Benign Prostatic Hyperplasia (BPH)

What is Benign Prostatic Hyperplasia (BPH)?

PAD treatments

The prostate is an organ of the male reproductive system, normally about the size of a walnut, that surrounds the urethra. In older men, the prostate can become enlarged, exerting pressure on the urethra and causing difficulties with urination and other symptoms that can negatively impact one’s quality of life.

This condition, Enlarged Prostate, or Benign Prostatic Hyperplasia (BPH), affects more than 50-60% of men in their sixties, 70-80% of men in their seventies, and 90% of men age 80 or older. Although the enlarged tissue in the prostate is non-cancerous, it can obstruct the lower urinary tract and cause a variety of issues.


  • Weak or interrupted urination
  • Difficulty starting or controlling urination
  • Sudden, urgent needs to urinate
  • Increased frequency of urination, especially at night

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How is Benign Prostatic Hyperplasia (BPH) treated?

In the past, many of the treatments available to men with BPH have been surgical in nature.

We prefer a safer, non-surgical alternative to BPH treatment called Prostate Artery Embolization, or PAE. The is a minimally invasive procedure, requires no general anesthesia, and is performed in our office-based laboratory on an outpatient basis, so there is no need for hospitalization. PAE has extremely low complication rates, with no reports of negative effects on sexual function. The procedure itself is so gentle that it requires almost no recovery time, and patients often report symptom relief within two to three weeks.

BPH Treatment


Prostate Artery Embolization (PAE)

PAE is performed under light sedation. After numbing the area with a local anesthetic, we insert a microcatheter into a tiny incision in the femoral artery. Then, using advanced imaging technologies, we guide it to the artery that supplies the prostate with blood. Once the catheter is in place, we inject small microspheres into the artery to block it, which causes the abnormal growth to shrink, soften and become absorbed into surrounding tissue.

Patients typically report relief from their negative symptoms within two to four weeks.


Watch a comprehensive educational video about how the PAE procedure is done.


These procedures are done with moderate sedation at our facility and recovery time is minimal. A closure device is used to seal your artery which decreases recovery time and can cause some bruising or soreness at the access site.


  • What makes my prostate grow?

    Enlargement of the prostate is called Benign Prostatic Hyperplasia (BPH). It occurs when the cells of the prostate gland begin to multiply. These additional cells cause your prostate gland to swell, which squeezes the urethra and limits the flow of urine.

  • How common is BPH?

    BPH is very common. About half of all men between ages 51 and 60 have BPH. Up to 90% of men over age 80 have it.

  • What causes BPH?

    Doctors aren’t sure exactly what makes this happen. Some think it may have to do with normal hormonal changes as you age, but it’s not clear.

    Common signs and symptoms of BPH include:

    • Frequent or urgent need to urinate
    • Increased frequency of urination at night (nocturia)
    • Difficulty starting urination
    • Weak urine stream or a urine flow that stops and starts
    • Dribbling at the end of urination
    • Inability to completely empty the bladder
    • Erectile dysfunction
  • What can I do if I’m having these symptoms?

    In some cases, especially where symptoms are mild, BPH requires no treatment. When treatment is necessary, many men will simply require daily medication(s). If this fails to completely treat the prostate enlargement symptoms, or if there are signs of damage from BPH, the doctor may recommend endoscopic surgery through the penis or traditional surgery to treat BPH.

    In contrast, prostate artery embolization is a minimally invasive outpatient procedure performed through a small needle puncture in the wrist or hip area. Nothing is inserted in the penis. (A collective sigh of relief, yes?)

  • How is BPH diagnosed?

    Your doctor may evaluate your condition by asking you questions about the severity and type of symptoms you have and how much of an impact they have on your daily routine. Other tests to detect BPH symptoms such as urine flow study, prostate-specific antigen (PSA) blood test, ultrasound or prostate MRI may be used to confirm the diagnosis or to rule out other digestive and kidney diseases. It is always a good idea to contact us, even with mild or moderate symptoms to see what exactly is going on.

  • What treatments are there for BPH?

    There are several treatment options for an enlarged prostate gland or symptomatic BPH depending on severity of the symptoms. Most men start with medications. Some of these have side effects. If the symptoms persist and the prostate enlarges or the patient can’t tolerate the medications, urologic procedures can be performed. Transurethral Resection of the Prostate (TURP) is considered the “gold standard” procedure. This device is inserted through the penis and the offending portion of the prostate is removed. This way, you won’t need major prostate surgery to relieve symptoms.

    Most patients who are candidates for a TURP as a treatment for BPH could also benefit from a less invasive prostate artery embolization procedure (PAE).

  • Can I do anything to prevent BPH?

    Lifestyle changes can’t prevent BPH, but they may still be good for your prostate. For starters, exercise and a heart-healthy diet can help manage your weight, which is great for your prostate. Exercise also helps your bladder empty at a normal rate.

  • Is BPH linked to bladder cancer?

    There is potential for Benign Prostatic Hyperplasia (BPH) to lead to bladder cancer, as urinary retention can lead to worse issues like cancer in the bladder. Even mild symptoms should be discussed with your doctor, so that potential problems can be identified early and treated.

  • Is BPH linked to prostate cancer?

    There is a chance that BPH can lead to prostate cancer. As always, you should always visit your doctor when you are experiencing painful lower urinary tract symptoms, so the cause can be found and treatment options can be discussed.

  • Can You Explain Why You Use PAE to Treat BPH?

    At ECCO Medical, we offer prostate artery embolization (PAE) as a treatment for frequent urination caused by benign prostatic hyperplasia (BPH). PAE is one of the best BPH treatment options for an enlarged prostate gland. Most patients will have tried medications first, such as an alpha blocker. However, these medications can have side effects such as sexual dysfunction, dry mouth and dizziness.

    As the prostate enlarges, it puts pressure on the urinary tract making it difficult to urinate. This can lead to frequent urination in the day or night, and it can even lead to urinary tract infections. Urinary urgency, a weak stream and incontinence are common urinary symptoms associated with benign prostatic hyperplasia. PAE is a minimally invasive procedure that shrinks the previously enlarged excess prostate tissue, relieving many of the bothersome urinary issues.

    Prostate artery embolization is a minimally invasive procedure performed in an outpatient center. There are no incisions, and nothing is inserted into the penis. This leads to a quicker and less painful recovery compared with the surgical options such as TURP. Dr. Kovaleski has been treating Prostates with PAE in Colorado for nearly a decade. The procedural expertise at ECCO Medical is unmatched in Colorado and the Rocky Mountain Region.

ECCO offers a safer, non-surgical option for BPH with no risk of impotence or incontinence, proven to be as effective as surgery.