Prostate Issues

As men age, prostate issues, including benign prostatic hyperplasia (BPH) and prostate cancer, increase.

Houston Methodist’s physicians and staff are committed to offering the most advanced approaches to preventing, diagnosing and treating prostate conditions.

Symptoms of Prostate Conditions 

The prostate is a walnut-shaped gland under a man’s bladder. The urethra, the tube that carries urine from the bladder out of the body, passes through the prostate to the penis. A growth spurt occurs in the urethra during puberty. A second growth spurt can occur around age 50.

During the second growth spurt, an enlarged prostate can block urine flow through the urethra similar to a clamp around a garden hose, a condition known as an enlarged prostate or benign prostatic hyperplasia (BPH). As the bladder fights to pass urine through the blocked urethra, the bladder wall thickens, causing symptoms, including:
  • Increased urination frequency
  • Weak stream
  • Start-and-stop flow
  • Incomplete emptying

Diagnosis and Treatment of Prostate Conditions 

BPH is common in men at least 50 years old. Not all men with BPH experience symptoms. If symptoms become a problem, most cases can be treated through lifestyle changes, medicine and, in some cases, surgery.

Tests that identify BPH causes and best treatment courses include:

Digital rectal exam (DRE) — should be a part of an annual exam and may be done between checkups if your doctor suspects a prostate problem. The doctor inserts a gloved, lubricated finger in the lower part of your rectum to feel the prostate and check for enlargement.

Prostate-specific antigen (PSA) blood test — measures blood levels of prostate-specific antigen (PSA), a substance the prostate makes. An increased amount may indicate prostate cancer.

Urine flow study — measures urine flow speed as you urinate in a special device. Slow speed could indicate BPH.

Cystoscopy — more accurately checks prostate size and collects more obstruction information. After giving you a local anesthetic, your doctor will insert a small tube called a cystoscope through the urethra opening in the penis. The tube contains a lens and light that allow your physician to see in the urethra and bladder.

A mild case of BPH may require lifestyle changes, including:
  • Urinating when you first get the urge
  • Urinating regularly throughout the day, whether you have the urge
  • Avoiding alcohol and caffeine
  • Spreading fluid intake throughout the day and limiting fluids at night
  • Avoiding medicines containing decongestants or antihistamines
  • Reducing stress
Medicines such as finasteride and dutasteride can inhibit production of hormones involved with prostate enlargement, preventing further prostate growth. Alpha 1 blockers such as terazosin, doxazosin, tamsulosin and alfuzosin can relax prostate and bladder neck muscles to improve urination.

Antibiotics also may be prescribed to treat chronic prostatitis (prostate inflammation) that sometimes accompanies BPH.

Your doctor may discuss surgical options to remove obstructing prostate tissue if medicines don’t work. Until recently, the only surgical option was transurethral resection of the prostate (TURP), in which a resectoscope and loop, similar to a hot wire, were used to remove enlarged tissue. Though effective, TURP often requires a 24- to 48-hour hospital stay and a longer catheterization period. Laser surgery now is a more favorable option.

In 2007, Houston Methodist Hospital became the first Texas Medical Center institution to offer GreenLight™XPS™ laser therapy, the most advanced enlarged prostate treatment available. GreenLight XPS transmits energy through a small fiber inserted into the urethra using a cystoscope. The laser superheats targeted prostate tissue and vaporizes it, creating a channel for urine to flow more freely. 

This procedure is minimally invasive and quicker than TURP. Many patients can go home without a catheter the same day. Most see immediate urine flow improvement.


Rezūm Water Vapor Therapy is a minimally invasive, in-office procedure that preserves sexual function while using the natural energy stored in water vapor (or steam) to effectively treat BPH. With this treatment, there are no incisions, no general anesthesia and most patients return to regular activities within a few days.

Prostate Cancer 

Prostate cancer is the most common non-skin cancer among men in the United States, particularly for men older than 50. Risk factors include:
  • Being at least age 65
  • A family history of prostate cancer
  • Having a high-grade prostatic intraepithelial neoplasia (PIN), or prostate cells that look abnormal under a microscope
  • Having certain genome changes
At Houston Methodist, your oncology team is committed to offering you the most advanced cancer treatments available. Our services include established approaches, as well as innovative treatments.