Benign prostatic hyperplasia — BPH — is a non-cancerous enlargement of the prostate gland. As the prostate grows, it can press on the urethra and make urination harder. It’s extremely common with age: most men notice some symptoms by their 60s. Common does not mean you have to live with it.
Symptoms to watch for
- Frequent urination, especially waking at night (nocturia)
- A weak, slow, or stop-and-start stream
- Difficulty starting, or straining to go
- A sense that the bladder never fully empties
- Sudden, urgent need to urinate
Left unaddressed, significant BPH can affect sleep, daily routine, and over time the bladder and kidneys. The good news is that an accurate diagnosis usually leads to straightforward relief.
Not sure how significant your symptoms are? The prostate symptom check takes about two minutes and gives you a score you can bring to your visit.
How we evaluate it
Dr. Shusterman starts by understanding the real picture — your symptom pattern, a focused exam, and targeted testing rather than a one-size-fits-all workup. Depending on your situation that may include a urine flow study, a measure of how completely the bladder empties, a PSA blood test, and an assessment of prostate size. The goal is to know exactly what’s driving your symptoms before recommending anything.
Treatment options
Treatment is matched to how much the symptoms affect you and what matters to you — including preserving sexual function.
Monitoring and lifestyle
For mild symptoms, simple adjustments to fluid timing, caffeine, and certain medications are often enough, with periodic check-ins to catch any change.
Medication
Several well-established medications relax the prostate or shrink it over time. They help many men, though some prefer to avoid long-term side effects.
Minimally invasive procedures
This is an area of particular focus. Modern, minimally invasive techniques relieve the obstruction with less downtime than traditional surgery — and several are specifically designed to preserve erections and ejaculation. For men who want lasting relief without the trade-offs of older operations, these options are often the turning point.
A note on sexual function. Many men delay BPH care out of fear it means choosing between relief and intimacy. With today’s minimally invasive options, that’s usually a false choice — and one worth discussing directly.
Common questions
Is an enlarged prostate the same as prostate cancer?
No. BPH is a benign, non-cancerous enlargement. It does not turn into cancer. Because both become more common with age, an evaluation often screens for each at the same time.
Will treatment affect my sexual function?
Protecting sexual function is a priority. Several modern procedures are designed to relieve symptoms while preserving erections and ejaculation. Dr. Shusterman walks through the trade-offs of each option with you.
Do I have to start with medication?
Not necessarily. Mild symptoms may only need monitoring. Medication helps many men, but minimally invasive procedures are a direct option when medication doesn’t work or causes side effects you’d rather avoid.
How soon can I be seen?
We hold same-week appointments. Call (212) 991-9991 or request a visit online and we’ll find a time quickly.