Enlarged prostate (BPH) treatment in Salt Lake City
A slow stream, incomplete emptying, and frequent nighttime urination can come from an enlarged prostate. Bladder problems and other conditions can cause similar symptoms, so evaluation comes first. Elisabeth Ferlic, MD, is a board-certified urologist who treats enlarged prostate in men across the Salt Lake Valley. Treatment starts with the least involved option that works and moves to a procedure only when you need one.
Request an appointment or call 435-344-4760.
Elisabeth Ferlic, MD
Board-certified urologist · Fellowship-trained in voiding dysfunction and female pelvic medicine
In this guide
- Symptoms of an enlarged prostate
- What is an enlarged prostate?
- Why see Dr. Ferlic for an enlarged prostate
- What are my options?
- Enlarged prostate treatment options
- Causes and risk factors
- How an enlarged prostate is diagnosed
- What to expect
- Managing symptoms day to day
- Benefits and risks, side by side
- What happens at the first visit?
- Enlarged prostate FAQs
Symptoms of an enlarged prostate
Symptoms build slowly, over years, so many men adjust without noticing how much has changed. The common ones fall into two groups.
Trouble emptying the bladder
- A weak or slow urine stream
- Straining or waiting for the stream to start
- A stream that stops and starts
- Dribbling at the end
- A feeling that the bladder is still not empty
Trouble holding urine
- Urinating more often during the day
- Sudden urges that are hard to put off
- Waking more than once a night to urinate
Other conditions cause the same symptoms, including a urinary tract infection, bladder stones, overactive bladder, and nerve-related bladder problems. An exam sorts out which one you have.
When to seek emergency care
Go to an emergency room if you cannot pass urine at all. A completely blocked bladder can harm the kidneys and needs to be drained the same day. Call a doctor promptly if you have fever or chills with urinary symptoms, blood in your urine, or pain in your lower abdomen when you urinate.
What is an enlarged prostate?
The prostate is a small gland, about the size of a walnut, that sits below the bladder and helps make semen. The urethra, the tube that carries urine out of the body, runs through the middle of it. The prostate keeps growing through most of a man's life. When it grows enough to squeeze the urethra, the clinical name is benign prostatic hyperplasia, or BPH. Most people call it an enlarged prostate.
"Benign" means it is not cancer. An enlarged prostate doesn't turn into prostate cancer and doesn't raise your risk of it, although the two can exist at the same time and share some symptoms.
About half of men have some signs of an enlarged prostate by age 60, and about 90% do by age 85. Roughly half of those men develop symptoms that need treatment. Size alone doesn't predict trouble; some men with a very large prostate have almost no symptoms.
Why see Dr. Ferlic for an enlarged prostate
Dr. Ferlic is a board-certified urologist and fellowship-trained in voiding dysfunction and female pelvic medicine. Voiding dysfunction training is advanced training in how the bladder stores and empties urine. That matters with an enlarged prostate because the prostate isn't always the whole story. Years of pushing against a blockage change the bladder, and an overactive bladder or a nerve problem can look the same. She tests before she treats, so your treatment targets the right problem.
Men are a core part of her practice. She explains treatment choices in plain language and considers how prostate and bladder function affect one another. If what you need is outside her scope, she knows who to send you to. Read more about Dr. Ferlic, or see everything Dr. Ferlic treats on the men's urology page.
What are my options?
A starting point for the conversation, not a prescription. Your evaluation decides what fits.
Mild symptoms, and the bladder empties well
Symptoms that hold steady and don't bother you much
Watchful waiting
Monitoring symptoms and bladder emptying, with follow-up
Symptoms that bother you
A larger gland suits medicine that slowly shrinks it
Medication
One type relaxes the prostate muscle; another shrinks the gland
Medication isn't helping enough
Or side effects bother you, or you'd rather not take a daily pill
Minimally invasive office procedure
Implants or steam open the channel, often with local anesthesia
Severe symptoms or a very large prostate
Or complications from the blockage
Surgery
Removes the blocking tissue, most often through the urethra
Enlarged prostate treatment options
Enlarged prostate treatment depends on how much your symptoms bother you, the size and shape of your prostate, and your general health. The options run from least to most involved, and many men never go past the first two or three.
| Medication | Minimally invasive office procedures | Surgery | |
|---|---|---|---|
| How it works | One type relaxes the muscle in the prostate and bladder opening; another slowly shrinks the prostate | Small implants hold tissue away from the urethra, or steam destroys the excess tissue | Removes the tissue blocking the channel, most often through the urethra with no incision |
| Setting | A pill you take every day | Many are done in an office with local anesthesia | Most are same-day or one-night stays under anesthesia |
| Timing and recovery | One type works within days to weeks; the other works over several months | Most men return to normal activity within a few days; relief tends to show over three to six weeks | A day or two of rest, and no heavy lifting for one to two weeks after most operations |
| Trade-offs | Side effects can include dizziness and changes in sexual function | Less likely to cause sexual side effects, but less long-term data, and some men need more treatment later | Bleeding, infection, temporary leakage, and semen flowing backward into the bladder at climax |
Medication
- How it works
- One type relaxes the muscle in the prostate and bladder opening; another slowly shrinks the prostate
- Setting
- A pill you take every day
- Timing and recovery
- One type works within days to weeks; the other works over several months
- Trade-offs
- Side effects can include dizziness and changes in sexual function
Minimally invasive office procedures
- How it works
- Small implants hold tissue away from the urethra, or steam destroys the excess tissue
- Setting
- Many are done in an office with local anesthesia
- Timing and recovery
- Most men return to normal activity within a few days; relief tends to show over three to six weeks
- Trade-offs
- Less likely to cause sexual side effects, but less long-term data, and some men need more treatment later
Surgery
- How it works
- Removes the tissue blocking the channel, most often through the urethra with no incision
- Setting
- Most are same-day or one-night stays under anesthesia
- Timing and recovery
- A day or two of rest, and no heavy lifting for one to two weeks after most operations
- Trade-offs
- Bleeding, infection, temporary leakage, and semen flowing backward into the bladder at climax
Watchful waiting
If your symptoms are mild and your bladder empties well, the right treatment can be none at all. Watchful waiting means monitoring symptoms and bladder emptying, with follow-up and tests based on your situation. Symptoms sometimes hold steady for years; in some men they improve.
Lifestyle changes
Cut back on fluids in the two hours before bed. Limit caffeine and alcohol, which make the body produce more urine and irritate the bladder. Stay active and keep your weight in a healthy range. The section on managing symptoms, below, covers bathroom habits that help.
Medication
Medication is one step, not the whole plan. One type relaxes the muscle in the prostate and the bladder opening and tends to work within days to weeks. Another type slowly shrinks the prostate over several months and suits larger glands. Some men take both. Side effects can include dizziness and changes in sexual function. A prescription that isn't helping is a reason to talk about other BPH treatment options.
Minimally invasive office procedures
This group of procedures opens the channel without removing large amounts of tissue. One approach places small implants that hold prostate tissue away from the urethra. Another uses water vapor (steam) to destroy the excess tissue, which the body then absorbs over several weeks. Many are done in an office with local anesthesia, and most men return to normal activity within a few days. They're less likely than traditional surgery to cause sexual side effects. The trade-off: there is less long-term data, and some men need further treatment later.
Prostate artery embolization shrinks the prostate by blocking part of its blood supply. An interventional radiologist performs it. Ask whether this approach is appropriate and whether a referral is needed.
Surgery
Surgery removes the tissue that is blocking the channel. It's usually recommended for severe symptoms, a very large prostate, or complications. Most operations go through the urethra with no incision. The long-established version, called TURP, trims the inner prostate with an electrical loop. Laser procedures vaporize the tissue or remove it in large sections, and a robotic waterjet procedure uses pressurized water. A very large prostate sometimes calls for removal of the inner gland through the lower abdomen. Most are same-day or one-night stays under anesthesia. Risks include bleeding, infection, temporary leakage, and semen flowing backward into the bladder at climax.
Not sure which step you're on? Reach out to the practice or call 435-344-4760, and ask which visit fits your concern.
Causes and risk factors
No one knows exactly why the prostate keeps growing. The leading explanation is a shift in sex hormones with age, including higher levels of DHT, a potent form of testosterone. Who tends to get an enlarged prostate is clearer:
- Age. Symptoms are rare before 40 and become steadily more common after that.
- Family history. A father or brother with prostate problems raises your odds.
- Diabetes and heart disease. Both are linked to a higher risk.
- Weight and activity. Obesity raises the risk, and regular exercise lowers it.
Some things don't cause an enlarged prostate but do make the symptoms worse. Decongestants and antihistamines tighten the muscle around the urethra. Water pills (diuretics), some older antidepressants, caffeine, and alcohol add to urgency and frequency. Bring a list of your medicines and supplements to your visit, because a change to that list is sometimes the first fix.
How an enlarged prostate is diagnosed
Diagnosis starts with a conversation about what you're noticing and how much it bothers you, often with a short symptom questionnaire that gives a score to track over time. From there, the usual steps are:
- A brief prostate exam to estimate its size and check for firm areas
- A urine test to rule out infection and blood
- A blood test for kidney function, and in some cases a PSA test, which can rise with an enlarged prostate, inflammation, or prostate cancer
- A urine flow test, which measures the strength of your stream
- A bladder scan, a quick ultrasound that shows how much urine is left after you go
Most men need nothing more. If the picture is unclear, or you're considering a procedure, a closer look helps: an ultrasound to measure the prostate or a cystoscopy to see the channel.
What to expect
A first visit is mostly conversation: your symptoms, your history, your medicines, and what you have already tried. A flow test and bladder scan can help assess emptying. Some patients need further tests to distinguish a blockage from a bladder muscle problem.
If you've been told you need a procedure and want another view, ask whether a second opinion or records review fits your situation. Confirm availability before scheduling.
After a minimally invasive procedure or surgery, expect a few days of more frequent urination, urgency, and some blood in the urine. Some men go home with a catheter for a day or more. Plan on a day or two of rest, and no heavy lifting for one to two weeks after most operations. Relief after a minimally invasive procedure tends to show up over three to six weeks. If you hope to father children, say so before any procedure, because several of them change ejaculation.
Managing symptoms day to day
There is no proven way to prevent an enlarged prostate, and little good evidence that supplements treat it. Talk with your doctor before you start one. Habits are a different story. These help many men:
- Go when you first feel the urge. Holding it for long stretches overstretches the bladder muscle.
- Try double voiding. Urinate, wait a moment, then try again.
- Use a schedule during the day. Urinating every couple of hours helps if urgency catches you off guard.
- Read the label on cold and allergy medicines. Decongestants and antihistamines can make it much harder to urinate.
- Stay warm. Cold can increase urgency and make retention more likely, which matters in a Utah winter.
If symptoms keep creeping up despite these steps, it's time to look at the next option.
Benefits and risks, side by side
Every treatment has trade-offs. Your history and your goals decide which ones matter most.
What treatment can address
- A weak stream, straining, and a bladder that doesn't empty
- Frequent daytime urination, sudden urges, and waking at night
- Repeated infections, bladder stones, or bleeding from a blockage
What to weigh first
- How much your symptoms bother you
- The size and shape of your prostate
- Your general health
- Effects on sex and fertility, which often decide between options
What happens at the first visit?
The visit starts with what has changed and what you want help with. Any treatment and follow-up plan is specific to you.
Talk through your symptoms
Bring your concerns, medication list, and relevant medical history.
Decide what needs checking
Testing depends on your symptoms and history, and some concerns need a separate workup.
Discuss a plan and follow-up
Review benefits, risks, alternatives, and what to watch for.
Before you schedule
Ask which appointments are available and whether your concern suits a video visit or needs an in-person evaluation.
Here’s what our great patients say
Is an enlarged prostate a sign of prostate cancer?
No. BPH is not cancer, and research shows it does not raise your risk of prostate cancer. The two conditions share symptoms and can be present at the same time, which is one reason an exam is worthwhile. Your urologist can tell you whether PSA screening makes sense for your age and family history.
Can an enlarged prostate shrink or go away without treatment?
The prostate doesn't usually shrink back by itself, but symptoms don't always get worse. In some men they hold steady for years or improve, which is why watchful waiting is a legitimate choice for mild symptoms. If your symptoms are getting worse, treatment can relieve them.
What happens if an enlarged prostate is left untreated?
Mild symptoms that don't bother you can be monitored safely. A blockage that keeps getting worse can lead to urinary tract infections, bladder stones, blood in the urine, a bladder that no longer empties, and in severe cases kidney damage. Follow-up can identify complications; the timing depends on your symptoms and risk.
When is a procedure a better choice than medication?
A procedure is worth discussing when medication hasn't helped enough, when side effects bother you, or when you prefer not to take a pill every day. It is usually recommended if you have been unable to urinate, keep getting infections or bladder stones, have repeated bleeding, or show signs of kidney strain. The size and shape of your prostate help decide which procedure fits.
Will enlarged prostate treatment affect my sex life?
It depends on the treatment. Some medications and many surgeries can cause semen to flow backward into the bladder at climax, which is harmless but affects fertility, and some medications can lower sex drive or affect erections. Several minimally invasive procedures are less likely to cause sexual side effects. Bring it up before you choose, because it often decides between options.
Can I see Dr. Ferlic for an enlarged prostate before the clinic opens?
Contact the practice to ask which visit types are available and when in-person appointments and procedures can be scheduled.
Talk with a urologist about your enlarged prostate
You can ask about care without a referral. Call 435-344-4760 or request an appointment, tell the practice what you're dealing with, and ask about the next step. Core Urology and Pelvic Health cares for men across the Salt Lake Valley.
This page is for general education and is not medical advice.