Enlarged prostate
Treatment in Vienna

What is an enlarged prostate?

Benign prostatic hyperplasia (BPH) is the most common cause of urinary symptoms in men over 50. The prostate grows with age, narrows the urethra and obstructs bladder emptying. About one in two men over 60 has an enlarged prostate – not everyone needs treatment.

Typical symptoms are a weak stream, hesitancy, dribbling, frequent urination – especially at night – and the feeling of not emptying the bladder completely. Left untreated, it can lead to urinary retention, bladder stones, recurrent infections and kidney damage.

Important: an enlarged prostate is not a precursor of cancer. The symptoms can, however, resemble those of prostate cancer, which is why a PSA test is part of the assessment.

More about prostate cancer

Assessment in the practice

Diagnosis is straightforward and painless. I record your symptoms with a standardised questionnaire (IPSS), measure your urinary flow (uroflowmetry) and use ultrasound to determine residual urine and prostate size. A PSA test largely rules out a malignant cause. This clarifies in a single visit whether, and which, treatment is needed.

Symptom questionnaire (IPSS) and history Uroflowmetry (flow measurement) Ultrasound of bladder, residual urine and prostate PSA test and urinalysis If needed: urodynamics or cystoscopy
More about cystoscopy

Treatment: from medication to laser

01.
Watchful waiting and lifestyle

With mild symptoms, small adjustments are often enough: drinking less in the evening, cutting bladder irritants such as caffeine, bladder training. Regular check-ups make sure no complications develop.

02.
Medication

Alpha blockers relax the prostate muscle and work within days. 5-alpha-reductase inhibitors shrink the gland over months. Both can be combined. Side effects such as dizziness, ejaculation changes or reduced libido are discussed openly with you.

03.
ThuLEP / HoLEP laser enucleation

When medication is not enough or complications arise, laser enucleation of the prostate is today's gold standard – regardless of gland size. The excess tissue is completely removed through the urethra, with minimal blood loss, a short catheter time and a lasting result.

More about ThuLEP / HoLEP
04.
Other surgical options

Classic TURP, water-vapour ablation or the UroLift implant have their place in specific situations – for example a small prostate, or when preserving ejaculation is a priority. I explain which procedure fits your anatomy and your goals.

Frequently asked questions

When does an enlarged prostate need surgery?

When medication no longer works or is not tolerated, with repeated urinary retention, bladder stones, bleeding, recurrent infections, or when the kidneys suffer from back-pressure. How much the symptoms bother you is an important criterion too.

Is laser surgery better than classic TURP?

Laser enucleation removes the tissue more completely, bleeds less and is possible even for very large prostates that once required open surgery. Results are durable and re-operation is rare.

Does treatment affect sexual function?

Erectile function is usually preserved after ThuLEP/HoLEP. After any enucleation of the prostate, however, most men experience so-called dry ejaculation, which I discuss with you in detail beforehand.

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