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Benign Prostatic Hyperplasia

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Benign Prostatic Hyperplasia

If you're suffering from an enlarged prostate, you're not alone. We will listen to your concerns, perform a thorough BPH evaluation, and partner with you to determine the best BPH treatment for YOU.

We help men spend less time in the bathroom, and more time doing the things they love. Get back control of your enlarged prostate with Pazona MD Urology.

Are you urinating too frequently? Standing at the urinal forever? Dribbling urine in your pants? You’re not alone. You may have Benign Prostatic Hyperplasia (BPH), a very common condition that can be fixed.

Whether you have just started experiencing symptoms or if you’ve tried various medications, our team at Pazona MD Urology in Nashville, Brentwood or Cookeville can help.

Our team specializes in giving you the BPH care you deserve.

We will listen to your concerns, perform a thorough BPH evaluation, and partner with you to determine the best BPH treatment for YOU.

If you’re experiencing symptoms of Benign Prostatic Hyperplasia, our urology practice in Nashville can help.

Schedule An Appointment

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You want your life back. Stop suffering from BPH symptoms.

You are in the prime of your life and a thriving career. You should be spending your days in happy productivity. Instead, you face the constant interruption of running back and forth to the restroom each day.

Perhaps you’ve reached retirement and now it’s time to kick back and enjoy life. However, instead of relaxation you find yourself constantly searching for the nearest men’s room.

For years you have noticed your urinary stream slowing and your frustration building because it takes so long to try and empty your bladder.

Exhaustion is a daily struggle. Instead of sleeping, you wake up to make frequent nighttime trips to the bathroom as well.

Sound familiar? You’re not alone.

Symptoms of an enlarged prostate (BPH) affect 40 million men and can begin at age 40. By age 60, there’s a 70% chance you’ll experience urinary difficulties due to BPH. Symptoms might include:

  • Slowing of your urinary stream
  • A sensation of not emptying your bladder
  • Strong urges to urinate with little warning
  • Going to the bathroom too frequently during the day
  • Waking up at night to urinate

There’s an abundance of information on the internet about “prostate health” but what does it all mean? And who can you trust? Will that prostate supplement from the infomercial actually work? What are the side effects from prescription medications? Is surgery going to affect my performance in the bedroom?

Our team of BPH experts at Pazona MD Urology in Nashville, Brentwood and Cookeville are here to help.

Let’s get you back in control of your prostate so you can get back to enjoying life.

Nashville’s Premier Benign Prostatic Hyperplasia Experts at Pazona MD Urology. We understand your frustrations.

You don’t need some urologist to rush you into surgery. You need someone who listens. Someone who is thorough. Someone who will develop the best plan of care for YOU.

If this does involve surgery, then rest assured that Dr. Pazona has expertise and experience with cutting edge Benign Prostatic Hyperplasia treatments being a Center of Excellence for The Urolift System and Robotic Aquablation.

The Urolift System Robotic Aquablation




But don't take our word for it. With over 1,000 five-star reviews in the Nashville region, Pazona MD Urology delivers an exceptional experience for BPH or any other urology concerns you may have.

Schedule An Appointment


WOULD YOU LIKE TO LEARN MORE ABOUT BPH? CLICK BELOW TO LEARN MORE FROM NASHVILLE’S BPH EXPERTS AT PAZONA MD UROLOGY.

Frequently Asked Questions

What is the prostate? add

The prostate is a male reproductive organ involved in the production and secretion of semen. It is located behind the pubic bone and sits just below the bladder. When a man urinates, the prostate is the first part of the urethra through which urine passes.

What is BPH? add

BPH or Benign Prostatic Hyperplasia, is a condition in which the prostate enlarges as men get older. As the prostate enlarges, it presses on and blocks the urethra, causing bothersome urinary symptoms such as:

  • Slowing of the urinary stream
  • Incomplete emptying of the bladder
  • Hesitancy when trying to start urinating
  • An intermittent urinary stream
  • Dribbling in your underwear when you thought you were finished

Is BPH related to prostate cancer? add

No. BPH is a benign, non-cancerous condition. Although both prostate cancer and BPH occur more frequently as men age, they are unrelated. Prostate cancer rarely causes any symptoms. This is why it is important that you screen for prostate cancer starting at age 50 or sooner if you have risk factors (e.g. family history, African American).

Our experts at Pazona MD Urology in Nashville can order a PSA blood test and perform a prostate exam (DRE - digital rectal exam), to ensure prostate cancer is not present.

How big is the prostate normally? add

Urologists measure the size of a prostate in grams. A normal size prostate is similar to a golf ball (20 g). In some cases a prostate may grow as large as a grapefruit (>100 g). Why one man’s prostate will grow bigger than another man’s is not entirely known. The male hormone testosterone and genetics likely play a key role.

What are the complications of BPH? add

While BPH is a benign condition and unrelated to prostate cancer, if left untreated, BPH can lead to serious issues. First, BPH may lead to permanent bladder damage where the bladder muscle is no longer capable of emptying urine (urinary retention). This requires a catheter or tube to be placed inside the urethra (penis) to help drain the urine. Other complications of BPH include:

  • Blood in the urine (hematuria)
  • Recurrent urinary tract infections
  • Bladder stones
  • Kidney blockage and damage

How do you diagnose BPH? add

Although a man may have an enlarged prostate, we diagnose BPH based on urinary symptoms. In other words your prostate may be physically “big”, but if you don’t have any bothersome urinary symptoms, then we wouldn’t necessarily recommend any evaluation or treatment.

You can measure the severity of your BPH symptoms by taking the International Prostate Symptom Score (IPSS) questionnaire. This provides a baseline assessment of your urine symptoms.

We recommend that you share this information with the BPH experts at Pazona MD Urology to help us better understand the severity of your symptoms.

I think I have BPH symptoms. What should I do? add

Your next step first depends on the severity of your symptoms. If you scored 8 or less on the IPSS questionnaire then you have mild BPH symptoms. You may want to consider lifestyle modifications (see below) to start. On the other hand if you have moderate to severe symptoms, then having an evaluation with a BPH expert like our team at Pazona MD Urology in Nashville, Brentwood, or Cookeville, will ensure that you get the care you deserve.

How can I treat BPH at home? add

Realize that not all urinary symptoms are due to BPH. The first thing you can do is examine how much and what types of fluids you drink. What goes in has to come out. Excess fluid intake (>2L per day) is the #1 cause of urinary frequency.

Beverages with caffeine, acid, sugar and alcohol (all the fun stuff) also produce more urine and irritate the bladder. Limiting these drinks can improve urinary symptoms as well.

Lastly, your other medical conditions might be playing a role. Untreated or poorly controlled diabetes and obstructive sleep apnea can both contribute to bothersome urinary symptoms.

Water pills for high blood pressure or heart issues also cause your kidneys to make more urine.

If you have any of these medical conditions, we recommend speaking to your primary care physician to see if any adjustments in medications can be made. Don’t ever stop taking these medications without consulting with your doctor first.

Is there a prostate friendly diet? add

A prostate healthy diet looks remarkably similar to a heart healthy diet. It should focus on the following foods:

  • Fruits and vegetables with high levels of antioxidants (e.g. tomatoes, berries, broccoli)
  • Lean proteins including fish with omega-3 fatty acids (e.g. salmon)
  • Legumes (e.g. beans, lentils) and nuts
  • Olive oil, avocados

This diet is primarily recommended for the prevention of prostate cancer. Nonetheless, these foods can minimize inflammation in your body and may help BPH symptoms.

Do you recommend any prostate supplements? add

You’ve seen them on TV and at your local pharmacy. 'Super Beta Prostate' and other 'natural' remedies to help men with enlarged prostates. Prostate supplements have been used to treat BPH symptoms for many years. Some of these supplements include:

  • Saw Palmetto
  • Pygeum Africanum
  • Selenium
  • Lycopene
  • ß-Sitosterol

Unfortunately most studies involving these supplements were poorly designed. Therefore it is difficult to make treatment recommendations about these compounds. In my experience, some men with mild symptoms may see a benefit when taking a prostate health supplement. However, nutritional supplements are not regulated by the FDA in the same rigorous fashion as prescription medications. Please use caution if you choose to take any of these supplements.

Are there prescription medications for BPH? add

Yes. There are several classes of medications that can be used to improve BPH symptoms.

Alpha blockers (e.g. tamsulosin): These medications act by relaxing the smooth muscle of the prostate which in turn relieves the blockage of the bladder. Although some men do well on these medications, there are possible side effects. These include:

  • Stuffy nose
  • Dizziness
  • Decreased ejaculation
  • Erectile dysfunction
  • Possible association with dementia

5-alpha reductase inhibitors (e.g. finasteride): are a different class of medications that aim to shrink the physical size of the prostate. Although theoretically this makes sense, these medications usually do not make significant improvements to a man’s urinary stream or quality of life. They also can have sexual side effects that are sometimes permanent.

Tadalafil: normally used for erectile dysfunction (ED), this generic version of Cialis can be prescribed on a daily basis to improve urinary symptoms. It can lead to headaches, backaches and changes in vision.

Our BPH experts at Pazona MD Urology can help you determine if a medication is right for you.

What BPH testing do you perform at Pazona MD Urology? add

An evaluation always starts with a thorough history. Next we will perform the following tests:

  • Digital rectal exam to rule out prostate nodules (a sign of prostate cancer).
  • Urinalysis to rule out blood in the urine or a urinary tract infection.
  • Pelvic ultrasound to measure the size of the prostate and amount of urine left in the bladder.

Depending on the severity of the urinary symptoms and above testing, we may then recommend a follow up visit to perform:

  • Bladder pressure study (Urocuff) to measure the flow of urine and the health of the bladder.
  • Cystoscopy - a direct visualization of the urethra, prostate and bladder with a sterile camera scope.

Do you have to perform a cystoscopy? I hear it hurts! add

A cystoscopy is necessary in select men to ensure the following:

  • Rule out more serious medical conditions like bladder cancer.
  • Assess if any permanent bladder damage has occurred due to BPH.
  • Better assess the size and shape of the prostate internally to determine the best surgical option for your BPH.

At Pazona MD Urology we offer lidocaine jelly and nitrous oxide (laughing gas) to make the cystoscopy experience less painful. The exam is usually completed in the office in less than 2 minutes.

What are the BPH surgical treatment options? add

At the moment there are over 10 surgical procedures that can be performed for BPH. These include: Minimally invasive surgical therapies typically performed in the office or as an outpatient:

  • Urolift
  • Rezum
  • iTind
  • Optilume
  • Transurethral incision of the prostate (TUIP)

Transurethral ablation procedures performed in a hospital or surgery center to remove BPH tissue:

  • Transurethral resection of the prostate (TURP)
  • Laser ablation of the prostate (Greenlight or Holmium laser)
  • Laser enucleation of the prostate (HoLEP)
  • Robotic aquablation

Simple prostatectomy performed with an abdominal incision with or without the aid of a robotic surgical system. This involves removal of the BPH portion of the prostate.

Prostatic artery embolization (PAE): a procedure performed by an interventional radiologist to selectively occlude or stop blood flow to the prostate so it shrinks.

How do I decide what BPH surgical therapy is best for me? add

Deciding on the best BPH surgery or treatment can be confusing. There is a lot of misinformation and bias in treatments. That’s why our trusted team of BPH experts at Pazona MD Urology are here to guide you to the best BPH therapy for you. Allow us to complete a thorough BPH evaluation and then we can personalize the BPH therapy for you.

What BPH surgical therapies do you offer at Pazona MD Urology? add

Dr. Pazona’s philosophy as a surgeon is to only perform the best surgeries for patients. With over 10 options for treating your BPH, it’s not possible for any surgeon to be an 'expert' in all surgeries. Instead Dr. Pazona has focused on two of the better options available for treating BPH: the Urolift system and Robotic aquablation.

We are constantly evaluating all of the BPH options available and can help guide you to the best therapy.