I was designated a UroLift Center of Excellence by NeoTract, the company that makes the device. The designation goes to urologists who have performed enough of these procedures to have genuine experience with them and who have a record of good patient outcomes.
I am including this here less as an announcement than as an excuse to answer the question underneath it, because it is one of the most common questions I get: if my prostate is enlarged, what are my options between taking a pill every day and having real surgery?
What BPH actually is
Benign prostatic hyperplasia is an enlargement of the prostate that comes with age. It is not cancer. The prostate surrounds the urethra, so as it grows it can squeeze the channel urine has to pass through. That produces the familiar complaints: a weak stream, starting and stopping, going frequently, getting up several times a night, and the sense that the bladder never quite empties.
The part patients underestimate is the sleep. Getting up three or four times a night, every night, for years, is not a minor inconvenience. It affects mood, energy, and daytime function, and it is often the thing that finally brings a man in.
The gap between pills and surgery
Medication is usually the first thing tried, and for a lot of men it is enough. But the relief can be partial, it can fade, and the side effects are real: dizziness, headaches, and sexual side effects that lead plenty of men to quietly stop taking the pills without telling anyone.
At the other end is traditional surgery, which cuts, heats, or removes prostate tissue. It works. It is also more of an undertaking, and it carries a meaningful risk of retrograde ejaculation and, less often, incontinence or erectile problems.
For a long time there was not much in between. That gap is what the minimally invasive treatments were built to fill.
Where UroLift fits
The UroLift procedure places small permanent implants that hold the enlarged prostate tissue open, rather than cutting or heating it. It is done through the urethra as an outpatient procedure. Because no tissue is removed or destroyed, it generally preserves sexual function, which for many men is the deciding factor.
It is recommended as a BPH treatment option in both the American Urological Association and European Association of Urology guidelines. The pivotal randomized trial showed durable improvement in symptoms and urinary flow without compromising sexual function. Common side effects are blood in the urine, burning with urination, urgency, and pelvic discomfort, and these are usually mild and settle within two to four weeks.
What I actually tell patients
It is not the right answer for everyone. Prostate size and shape matter, and so does anatomy that does not show up until you look. A very large gland, or a prominent median lobe, may point toward a different approach. Someone whose main problem turns out to be bladder function rather than obstruction will not be helped by opening the channel at all, which is exactly why the evaluation matters more than the brochure.
What I would want you to take from this is simpler than any brand name. If you are living with these symptoms and have been told your only options are a daily pill or a real operation, that is no longer true. There is a middle ground now, and it is worth understanding before you settle for either end of it.
Minimally invasive treatment for an enlarged prostate remains an active part of my practice.