What BPH is
Benign prostatic hyperplasia (BPH) is a non-cancerous enlargement of the prostate. It is very common: most men develop some prostate growth as they age. Because the prostate surrounds the urethra, growth can narrow the channel urine passes through and make the bladder work harder.
Symptoms
- Weak or slow stream, or a stream that stops and starts
- Waking at night to urinate (nocturia)
- Urgency and frequency
- A feeling the bladder is not empty
- Straining to start urinating
- In some men, urinary retention, bladder stones, infections or blood in the urine
Evaluation
Dr. Neal Patel uses a symptom score, a urine test, a bladder scan to measure the urine left after voiding, and often a flow test. PSA testing may be discussed, because prostate cancer can cause similar symptoms and the two conditions can coexist. Imaging or cystoscopy helps measure prostate size and shape when a procedure is being considered, because the best procedure depends on the anatomy.
Treatment options
Mild symptoms may only need monitoring and simple changes, such as limiting fluids in the evening and reducing caffeine and alcohol. Medications include alpha-blockers, which relax the prostate, and 5-alpha reductase inhibitors, which can shrink it over months. For men who prefer to avoid long-term medication, or whose symptoms do not respond, minimally invasive and surgical options include prostatic urethral lift, water vapor therapy, transurethral resection (TURP), laser enucleation and, for very large glands, robotic simple prostatectomy. Each option involves trade-offs in recovery, durability and sexual side effects, which Dr. Neal Patel reviews with you before you decide.
Prostate artery embolization
For some men, especially those with large prostates or who want to avoid surgery on the urethra, prostate artery embolization (PAE) is another option. It is performed through a small puncture at the wrist or groin, with no incision in the urinary tract.
When to call sooner
If you cannot urinate at all, have fever with urinary symptoms, or see blood clots in the urine, seek care promptly. Same-day and next-day appointments are often available at 678-344-8900.
Preparing for your visit with Dr. Neal Patel
Bring a list of your current medications and supplements, any prior urine, blood or PSA results, and the reports (or discs) from recent imaging. If you can, arrive with a comfortably full bladder, because a urine sample and a bladder scan are often part of the first visit. Write down your main questions so nothing is missed. A family member is welcome to join you. If you prefer Spanish or Korean, let the office know when you book so language support is ready.
Your chart is reviewed before you arrive, and insurance requirements for likely imaging or procedures are checked up front so approvals can move sooner. Before you leave, your orders, prescriptions and follow-up plan are reviewed with you, and you receive education materials tailored to your condition.
At the end of the visit you will receive a written summary in your preferred language that explains what was found, what was ordered and what happens next. Your primary care physician or referring doctor receives a clear update letter with findings, plan and next steps, so everyone caring for you stays informed. Appointments are available at the Johns Creek, Cumming, Decatur and Braselton offices; call 678-344-8900.
Reviewed by Dr. Neal Patel, MD, board-certified urologist. This page is general information and not a substitute for medical advice.