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Prostate care
An enlarged prostate is one of the most common reasons men see a urologist — and one of the most treatable. We'll walk you through the full range of options, from a simple pill to in-office procedures that skip the operating room entirely.
Benign prostatic hyperplasia (BPH) — an enlarged prostate — is a non-cancerous growth of the prostate gland that's extremely common as men age. As the gland enlarges, it presses on the urethra and makes urinating harder, leading to the symptoms most men notice first. It's not prostate cancer, and it's not dangerous on its own, but it can quietly chip away at sleep and quality of life.
A look at how an enlarged prostate narrows the urethra — and what treatment aims to relieve.
If these sound familiar, it's worth an evaluation — not because it's an emergency, but because the earlier we look, the gentler the options tend to be.
There's a whole ladder of treatments for BPH, and most men never need surgery. Here's the short version — and where to go deeper.
Behind the full menu of options, my own approach reduces to two preferred procedures divided by one thing — the size of the prostate. For a smaller gland (roughly under 35 grams), Rezūm — water-vapor (steam) therapy — is fast, needs no cutting, and is done in minutes. For a larger gland (above roughly 35 grams), prostate artery embolization is, in my clinical experience, the best option — measured against the surgical and minimally invasive alternatives, not held back as a fallback for men who can't have surgery. It needs no instrument passed through the urethra, removes no tissue, avoids general anesthesia, and preserves ejaculatory function.
I'll also tell you the honest exception, because a preference is only credible if it has one: PAE depends on being able to reach the gland through its arteries, and in roughly one man in a hundred those arteries are too blocked or narrowed for it to work. That's an anatomic limit, not a clinical guess, and we check for it before recommending the procedure.
For milder symptoms, daily medication can relax the prostate or shrink it over time. Often the first step.
Quick, minimally invasive options done right in the office. UroLift holds the prostate open with tiny implants; Rezūm uses steam to shrink the tissue — both without major surgery.
A newer, image-guided approach that shrinks the prostate by reducing its blood supply — typically done in under an hour with moderate sedation, and most patients walk out without a catheter. It's a team procedure with a clear division of labor: the urologist diagnoses, selects who is genuinely suited to it, and provides the aftercare; our interventional radiologist performs the embolization. Across more than 1,000 combined cases since 2021 — the highest PAE volume in the Northeast by procedure-volume data — that model is what makes both the patient selection and the outcomes reliable. See the full picture of prostate artery embolization at 1Prostate, our dedicated prostate center.
Going deeper
For an in-depth look at every BPH option — medication through PAE — visit our dedicated prostate center. For more on treating prostate conditions without the operating room, Modern Urologist covers minimally invasive prostate care in detail.
Visit 1Prostate Modern UrologistTreated late, an enlarged prostate can progress to urinary retention — the bladder no longer emptying. We prefer to treat obstruction earlier, often non-surgically, to help preserve bladder function rather than waiting for a crisis.
Book an evaluation if symptoms are disrupting your sleep or daily routine, if they're getting worse, or if you've noticed blood in your urine or trouble urinating at all (which needs prompt attention). We'll confirm what's going on and map out the options that fit your life — at our Manhattan or Forest Hills office.
Common early signs include needing to urinate more often (especially at night), a weaker or slower stream, trouble starting, dribbling, and a feeling that the bladder isn't fully empty. These tend to come on gradually.
No. Many men are managed with medication or in-office procedures. There's a full treatment ladder — medication, UroLift, Rezūm, prostate artery embolization — and surgery is only one end of it.
No. BPH is a non-cancerous enlargement of the prostate. It's very common with age and unrelated to prostate cancer — though both can cause urinary symptoms, which is exactly why an evaluation matters.
It depends on your symptoms, prostate size, and goals. We start with an evaluation, then walk through the options together — from medication to minimally invasive procedures — at either office.
Book an evaluation at our Manhattan or Forest Hills office — most patients are seen within the week.
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