Last updated on May 14, 2026
Struggling with frequent urination, a weak stream or disrupted sleep, and not sure what’s behind it? At Vein Doctors Sydney, we regularly see men seeking minimally invasive treatment options for an enlarged prostate. Prostate artery embolisation (PAE) offers a minimally invasive alternative to help manage symptoms.
In this latest blog, we explain what an enlarged prostate is, the symptoms to watch for, what causes it and the treatment options available to help you manage your condition.
What Is an Enlarged Prostate (BPH)?
Benign prostatic hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland. It is one of the most common conditions affecting men over 50, and while it is not life-threatening, it can significantly impact daily life if left unmanaged. BPH is not related to prostate cancer, though both conditions can cause similar urinary symptoms.
Key facts about BPH:
- Affects the prostate gland, which sits just below the bladder
- As the prostate enlarges, it can press on the urethra and restrict urine flow
- Leads to a range of urinary symptoms that tend to worsen over time if untreated
Common Enlarged Prostate (BPH) Symptoms
BPH symptoms can develop gradually and are often dismissed as a normal part of ageing.
Urinary Symptoms
- Frequent urination, particularly at night (nocturia)
- A sudden and urgent need to urinate
- A weak or interrupted urine stream
- Difficulty starting urination despite feeling the urge
Bladder Emptying Issues
- A sensation that the bladder has not fully emptied after urination
- Dribbling at the end of urination
Advanced Symptoms
- Urinary retention, where urination becomes difficult or impossible
- Increased susceptibility to urinary tract infections as a result of incomplete bladder emptying
Causes of an enlarged prostate include hormonal changes, ageing and genetics.
What Causes an Enlarged Prostate?
The exact cause of BPH is not fully understood, but several factors are known to contribute to its development:
Hormonal changes
As men age, shifts in the balance of testosterone and dihydrotestosterone (DHT) are thought to stimulate prostate cell growth. DHT in particular plays a significant role in prostate enlargement, as it binds to receptors in the prostate and encourages tissue to grow beyond its normal size. This is why some medications used to treat BPH work by targeting and reducing DHT levels in the body.
Ageing
BPH is closely associated with age and is considered a natural part of the ageing process for many men. It is rare in men under 40 but becomes increasingly common from the 50s onwards, with the majority of men experiencing some degree of prostate enlargement by their 70s. While not all men with an enlarged prostate will develop noticeable symptoms, the likelihood increases as the gland continues to grow over time.
Genetics
A family history of BPH increases the likelihood of developing the condition. If a close male relative, such as a father or brother, has had BPH, your own risk may be higher. Men with a strong family history may also develop symptoms at an earlier age, making it worth monitoring prostate health from their 40s onwards.
Treatment options for an enlarged prostate include lifestyle changes, medications and surgical options such as prostate artery embolisation.
When Should You See a Doctor?
While BPH symptoms can be easy to brush off, there are circumstances where seeking medical advice promptly is important. You should consider seeing a doctor if you are experiencing:
- Frequent urination that is disrupting your sleep or daily routine
- Difficulty starting urination or maintaining a consistent stream
- Pain or discomfort when urinating
- A sudden and complete inability to urinate, which requires urgent medical attention
- Recurrent urinary tract infections
Early assessment means more treatment options and a better chance of managing symptoms before they significantly affect your quality of life.
How is BPH diagnosed?
If your doctor suspects BPH, they will likely recommend one or more of the following:
PSA Blood Test
A prostate-specific antigen (PSA) test measures a protein produced by the prostate. While elevated PSA levels can indicate BPH, they can also signal other conditions, including prostate cancer, so results are always assessed alongside other findings.
Ultrasound
An ultrasound scan can assess the size of the prostate and identify any abnormalities. It can also be used to measure the amount of urine remaining in the bladder after urination.
Urine Flow Tests
Also known as uroflowmetry, these tests measure the speed and volume of urine flow to assess how effectively the bladder is emptying and where any obstruction may be occurring.
Enlarged Prostate Treatment Options
Treatment for BPH depends on factors such as the severity of your symptoms and your overall health. Options range from simple lifestyle adjustments to minimally invasive procedures and surgery.
Lifestyle Changes
For mild symptoms, lifestyle modifications can be sufficient. These include managing fluid intake, particularly in the evenings and reducing caffeine and alcohol intake, both of which can irritate the bladder and increase urinary urgency.
Medications
Alpha blockers
Works by relaxing the muscles of the prostate and bladder neck, making it easier to urinate. Alpha blockers typically provide relatively quick symptom relief, but do not reduce the size of the prostate.
Hormone-related medications
Hormone-related medications such as 5-alpha reductase inhibitors, for example, work by reducing DHT levels, which can gradually shrink the prostate over time. They are often used in combination with alpha blockers for men with more significant enlargement.
Surgical Options
TURP (transurethral resection of the prostate)
One of the most common surgical procedures for BPH. It involves removing part of the prostate tissue through the urethra using a specialised instrument. While effective, it carries risks including bleeding, infection and sexual side effects.
Laser surgery
Laser surgery uses focused laser energy to remove or destroy excess prostate tissue. It is associated with less bleeding than traditional TURP and may be suitable for men on blood-thinning medications.
Prostate Artery Embolisation (PAE)
Prostate artery embolisation is offered at Vein Doctors Sydney and is a minimally invasive procedure performed by Dr Ryan McConnell. The procedure works by reducing blood supply to the prostate gland, causing it to gradually shrink over time and relieving the pressure it places on the urethra.
How it works
A thin catheter is guided through a small puncture in the skin to the arteries supplying the prostate. Tiny embolic particles are then delivered through the catheter to block blood flow to the enlarged tissue. The procedure is performed under local anaesthesia with sedation and does not require open surgery.
Key benefits of PAE include:
- No major surgery or general anaesthesia required
- Recovery times can vary, but patients often resume normal activities within a few days
- Often completed as a day procedure
- May be an option for men who are not suitable candidates for surgery
PAE is not appropriate for every patient, and a comprehensive assessme
How to Book an Appointment
At Vein Doctors Sydney, we are committed to providing comprehensive consultations and support for patients seeking treatment for an enlarged prostate. For more information on our services or to schedule a consultation at our clinic, please contact our staff by calling us on (02) 9023 9970, via our online form or by sending us an email.
Frequently Asked Questions
Is BPH the same as prostate cancer?
No, BPH is a benign (non-cancerous) condition and is not related to prostate cancer. However, both conditions can cause similar urinary symptoms, which is why a thorough assessment, including a PSA test, is important to rule out other causes.
Can BPH go away on its own?
Unlike some conditions, BPH does not typically resolve on its own. While symptoms may remain stable for a period of time, they tend to worsen gradually in many men without appropriate management. If your symptoms are progressing or affecting your quality of life, it is worth speaking to a specialist about your options.
What is the best treatment for BPH?
The most appropriate treatment depends on the severity of your symptoms, the size of your prostate and your personal circumstances. Some men manage well with lifestyle changes and medication, while others benefit from a procedure such as PAE or surgery. A specialist consultation is necessary to determine a suitable treatment approach for your circumstances.
Is prostate artery embolisation safe?
Prostate artery embolisation is generally a safe procedure. As with any medical intervention, however, there are potential risks, which your specialist will discuss in detail at your consultation.
How long does it take to see results from PAE?
Symptom improvement after prostate artery embolisation is typically gradual rather than immediate. Many patients begin to notice changes within four to eight weeks as the prostate gradually shrinks due to reduced blood supply. Full recovery usually occurs over three to six months.
This information is not intended to be used for diagnosis or treatment. It is aimed at presenting a perspective only and is not a substitute for a prescription. Anyone experiencing a medical condition should consult their doctor.
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