Specialty
Prostate Care: Enlarged Prostate & Prostate Cancer
In brief
The prostate is a gland below the bladder that commonly enlarges with age and can be affected by cancer. Most prostate problems can be treated effectively — from medication and minimally invasive procedures such as Rezūm and UroLift, to TURP and, for prostate cancer, robotic surgery.
Medically reviewed by Dr. Atip Chatsudthipong, MD on
Written by Editorial teamPublished Updated
What are the most common prostate problems?
- Benign prostatic hyperplasia (BPH) — non-cancerous enlargement that can cause a weak stream, frequency and getting up at night. It is very common from middle age onwards.
- Prostate cancer — often found through PSA testing before it causes symptoms. Many cancers grow slowly; others need treatment.
- Prostatitis — inflammation or infection of the prostate, which can cause pain and urinary symptoms.
Urinary symptoms are not specific to one condition, so an accurate assessment comes first — usually a history, symptom score, urine test, and, where appropriate, a PSA test, ultrasound and urine-flow measurement.
What treatments are available for an enlarged prostate?
Treatment is guided by how bothersome your symptoms are, the size and shape of your prostate, any complications, and your priorities — including the preservation of sexual function. Options range from lifestyle changes and medication to minimally invasive procedures and surgery.
| Rezūm water vapour therapy | UroLift | TURP | |
|---|---|---|---|
| How it works | Steam injected into the prostate; treated tissue is reabsorbed over weeks to months | Small implants hold the enlarged lobes apart | Obstructing tissue is removed through the urethra with an electrical loop |
| Typical prostate size | About 30–80 g | Up to about 100 g (certain shapes excluded) | About 30–80 g |
| Anaesthesia | Local or sedation | Local or sedation | Spinal or general |
| Catheter afterwards | Usually a few days | Often none | Usually 1–3 days |
| When improvement is felt | Gradually, over about 2–12 weeks | Within about 2 weeks | Within a few weeks |
| Ejaculation | Usually preserved | Usually preserved | Most men have retrograde (dry) ejaculation |
| Durability | Low retreatment rate over 5 years in trials | Some men need further treatment in later years | Long track record; most durable relief |
No single procedure is best for everyone. Minimally invasive options suit many men who wish to avoid long-term medication or preserve ejaculation; TURP and laser procedures remain the most effective for larger or more obstructive prostates. Read the full comparison: Rezūm vs TURP.
How is prostate cancer diagnosed and treated?
A raised PSA or abnormal examination is usually followed by a prostate MRI and, if needed, an MRI-fusion targeted biopsy, which samples suspicious areas precisely. Treatment then depends on the cancer's risk group: options include active surveillance for lower-risk cancers, robotic prostatectomy, and radiation therapy. Learn more about prostate cancer and understanding your PSA test.
When should you see a urologist about your prostate?
- Urinary symptoms that affect your sleep, work or quality of life
- Blood in the urine or semen
- Recurrent urinary infections or difficulty emptying your bladder
- A raised or rising PSA result
Seek emergency care if you:
- Suddenly cannot pass urine
- Have fever and chills with urinary symptoms
How Dr. Atip can help
The prostate is one of Dr. Atip's three core areas of practice. He treats enlarged prostate with medication, minimally invasive Rezūm and UroLift, and TURP; routinely performs MRI-fusion prostate biopsy, and performs robotic prostatectomy for prostate cancer at Bumrungrad International Hospital. He will explain the realistic benefits and side effects of each option and help you choose the approach that fits your goals.
Frequently asked questions
Is an enlarged prostate the same as prostate cancer?
No. Benign prostatic hyperplasia (BPH) is non-cancerous and does not turn into cancer. However, both are common in older men and can occur together, which is why assessment may include a PSA test.
Which enlarged prostate treatment is best?
There is no single best treatment. The right choice depends on prostate size and shape, symptom severity, other health conditions and your priorities, such as avoiding a catheter or preserving ejaculation. A urologist can explain the trade-offs for your situation.
Do minimally invasive prostate treatments affect sexual function?
Rezūm and UroLift are designed to preserve erectile and ejaculatory function, and most men notice no lasting change. TURP commonly causes retrograde (dry) ejaculation but rarely affects erections.
References
- 1.Lerner LB, et al. Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: AUA Guideline Part I — Initial Work-up and Medical Management. J Urol. 2021;206(4):806–817. (opens in a new tab)
- 2.Lerner LB, et al. Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: AUA Guideline Part II — Surgical Evaluation and Treatment. J Urol. 2021;206(4):818–826. (opens in a new tab)
- 3.Sandhu JS, et al. Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia (BPH): AUA Guideline Amendment 2023. J Urol. 2024;211(1):11–19. (opens in a new tab)
- 4.McVary KT, et al. Final 5-Year Outcomes of the Multicenter Randomized Sham-Controlled Trial of a Water Vapor Thermal Therapy for Treatment of Moderate to Severe Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia. J Urol. 2021;206(3):715–724. (opens in a new tab)
- 5.Roehrborn CG, et al. The Prostatic Urethral Lift for the Treatment of Lower Urinary Tract Symptoms Associated with Prostate Enlargement Due to Benign Prostatic Hyperplasia: The L.I.F.T. Study. J Urol. 2013;190(6):2161–2167. (opens in a new tab)
- 6.European Association of Urology. EAU Guidelines on Management of Non-neurogenic Male LUTS. (opens in a new tab)
- 7.Eastham JA, et al. Clinically Localized Prostate Cancer: AUA/ASTRO Guideline, Part I — Introduction, Risk Assessment, Staging, and Risk-Based Management. J Urol. 2022;208(1):10–18. (opens in a new tab)
This information is for general education and does not replace a consultation with a qualified doctor. If you have severe symptoms, seek emergency care (in Thailand, call 1669). See our medical disclaimer.