Benign Prostatic Hyperplasia (BPH)

Enlarged Prostate

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Frequent urination, an overwhelming urge to urinate, difficulty urinating, and urinary leakage are uncomfortable symptoms that may be signs of benign prostatic hyperplasia (BPH), typically known as an enlarged prostate. While the condition is most common among older men, it should be treated at any age to prevent more serious issues from occurring, such as damage to your bladder or kidneys. Untreated BPH can also have a negative impact on quality of life. Duke’s urologists are experts in diagnosing and treating enlarged prostates. They can recommend the best treatment to help you achieve better control of your urine flow.

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Testing for Benign Prostatic Hyperplasia

In addition to an in-depth discussion of your urinary symptoms and a review of your medical history, more testing may be required.


A urine test checks for things such as blood and inflammation. It can assess whether a bladder infection may be causing your symptoms.


A uroflow test measures the speed of your urinary stream. Slower than normal rates may indicate that an enlarged prostate is reducing the stream.

Post-Void Residual Urine Test

After you urinate, your urologist may use ultrasound to see how much urine is left in your bladder. This may identify a blockage or signs of bladder dysfunction.


Your urologist will place a long, thin camera through your urethra to see the inside of your prostate and bladder. This is used to assess how much the prostate is blocking urine flow and the effects it is having on the bladder.

Transrectal Ultrasound

Your urologist will place a finger-sized ultrasound probe through your rectum to measure the size of the prostate. Knowing the prostate size is critical to treatment success since not all prostates will benefit from certain procedures. 

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Duke Health offers locations throughout the Triangle. Find one near you.

Treatments for Benign Prostatic Hyperplasia

There are a range of treatments for BPH. To begin, your doctor may recommend changes to your diet, exercise, or medication. If your symptoms get worse, your urologist will work with you to determine if a minimally invasive treatment is right for you based on the size of your prostate and how it affects your quality of life. More definitive surgeries are offered depending on treatment goals, the size of your enlarged prostate, and severity of your BPH symptoms.


Your doctor may prescribe medication that can decrease the blockage and/or shrink your prostate, allowing urine to flow more freely. This can relieve symptoms and eliminate, or at least delay, the need for surgery.


During this minimally invasive procedure, your urologist places implants onto your prostate gland to hold prostate tissue away from your urethra. This allows for the free flow of urine. UroLift offers relief by opening your blockage directly and does not require cutting, heating, or removing prostate tissue.


Steam is injected into the prostate, which leads to a reduction in the size of the prostate, making it easier to urinate and reducing urinary symptoms. This minimally invasive procedure is done in the office without the need for general anesthesia.

Holmium Laser Enucleation of the Prostate (HoLEP)

Using a scope and laser, your surgeon will remove the entire BPH portion of the prostate. This unblocks your urethra and improves urine flow leading to improvement in urinary symptoms. Often, people never need BPH medications or another BPH surgery following this minimally invasive procedure.

Transurethral Resection of the Prostate (TURP)

During this surgery, BPH tissue is removed systematically to open a channel in the prostate, making it easier to urinate and reduce urinary symptoms. This procedure is the most commonly performed BPH surgery in the United States.

Robotic Simple Prostatectomy (Partial Prostate Removal)

Your doctor may recommend that you undergo robotic BPH surgery if the prostate grows too large, you have other related bladder and prostate conditions, or other surgical treatments aren’t effective. Your doctor will consider the size of your prostate to determine the best approach to this surgery.


Conditions Related to an Enlarged Prostate

Male Incontinence
An enlarged prostate can make it hard for your bladder to empty, leading to urinary leakage.

Best Hospital for Urology in North Carolina

Where you receive your care matters. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our urology program is nationally ranked, and the highest-ranked program in North Carolina, according to U.S. News & World Report for 2024–2025.

Why Choose Duke

Accurate Diagnosis
We perform a comprehensive evaluation and use advanced techniques and diagnostic equipment to accurately diagnose the cause of your prostate problem. We follow American Urological Association guidelines and utilize an evidence-based approach to provide you with the best care.

Experts in BPH
Duke Health is a high-volume, regional referral center for people who need advanced and complex BPH surgery. Our urologists who treat BPH and prostate problems are board-certified and have undergone additional advanced training through fellowships in laser surgery and robotics.

High Cure Rates and Low Complication Rates
Our use of modern surgical techniques, adherence to treatment guidelines, sophisticated tools and equipment, and our skill and experience are the reasons why our surgeries have such high rates of success.

Assistance for Men Who Have Failed Previous Treatments
Many patients are referred to us or seek our care after multiple failed attempts at treatment. Often this results from being diagnosed without proper imaging tests, or because people were unaware they could benefit from a single surgery that has a cure rate over 98%.

This page was medically reviewed on 07/25/2023 by