After a man reaches the age of 40, his prostate frequently begins to enlarge, a condition known as benign prostatic hyperplasia (BPH). The likelihood of developing BPH increases with age. Eventually about 80 percent of men have enlarged prostates, but only about half will experience difficulty urinating.

When BPH interferes with urine flow, however, some characteristic symptoms can include:

A slow, weak urinary stream

A sense of incomplete bladder emptying

Difficult starting urination

Frequent urination

Urgency (difficulty postponing urination)

Awakening frequently at night to urinate

Interruption of the stream (stopping and starting)

If you have bothersome BPH symptoms, you may decide with your doctor to choose treatment. Surgical resection of the prostate using a scope (TURP) is currently the most effective treatment. In addition, several minimally invasive techniques are available, including microwave therapy and TUNA treatment. Several medications are available to help relieve the symptoms of BPH. Although less effective than surgery, these medications have less risk.

TUMT - transurethral microwave therapy involves placing a probe into the urethra under local anesthesia. The probe sends microwaves into the prostatic tissue and causes heat damage. Several weeks after the procedure the prostate will shrink and allow easier passage of urine. This procedure is performed in the office.   While not quite as long lasting  as other procedures, it does have the benefit of being catheterless for 80% of patients and recovery is usuallly just 24 hrs. 

TUNA  -  transurethral needle ablation involves using a telescope into the urethra under local anesthesia.  The surgeon then engages needles which then conduct high intensity radiowaves through the needles, which heat up a small area around each needle.  This heated area then undergoes necrosis(cell death), which causes scarring.   Over the next several weeks the scarring causes retraction on the urethra through the prostate, which opens the urethra and allows urine to pass more readily.  A temporary catheter is required for 4-5 days, pain is limited and results are often very satisfactory.  This procedure is done in the office.