TL;DR Prostate treatment options depend on what is causing your symptoms, the size of your prostate, your cancer risk, and your personal treatment goals. Men with BPH may consider medications, minimally invasive treatments such as Rezum, UroLift or PAE, or surgical options including TURP, Aquablation and HoLEP. Men diagnosed with prostate cancer may be candidates for active surveillance, surgery, radiation, hormone therapy, or focal treatments such as HIFU, Echolaser, TPLA, or NanoKnife . At Urology Specialists of Austin, treatment is personalized to your diagnosis, anatomy, and priorities—including urinary relief, recovery time, and sexual function.
If you’re researching prostate treatment options, you may be dealing with frequent urination, weak urine flow, disrupted sleep, or concerns about prostate cancer. Understanding your choices can make it easier to have an informed conversation with your urologist.
At Urology Specialists of Austin, we believe prostate treatment should be personalized. The right option depends on what is causing your symptoms, the size of your prostate, your cancer risk when applicable, your overall health, and what matters most to you when it comes to recovery and side effects.
Understanding Your Prostate Treatment Options
Before choosing a treatment, it’s important to determine what is causing the problem. Two common prostate-related conditions are benign prostatic hyperplasia (BPH) and prostate cancer.
BPH is an enlarged prostate that is not cancerous. It can cause urinary symptoms such as a weak stream, frequent urination, difficulty starting urination, or getting up frequently at night.
A prostate cancer diagnosis requires a different approach. Treatment decisions may depend on biopsy results, PSA levels, MRI findings, Gleason score or Grade Group, cancer stage, and whether the cancer has spread.
A urologic evaluation may include a symptom assessment, PSA testing, physical examination, urine testing, ultrasound, MRI, cystoscopy, or prostate biopsy, depending on your individual situation.
Treatment Options for an Enlarged Prostate (BPH)
For men with BPH, medication is often an initial treatment option. Alpha blockers relax the prostate and bladder neck to improve urine flow, while 5-alpha reductase inhibitors can gradually reduce prostate size. Although medications can be effective, some men experience side effects such as dizziness, reduced sex drive, or changes in ejaculation.
When medication isn’t providing the relief you want, minimally invasive procedures may be considered.
Rezum uses steam to treat prostate tissue, allowing the prostate to shrink over time. UroLift uses small implants to move prostate tissue away from the urethra and can be an option for appropriately selected patients who want a minimally invasive treatment and quicker recovery.
Another option is prostate artery embolization (PAE). PAE reduces blood flow to the prostate, causing it to shrink over time. It can be particularly appealing to some men with larger prostates who want urinary symptom relief without traditional surgery.
For men who need more definitive treatment, surgical options include TURP, Aquablation, and HoLEP. TURP removes obstructing prostate tissue through the urethra. Aquablation uses a high-pressure water jet to remove prostate tissue, while HoLEP uses a laser to remove enlarged prostate tissue. These procedures can provide significant and lasting symptom relief, although ejaculation changes are an important consideration.
How Prostate Treatment Can Affect Sexual Function
Sexual side effects are an important part of choosing among prostate treatment options. Ejaculation and erections are not the same thing.
Some BPH treatments can cause retrograde ejaculation, meaning semen travels into the bladder instead of exiting through the penis. An orgasm may still occur, but little or no semen may be released.
For many men, preserving sexual function is a major treatment priority. Tell your urologist what matters most to you before deciding on a procedure.
Prostate Cancer Treatment Options
When prostate cancer is diagnosed, treatment depends on the cancer’s grade, stage, location, biopsy findings, imaging, and your overall health.
Some prostate cancers grow slowly and may be appropriate for active surveillance or watchful waiting rather than immediate treatment. Other cancers may require more active treatment, including surgery, radiation therapy, hormone therapy, or focal therapy in appropriately selected patients.
HIFU for Selected Prostate Cancer Patients
High-intensity focused ultrasound (HIFU) uses concentrated sound waves to heat and destroy targeted prostate tissue. Focal HIFU may be considered for certain men with localized prostate cancer, particularly when the cancer is confined to a specific area of the prostate.
The goal of focal treatment is to target cancer while preserving as much healthy prostate tissue as possible. However, HIFU is not appropriate for every patient. Cancer location, aggressiveness, and other individual factors must be considered when determining whether focal therapy is a reasonable option.
Finding the Right Prostate Treatment Option
There is no single prostate treatment that is right for every man. The best choice depends on your diagnosis, prostate size, symptoms, cancer risk, treatment goals, and priorities regarding sexual function and recovery.
If you are considering prostate treatment options, ask your urologist about both the short-term and long-term effects of each approach. Understanding your options can help you make a treatment decision that fits your health and your life.
At Urology Specialists of Austin, our urology team provides individualized evaluation and treatment for men experiencing prostate and urinary conditions. If you’re unsure which prostate treatment option is right for you, a comprehensive evaluation can help you understand your choices and determine the next step.
Frequently Asked Questions
What are the main prostate treatment options?
Treatment depends on whether you have BPH or prostate cancer. BPH treatment options include medication, Rezum, UroLift, PAE, TURP, Aquablation, and HoLEP. Prostate cancer treatment options may include active surveillance, surgery, radiation, hormone therapy, or focal therapy such as HIFU.
What is the best treatment for an enlarged prostate?
There is no single best treatment for every man. The right option depends on prostate size, urinary symptoms, previous treatments, overall health, and priorities such as preserving ejaculation or avoiding surgery.
Is prostate artery embolization (PAE) an option for BPH?
Yes. PAE can be an option for some men with enlarged prostates who want relief from urinary symptoms through a less invasive approach. During PAE, blood flow to the prostate is reduced, causing the prostate to shrink over time.
What prostate treatments have the quickest recovery?
Some minimally invasive treatments, including UroLift and PAE, may offer easier recovery than traditional surgery. However, recovery varies based on the procedure and the individual patient.
Can prostate treatment affect ejaculation?
Yes. Some BPH procedures can cause retrograde ejaculation, in which semen travels into the bladder rather than out through the penis. This is different from erectile dysfunction, and an orgasm may still occur.
What are the treatment options for prostate cancer?
Depending on the cancer’s grade, stage, biopsy findings, imaging, and other factors, options may include active surveillance, surgery, radiation therapy, hormone therapy, or focal therapy.
What is HIFU for prostate cancer?
HIFU, or high-intensity focused ultrasound, uses concentrated sound waves to heat and destroy targeted prostate tissue. It may be appropriate for selected men with localized prostate cancer, but it is not the right treatment for every patient.What is
NanoKnife for prostate cancer?
NanoKnife®, also known as irreversible electroporation (IRE), is a minimally invasive focal therapy that uses short electrical pulses to disrupt cancer cell membranes. Unlike HIFU, NanoKnife is a non-thermal treatment, meaning it does not rely on heat to destroy the targeted tissue. It is generally considered for carefully selected patients with localized prostate cancer.
What is TPLA prostate treatment?
TPLA, or transperineal laser ablation, is a focal therapy approach that uses laser energy to target and ablate prostate tissue. Like other focal therapies, the treatment is designed to focus on the targeted area while limiting treatment of surrounding healthy tissue. Whether TPLA is appropriate depends on factors such as cancer location, MRI findings, biopsy results, and overall treatment goals.
What is the difference between HIFU, NanoKnife, and TPLA?
All three are focal treatment approaches, but they use different types of energy. HIFU uses focused ultrasound energy and heat, NanoKnife uses electrical pulses through irreversible electroporation, and TPLA uses laser energy. The best option depends on the location and characteristics of the cancer, prostate anatomy, and the patient’s individual goals.
Can focal therapy preserve sexual and urinary function?
One of the goals of focal therapy is to treat the targeted cancer while limiting exposure to surrounding healthy tissue. This may help reduce the potential impact on urinary continence and erectile function compared with some whole-gland treatments. However, every treatment has potential risks, and outcomes vary by patient.
Is focal therapy an option for every man with prostate cancer?
No. Focal therapy is not appropriate for every prostate cancer patient. MRI findings, biopsy results, PSA levels, tumor location, cancer characteristics, and other factors are considered when determining whether a patient is a candidate.
Should I get a second opinion before choosing prostate treatment?
A second opinion can be helpful if you have already undergone previous procedures, have been told you need surgery, are concerned about side effects, or have been diagnosed with prostate cancer and want to understand your treatment options.