An enlarged prostate (benign prostatic hyperplasia, or BPH) is one of the most common conditions affecting men over 50. It can cause bothersome urinary symptoms including poor flow, frequent trips to the bathroom, difficulty starting or stopping, and incomplete emptying. A range of minimally invasive treatments is now available that can relieve these symptoms with minimal disruption to daily life.
TREATMENTS
Minimally Invasive Surgical Treatments (MIST) for Benign Prostatic Hyperplasia (BPH)
Understanding Prostate Enlargement
BPH is not cancer, but it can significantly affect quality of life. The degree of symptom burden and prostate size vary widely between patients, and so does the most appropriate treatment:
Mild to moderate symptoms may be well managed with medication
Patients who cannot tolerate, or prefer to avoid, long-term medication may benefit from a procedural approach
MIST procedures typically achieve around a 50% improvement in symptom scores while preserving existing sexual function, including ejaculation, in most men
Symptom relief with MIST may be less durable than TURP or laser surgery, and some men will need further treatment after ~ 5 years
Very large prostates, or those with specific anatomical features, may be better suited to certain procedures
Treatment Options
UroLift: Small implants hold the prostate lobes apart to open the urinary channel — no tissue removal, no heat, and a good profile for preserving ejaculatory function.
Rezūm Water Vapour Therapy: Controlled steam energy is delivered directly into prostate tissue, causing it to shrink over several weeks. Suitable for a range of prostate sizes and anatomies.
iTind: A temporary implantable device that reshapes the prostatic urethra. The device is left in place for 5–7 days before being removed.
Prostate Artery Embolisation (PAE): A radiological (non-surgical) procedure that places tiny particles into the arteries supplying the prostate, reducing blood flow and causing the prostate to shrink. Performed by an interventional radiologist through the wrist or groin. It has a small ~2–3% risk of sexual side effects.
Optilume: A drug covered balloon used to expand narrowing in the urinary tract that can also be applied to the prostate. Longer term data is still pending.
Risks and Considerations
All procedures carry risks, which your surgeon will discuss with you in detail. These may include:
Temporary burning, frequency, urgency and blood in the urine for days to weeks
Urinary tract infection
A temporary catheter, depending on the treatment and prostate size
The possibility of retreatment in future years
Recovery at a glance: Most options are day procedures; irritative urinary symptoms typically settle over 2–6 weeks.
1
Symptom Review and Assessment
A detailed assessment of your urinary symptoms, flow rate and bladder emptying is the first-line investigation. Ultrasound or MRI may be used to measure prostate size, combined with cystoscopy to examine your specific anatomy — including lateral or median lobes and prostatic urethral length — to help determine which treatment may suit you.
2
Individualised Treatment Selection
Your surgeon will discuss all available options, taking into account your symptom profile, prostate anatomy, sexual function priorities, and overall health.
3
MIST Procedure
Treatment is usually a day procedure, with a possible short-term catheter depending on the treatment and prostate size. The first weeks can bring irritative symptoms (frequency, burning) and some blood in the urine, which steadily improve. You will have a management plan for these symptoms that may include medications.
4
Outcome Monitoring
Symptom scores and flow rates are reassessed after treatment to confirm improvement and guide any further management.
Our Approach
