BPH Treatment Options in San Antonio

As men age, it’s normal for the prostate gland to grow.

Sometimes that growth becomes large enough to press against the tube that carries urine out of the body and the bladder. The medical term for this enlargement is benign prostatic hyperplasia (BPH).

BPH is not prostate cancer, but it can cause uncomfortable and frustrating urinary symptoms that affect your daily life, such as:

• Needing to urinate often, especially at night, called nocturia
• A weak or interrupted urine flow
• Difficulty starting urination
• The feeling that your bladder doesn’t completely empty

BPH treatment options in San Antonio are available at Urology San Antonio, and we see patients from across Texas and the United States.

There are many effective BPH treatment options in San Antonio and beyond. Today’s treatments offer many ways to relieve symptoms. They range from medications to advanced surgical techniques. Your urologist will help you decide which option best matches your symptoms, prostate size, and therapeutic goals.

Medications

Medication is often the first line of treatment for men with mild to moderate symptoms. There are two main categories of medicines that target prostate tissue differently, and sometimes they are used together for added benefit.

• Alpha-blockers: These medications work by relaxing the smooth muscles around the prostate and at the base of the bladder. This improves urine flow and makes it easier to start urinating. They offer quick symptom relief, usually within days. Examples include:
  • Tamsulosin (Flomax)
  • Alfuzosin (Uroxatral)
  • Doxazosin (Cardura)

Some men may experience side effects such as dizziness or fatigue, so it’s important to take them as prescribed and report any issues to your doctor.

• 5-alpha-reductase inhibitors: These medications work more slowly but address the root cause of prostate enlargement. They block the hormone that causes prostate tissue to grow, helping shrink the gland over time. The goal is to reduce prostate size and lower the chance of needing surgery. Examples include
  • Finasteride (Proscar)
  • Dutasteride (Avodart)

While these drugs often take several months to show improvement, they can lead to lasting results.

Minimally invasive procedures

Sometimes medication isn’t enough or causes side effects. Minimally invasive procedures can relieve urethral blockage without traditional surgery. These procedures are performed in a urologist’s office or outpatient setting. They typically allow men to return to normal activities quickly.

• UroLift: UroLift uses small implants to hold the enlarged prostate tissue away from the urethra, restoring normal urine flow. There is no cutting or tissue removal, and symptoms are relieved quickly, often within days. This approach is ideal for men who want lasting improvement while preserving sexual function.
• Rezūm Water Vapor Therapy: Rezūm uses the natural energy of stream water vapor to shrink excess prostate tissue. The vapor is delivered through a small device inserted into the urethra under local anesthesia. As the body absorbs the treated tissue, the prostate gradually becomes smaller. There are no incisions or stitches needed, and this procedure helps reduce dependence on long-term medication.
• Aquablation Therapy: Aquablation is a robot-assisted procedure that uses a high-pressure jet of water to remove the part of the prostate blocking urine flow. Guided by real-time imaging, the surgeon can precisely target the tissue while avoiding critical areas that control urinary and sexual function. There is no external incision, and this method produces consistent results for prostates of various sizes. It carries a low risk of incontinence or erectile dysfunction.

These newer approaches have expanded treatment options for men who want an effective, minimally invasive solution with minimal downtime.

Laser and energy-based treatments

Some procedures use focused heat or laser energy to remove or destroy overgrown prostate tissue. These options can provide lasting relief for men with moderate to severe symptoms.

• HoLEP (Holmium Laser Enucleation of the Prostate): HoLEP is an advanced laser surgery that removes the obstructing portion of the prostate while leaving the outer capsule intact. The removed tissue is then suctioned out through the urethra. It is effective for prostates of all sizes, including very large ones, and offers durable results with low retreatment. Minimal bleeding and a short hospital stay may be required.
• Heat-based procedures: Some nonsurgical therapies use microwave or radiofrequency energy to shrink prostate tissue. The heat causes the extra tissue to die off, allowing the urethra to stay open. It is usually performed in an outpatient setting and is suitable for men with moderate symptoms. However, it may take a few weeks to see full improvement.

Surgical Procedures

For men with very large prostates or severe symptoms that don’t improve with other methods, surgery can provide long-term relief. Surgery removes the part of the prostate that’s blocking the urethra and restores normal urine flow.

TURP (transurethral resection of the prostate): TURP has long been considered the standard surgical treatment for BPH. During this procedure, a thin instrument is passed through the urethra. The urologist removes pieces of prostate tissue using an electrical loop or laser energy to clear the blockage.

The procedure usually requires a short hospital stay. Most men notice a significant improvement in urinary flow within a few weeks. TURP remains an excellent and time-tested option. However, many men choose minimally invasive or laser procedures that can provide similar results with shorter recovery times and less risk of side effects.

Every man’s experience with BPH is different. The right approach depends on:

• Prostate size. Some procedures are better suited for smaller glands, while others are designed for very large prostates.
• Symptom severity. Mild cases may improve with medication, while more severe obstruction often requires a procedure.
• Certain health conditions or medications. A man’s overall health and the medication he takes can influence which treatments are safest.
• Personal priorities. Some men prefer the quickest recovery, while others focus on long-term results or preserving sexual function.

A urologist will review your symptoms and perform tests such as a PSA (prostate-specific antigen) blood test or imaging. They will guide you through the pros and cons of each option before creating a treatment plan.

1. Will treatment affect my ability to have sex?

Most modern therapies, such as UroLift and Rezūm, are designed to preserve sexual function. Some surgical procedures, like TURP or HoLEP, may cause retrograde ejaculation, a harmless condition where semen flows backward into the bladder instead of out through the penis. This doesn’t affect pleasure but can reduce fertility. Be sure to discuss your priorities with your doctor before choosing a treatment.

2. How long will the results last?

Results vary by treatment. Medications work only while you continue taking them. Minimally invasive or surgical procedures often provide results that last many years. Your urologist will recommend follow-up visits to monitor your prostate and ensure your treatment remains effective.