PSA is a protein made in the prostate. PSA levels go up when the prostate becomes enlarged. But higher PSA levels also can be due to recent procedures, illnesses, surgery or prostate cancer.
  • Urinary flow test. You pee into a container attached to a machine. The machine measures how strong your urine flow is and how much urine you pass. Test results can show over time whether your condition is getting better or worse.
  • Postvoid residual volume test. This test measures whether you can empty your bladder fully. The test can be done using an imaging exam called ultrasound. Or it can be done with a tube called a catheter placed into your bladder after you pee to measure how much urine is left in the bladder.
  • 24-hour voiding diary. This involves noting how often and how much you pee. It might be extra helpful if you make more than a third of your daily urine at night.

If your health problem is more complex, you may need tests including:

  • Transrectal ultrasound. A device that uses sound waves to make pictures is inserted into the rectum. It measures the size of the prostate.
  • Prostate MRI.  A test that uses magnetic energy to take pictures of the prostate.
  • Prostate biopsy. This test uses ultrasound imaging to guide needles that take tissue samples of the prostate. Checking the prostate tissue can help your doctor find out if you have prostate cancer.
  • Urocuff. Diagnostic tool used to measure bladder pressure, urine flow rate, and volume to evaluate male lower urinary tract symptoms. By placing a pneumatic cuff on the penis that inflates to momentarily interrupt urine flow, it helps doctors diagnose obstructions, such as those caused by an enlarged prostate (BPH).
  • Urodynamic and pressure flow studies. A catheter is threaded through the urethra into the bladder. Water — or, less often, air — is slowly sent into the bladder to measure bladder pressure and check how well the bladder muscles work when you try to pass urine.
  • Cystoscopy. A lighted, flexible tool is placed into the urethra. It lets a provider see inside the urethra and bladder. Before this test, you may be given a topical medicine that numbs the urethra.

Treatment Options for BPH

Treatment will depend on the severity of your symptoms and how much they interfere with your lifestyle. Treatments vary from watchful waiting to surgical procedures. Men with minimal symptoms may only need to make lifestyle changes; those with more pronounced symptoms or complications may benefit from medication or a procedure. Your doctor can help you determine which treatment is most appropriate for you.

Lifestyle Changes to Address BPH

  • Avoid caffeine, acidic drinks such as colas, tomato and orange juice, and alcohol. Cold medications containing antihistamines or pseudoephedrine, can make it more difficult to urinate. Constipation can also worsen symptoms.
  • Limit evening beverages if night time-frequency is a problem.
  • Healthy diet and good physical conditioning can be of benefit.

Treating BPH With Medication

When symptoms progress and watchful waiting is no longer acceptable, then a trial of medications is often the next best option.

Medications for Treating BPH May Include:

  • Alpha blockers to relax the smooth muscle tissue in the bladder neck and prostate, increasing urinary flow (examples are tamsulosin and doxazosin).
  • Five alpha reductase inhibitors which shrink the prostate by preventing the conversion of testosterone to dihydrotestosterone, a testosterone metabolite which can cause prostate enlargement.
  • Anticholinergics or Beta 3 agonists (bladder relaxants) to reduce frequency and urgency.
  • Phosphodiesterase Inhibitors such as daily, low dose tadalafil which relaxes the smooth muscles in the prostate and bladder, improving urinary flow and reducing BPH symptoms.

Minimally Invasive Treatment Options

When medications are not effective, your urologist may suggest a prostate procedure. Additional workup is often times needed prior to this. These procedures seek to open a passage through the prostate to allow urine to flow with less effort. Many are called “transurethral” because instruments are passed through the opening at the tip of the penis and into the urethra. 

  • Prostatic urethral lift – The Urolift system is a minimally invasive outpatient procedure designed to treat symptoms of an enlarged prostate (BPH) by lifting and holding the obstructing prostate tissue out of the way. Small titanium implants are placed through the urethra to hold the prostate lobes apart, creating an open channel for urine flow. Unlike traditional surgeries, this technique typically preserves sexual function. KCUC is a center of excellence for urolift placement. 
  • Aquablation – Aquablation therapy is a robotic-assisted surgical procedure used to treat urinary symptoms caused by an enlarged prostate (BPH). It combines real-time ultrasound imaging with a heat-free, high-velocity waterjet to precisely remove prostate tissue via the urethra. There is a reduced risk of sexual dysfunction after the procedure compared to other traditional surgical techniques. A catheter is typically required for a short duration (1-3 days). KCUC providers have performed the most Aquablation cases in Kansas City.
  • Prostatic Artery Embolization – Prostatic artery embolization (PAE) is a minimally invasive, outpatient procedure performed by an interventional radiologist to treat lower urinary tract symptoms caused by an enlarged prostate (BPH). A tiny catheter is inserted into an artery in the groin and navigated to the vessels supplying blood to the prostate. Specialized embolic microspheres are then injected through the catheter to safely plug these arteries and intentionally reduce the blood supply to the prostate gland. Over the following weeks and months, the prostate shrinks resulting in improved urine flow and reduced urinary urgency. The interventional radiologists at KCIR have performed the most PAE’s in Kansas City.
  • Transurethral needle ablation with steam (REZUM) — is a minimally invasive, in-office procedure designed to treat benign prostatic hyperplasia (BPH) or an enlarged prostate. It works by using a handheld device to inject small, controlled bursts of steam (water vapor) into the prostate tissue through the urethra. The treatment typically takes only a few minutes, helps restore urinary flow, and is known for preserving sexual function compared to traditional surgeries. A catheter is typically required for a period of time after the procedure. 
  • Enucleation of the prostate – Enucleation of the prostate is a surgical procedure used to remove obstructive inner prostate tissue, treating Benign Prostatic Hyperplasia (BPH). Under anesthesia, a surgeon uses a laser through the urethra to separate the enlarged adenoma from the surrounding capsule, similar to removing an orange from its peel. The detached tissue is then moved into the bladder and removed using a device called a morcellator. This technique offers a durable, long-lasting solution for prostate enlargement, often allowing for same-day discharge and reduced bleeding risks compared to traditional surgery. A catheter is typically required for a period of time after the procedure.
  • Laser vaporization — (Greenlight or CyberTM) Laser energy is delivered through a small quartz fiber which heats and vaporizes the obstructing prostate tissue. This minimizes the bleeding risks associated with prostate surgery. A catheter is typically required for a period of time after the procedure.
  • Transurethral resection of the prostate (TURP) — TURP is a surgical procedure where a specialized wire loop uses electrical current to cut away the inner portion of the prostate gland that is blocking urine flow. The tissue pieces are flushed into the bladder and out of the body, allowing for improved urinary function. A catheter is typically required for a period of time after the procedure.
  • Robotic Simple prostatectomy – This surgical procedure is typically reserved for very large prostates (>100g). It involves using small key hole incisions on your abdomen to remove the portion of your prostate that wraps around your urethra. A short hospital stay is generally required. A catheter is generally needed for 5-7 days.