Care at Milton S. Hershey Medical Center

The surgical urology team at Penn State Health Milton S. Hershey Medical Center offers a full range of office based and minimally invasive surgical treatments for enlarged prostate, also called benign prostatic hyperplasia or BPH. Our fellowship-trained urologists will develop a personalized treatment plan for you to provide relief from the symptoms of enlarged prostate and improve your quality of life. 

Penn State Health Urology
200 Campus Drive
Entrance 4, Suite 3100
Hershey, PA 17033
Phone: 717-531-8887

Minimally invasive treatment options

Medications to relax or shrink the prostate, such as alpha blockers, 5-alpha reductase inhibitors or a combination of both, are the first line of treatment for an enlarged prostate. However, in some patients the medications aren’t effective or can lose their effectiveness over time. Patients may also experience side effects such as low blood pressure, dizziness or decreased libido with the drugs. 

A minimally invasive procedure or surgery may be recommended in these cases. Most treatments for an enlarged prostate are minimally invasive and performed with transurethral approach, in which a device is inserted through the penis and urethra to reach the prostate. No incision is made on the outside of the body. 

Urologists at Penn State Health may use one of these state-of-the-art treatments, depending on your individual case: 

  • Transurethral resection of the prostate (TURP). Transurethral resection of the prostate has been the gold standard surgery for an enlarged prostate. In this procedure, an electrical cautery loop shaves chips off the inside of the prostate gland. The tissue pieces are carried in fluid to the bladder and then flushed out. The TURP procedure requires general or spinal anesthesia and at least a one-night hospital stay, with catheterization for several days after the procedure.

Although TURP has been the most common procedure performed for an enlarged prostate, other minimally invasive procedures offered at Penn State Health are also gaining in popularity: 

  • Holmium Laser Enucleation of Prostate (HoLEP). In the HoLEP procedure, a laser is used to remove overgrown tissue from the prostate. The tissue fragments are pushed into the bladder and then removed. The HoLEP procedure can be used for an enlarged prostate of any size, but it’s among the best choices for exceptionally large prostate glands that weigh more than 80 grams. The technique has a low likelihood of post-procedural bleeding (1%), making it a good option for patients who take anticoagulant medications or who have bleeding disorders. The HoLEP procedure can be performed in an outpatient setting or can require an overnight stay. It removes more excess prostate tissue than other procedures, giving it the lowest reoperation rate. The odds of needing another surgery or to go back on medication is about 1% to 2% after a HoLEP. 
  • GreenLight Laser. Penn State Health also offers another laser treatment for benign prostatic hyperplasia called GreenLight Laser therapy. High-powered green light laser pulses are aimed at excess prostate tissue. Red blood cells in the tissue absorb the light and heat up, causing the tissue to vaporize. The vapor is then irrigated from the bladder. The technique—also known as photoselective vaporization of the prostate, or PVP—seals off the blood vessels, resulting in low rates of bleeding. Urologists at Penn State Health use the latest-generation GreenLight Laser device, which is notable for improvements in the laser technology. Most patients who have the procedure go home the same day. 
  • UroLift System. The UroLift System is one of the newest minimally invasive techniques for benign prostatic hyperplasia. In this quick outpatient procedure, small implants are inserted to hold the prostate lobes open, making more room for urine to flow through the urethra. The technique is appropriate for men with enlarged prostate symptoms whose prostate glands weigh less than 80 grams. Because it takes less than one hour to perform the procedure, it may be recommended for patients with more medical problems or in whom longer sedation is a concern. 

The UroLift procedure was previously approved only for older men with enlarged lateral prostate lobes. Recently, its use has been expanded to include men younger than 45 years old, as well as those with enlarged median prostate lobes. Although the UroLift treatment is the least invasive of the benign prostatic hyperplasia procedures, symptoms and flow rate improve more with TURP. In clinical studies, the UroLift procedure has been proven to be safe and effective in patients for five years. One advantage of the procedure is that it does not rule out other treatment options such as the GreenLight Laser, HoLEP or TURP if needed in the future.

After the procedure

The recovery period for all these enlarged prostate procedures can range from a few days to a few weeks, with the UroLift often having the shortest recovery. After a TURP or HoLEP procedure, most patients experience retrograde ejaculation—or dry orgasms. Additionally, at least one-third of patients experience dry orgasms with the GreenLight Laser procedure. Conversely, the UroLift procedure preserves both erectile and ejaculatory function. 

The right procedure for enlarged prostate will depend on several factors, including:

  • The size of your prostate
  • Your age
  • The amount of discomfort you are experiencing
  • Other medical conditions you may have
     

Groups, Classes & Support

Support groups provide an opportunity to share your feelings and connect with other parents and caregivers who are experiencing similar struggles.

Learn more about support groups offered at Penn State Health Milton S. Hershey Medical Center.

Research & Clinical Trials

Visit StudyFinder for information on our current clinical trials.

Symptoms, Diagnosis & Outlook

Enlarged prostate can cause urination problems, including:

  • Increased frequency or urgency
  • Delayed, interrupted or weak stream 
  • Urinary retention or incontinence 
  • Complications of urine retention, such as stones or infections

Symptoms

Enlarged prostate can cause urination problems, including:

  • Increased frequency or urgency
  • Delayed, interrupted or weak stream 
  • Urinary retention or incontinence 
  • Complications of urine retention, such as stones or infections

Diagnosis

To diagnose an enlarged prostate and rule out cancer, your doctor will:

  • Ask you questions about your health history and behaviors like smoking
  • Perform a rectal exam to gauge the size, shape and tenderness of your prostate
  • Order urine and blood tests

Your doctor will order these laboratory tests:

  • Urinalysis – a urine test to detect a urinary tract infection or blood in the urine
  • Prostate-specific antigen – a blood test that measures a protein that can be elevated in men with an enlarged prostate, prostate cancer or other prostate conditions

In some cases, your doctor may also order or perform one or more of these tests:

  • Urine cytology – a urine test to screen for bladder cancer
  • Genitourinary ultrasonography – an ultrasound to rule out an obstruction
  • Post-void residual urine volume – a test that measures how much urine remains in your bladder after urination
  • Urethrocystoscopy – a visual exam of the urinary tract using an instrument called an endoscope
  • Urodynamics – an office test to determine how well your bladder functions and how severe your obstruction may be

Outlook & Prognosis

If your condition is not overly bothersome, your urologist may simply monitor you for worsening symptoms. You may be advised to make lifestyle changes, such as limiting liquids before sleep or cutting back on caffeine or alcohol. 

If your condition worsens, medications are the first line of treatment for an enlarged prostate. However, in some patients the medications aren’t effective or can lose their effectiveness over time. Patients may also experience side effects such as low blood pressure, dizziness or decreased libido with the drugs. A minimally invasive procedure or surgery may be recommended in these cases.

We can help

To schedule an appointment, please call
717-531-8887