By Dr. Rich Bevan-Thomas, M.D., Urologic Surgeon and Partner at Urology Partners of North Texas
For many men, the first signs of an enlarged prostate — getting up at night to urinate, weak stream, or sudden urgency — feel like just another part of getting older. And for years, the idea of prostate surgery brought fear of long recoveries, catheters, or even complications.
But those days are gone. Advances in urologic surgery have completely changed how benign prostatic hyperplasia (BPH) — or enlarged prostate — is treated.
Today, men have options that are faster, safer, and far more precise than ever before.
What Really Happens with BPH
BPH is one of the most common conditions men face as they age. The prostate, which sits just below the bladder, gradually enlarges and begins to squeeze the urethra — the channel that carries urine out of the body.
The result: slow stream, dribbling, frequent urination, and that never-quite-empty feeling after using the bathroom. While medications can sometimes help, they often lose effectiveness over time or cause side effects like dizziness or fatigue.
That’s when it’s time to consider a procedure — but today’s options look nothing like the surgeries of the past.
The “Roto-Rooter” Days
For decades, the standard surgical treatment for BPH was the TURP, or transurethral resection of the prostate. The procedure worked, but it earned a memorable nickname: the “Roto-Rooter job.”
That’s because surgeons would insert a scope through the urethra and literally “core out” the inside of the prostate to relieve the blockage — much like the Roto-Rooter company clearing a clogged pipe.
The TURP was effective but came with drawbacks: hospital stays, bleeding, catheter time, and longer recovery. It was a major operation for a problem that most men just wanted fixed quickly and safely.
A New Generation of Procedures
Fortunately, the field has come a long way. Today’s urologists use minimally invasive techniques that restore urinary flow without the cutting or recovery time once required.
Among the most advanced options are:
- UroLift®: Works like tie-backs on a curtain, gently pulling back the enlarged prostate tissue to open the channel and allow urine to flow freely again. It’s an excellent choice for men with small to medium-sized prostates, particularly those who want a quick procedure and minimal downtime.
- Aquablation®: Uses a robotic-controlled water jet guided by real-time ultrasound to remove only the tissue causing blockage. Aquablation is best suited for medium to large prostates, combining precision with excellent long-term results.
- Prostate Artery Embolization (PAE): A minimally invasive procedure performed by an interventional radiologist. Tiny particles are injected into the arteries that feed the prostate, reducing blood flow and gradually shrinking the gland — ideal for medium to large prostates, especially for men who are not good surgical candidates.
- Robotic Simple Prostatectomy: The most advanced option for large to extra-large prostates. Robotic instruments and a high-definition 3D camera allow surgeons to remove the obstructing portion of the gland with unmatched precision while protecting surrounding nerves and tissues.
Each of these procedures achieves the same goal as the old TURP — restoring flow — but with far less bleeding, discomfort, and recovery time.
The Rise of Robotic Precision
The robotic simple prostatectomy has revolutionized care for men with extremely large prostates (often over 100 grams). Using robotic instruments and magnified 3D imaging, surgeons can operate with extraordinary precision and visualization.
“Robotic surgery allows us to treat very large prostates with incredible accuracy while minimizing blood loss, pain, and recovery time,” says Dr. Rich Bevan-Thomas, a urologic surgeon and partner at Urology Partners of North Texas. “Most men are able to go home the next day and experience significant improvement in their symptoms within weeks.”
Compared to traditional open surgery, the robotic approach typically means smaller incisions, less bleeding, shorter catheter time, and faster return to normal activities.
Matching Treatment to Anatomy
Perhaps the most important factor in choosing the right BPH treatment is understanding the anatomy. The size and shape of each man’s prostate determine which procedure will deliver the best outcome.
“The prostate’s anatomy really dictates what we can do to get the best response,” Dr. Bevan-Thomas explains. “UroLift is excellent for smaller glands, Aquablation and PAE work beautifully for medium or large ones, and robotic surgery gives us the best results in very large prostates. It’s about precision and personalizing the plan to the patient.”
This anatomy-based approach ensures that every man receives treatment tailored to his unique situation — maximizing success and minimizing side effects.
Recovery and Results
No matter which option is used, today’s BPH treatments can dramatically improve quality of life. Most men experience:
- Stronger urine stream and better bladder emptying
- Fewer nighttime trips to the bathroom
- Less urgency and dribbling
- Improved confidence and energy
For most patients, recovery is quick — and results last for years.
The Takeaway
BPH surgery today is nothing like the old “Roto-Rooter” days. With advanced, minimally invasive technologies, men now have customized options to match their anatomy, lifestyle, and goals.
For men in the Dallas–Fort Worth area seeking advanced options for enlarged prostate treatment, the physicians at Urology Partners of North Texas offer a full range of minimally invasive procedures — including UroLift, Aquablation, PAE, and robotic simple prostatectomy — designed to help men get back to living without the constant interruptions of BPH.
To learn more, visit Urology Partners of North Texas.
