Treatment Options

With approximately 32 million men worldwide experiencing symptoms of enlarged prostate, there has to be some way to treat these symptoms. We will take you through the most common treatment options. There are a number of treatments available for enlarged prostate. You will need to discuss the advantages and disadvantages of each treatment with your urologist.  Depending on your medical history and the severity of your symptoms, you and your physician will decide together which treatment is right for you.


Many physicians still use medication as the primary treatment option for patients. However, drugs must be taken daily for the rest of your life and have the potential for significant side effects. Over time, the cost of the medication can become very expensive. Also, medication is not effective for all men with a reported 48% of patients not showing clinically significant symptom improvement.1

Limited Durability

While medications can provide initial relief from BPH symptoms, some men find that the drugs aren’t effective or their effectiveness decreases over time and their symptoms return. In fact, over 50% of patients who start a regimen of medications for BPH discontinue the treatment within three years.3 This is unfortunate, because once a man stops taking his medication, it stops working. However, due to the nature of one class of the drugs, sexual side effects may last for months to years, even after stopping the drug.8


For many men and their families, the cost of BPH medications is an expensive burden. BPH patients can expect to spend thousands of dollars on these medications over time.
As with any medical procedure individual results will vary. Please consult your urologist for more information.


Surgery has always been considered the “Gold Standard” the reason for it being considered that is because it removes tissue. 

Surgical procedures typically remove large amounts of prostate tissue and are performed in a hospital or surgical center. These operations are done under anesthesia and most patients will spend 1-2 nights in the hospital. You will have to wear a catheter for some time while you heal, and then it can be removed. Typically, the patient can expect a four-to-six-week recovery period where they need to maintain reduced physical activity.
The most commonly performed surgical option is a Transurethral Resection of the Prostate. This involves the insertion of a small rigid metal instrument through the urethra to cut away the enlarged prostate tissue. Another alternative surgical procedure uses a laser to ablate prostatic tissue in much the same manner. Surgery is typically successful in resolving the patient’s BPH symptoms, but unfortunately involves a number of risks and side effects including a very high rate of retrograde ejaculation.

In-Office Therapy

Urologix noticed that there should be something in the middle of taking medication for the rest of your life or needing to have a surgical procedure in the hospital.
This is where In-Office treatments fit, right in between a daily medication and visiting a hospital for a few nights.

There are a few different In-office BPH treatments out there. While all of them may provide some relief from your BPH symptoms, there are some very key differences between the treatments.

TUMT (Cooled ThermoTherapy)

TUMT stands for Transurethral Microwave treatment. Urologix Cooled ThermoTherapy the TUMT BPH treatment that has been around since 1997 when it was approved by the FDA. There have been several other microwave treatments before and since Cooled ThermoTherapy. In 2009 a 5 year durability study was conducted across several different locations. What this study showed was that 90.4% of patients did not require any additional in-office treatment or surgical intervention for their BPH 5 years after the treatment(8). Cooled ThermoTherapy has been around since 1997 simply because it works.
Think about that success rate, 9 out of 10 men had Cooled ThermoTherapy and then required no additional in office or surgical treatment for their BPH after 5 years!


TUNA (Prostiva RF Therapy)

TUNA or Transurethral Needle Ablation is often referred to as Prostiva RF. Prostiva® RF Therapy is a safe, effective, non-surgical in-office therapy which provides long-term relief from BPH symptoms and urinary obstruction without the side effects and high cost of chronic BPH medication or the risks and high costs associated with invasive surgery. There have been several different studies comparing Prostiva RF to the TURP, the Gold Standard of BPH treatments. In all of the studies the TURP had a somewhat greater improvement over Prostiva. When you are comparing to the Gold Standard, having a doctor say that the TURP is only somewhat better is a huge success. Especially when you are comparing something that can only take about 30 minutes in the comfort of your doctors office versus a 1-2 night stay at a hospital after surgery.

PUL (Prostatic Urethral Lift)

PUL treatment is one of the newer treatments for BPH as it was approved in 2013, 16 years after Cooled ThermoTherapy. A PUL treatment in a sense staples back the enlarged prostate tissue to clear a pathway for urine. This “staple” is left in the prostate tissue until it has a need to be surgically removed. Earlier we mentioned the Gold Standard a PUL is the ONLY major in-office BPH treatment that does not remove any tissue or follow the Gold Standard.


Rezum™ is the newest major in office BPH treatment. It follows the Gold Standard like Cooled ThermoTherapy and Prostiva RF and removes tissue. While Cooled ThermoTherapy and Prostiva RF both use a form of microwave energy safely kill the enlarged tissue, Rezum™ heats using very hot water vapor to scorch the tissue in the prostate.

There are many different ways to deal with your BPH, talk to your doctor about what is right for you. If you are interested in learning for about Cooled ThermoTherapy or Prostiva RF, we suggest you give us a call or fill out our contact us page and we can get in touch with you. Take a look at our Cooled ThermoTherapy page and Prostiva RF page to learn about the treatments and hear from real patients.

1Wei, et al, High Rates for Continued BPH Medical Therapy among Non responders, AUA2010 Abstract 498 3Long-Term Risk of Re-Treatment of patients using Alpha-Blockers for Lower Urinary Tract Symptoms. J. De La Rosette, et al. The Journal of Urology, Vol. 167, 1734-1739, April 2002. 4Combination Therapy is with Flomax® and Avodart®. Prescription drug cost from www.drugstore.com, accessed 4/2010 5Calculated using Medicare 2010 rates, www.medicare.gov, accessed 4/2010 6Calculated using the CMS maximum allowance for service covered. https://catalog.ama-assn.org/Catalog/cpt/cpt_search_result.jsp?_requestid=899945 7Center for Medicare & Medicaid Services, 2010, Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare, www.medicare.gov/medigap/default.asp Flomax is a registered trademark of Boehringer Ingelheim Pharmaceuticals, Avodart is a registered trademark of GlaxoSmithKline. 8Journal of Sexual Medicine: July 12, 2012 8 5 Year Results of a Multi-Center Trial of a New Generation Cooled TUMT for BPH, Roehrborn, C. et. al., Moderated Poster, AUA 2009.