If you are living with the frustration of getting up multiple times a night to urinate, struggling with a weak stream, or feeling like your bladder never fully empties, you are not alone. Benign prostatic hyperplasia (BPH) affects millions of men, and the symptoms tend to worsen over time if left untreated. The good news is that effective treatment options exist, and at Urology Associates of Green Bay, we offer more of them than any other practice in the region.
What sets us apart is our commitment to individualized care. We do not believe in a one size fits all approach to BPH. Some practices offer only one or two procedures and steer every patient toward those options. At Urology Associates, we offer the full spectrum of BPH treatments, from medications and supplements to minimally invasive office procedures to advanced surgical options. Our goal is to match the right treatment to your specific symptoms, prostate anatomy, and personal priorities, including concerns about sexual function and recovery time.
We are a high volume BPH practice, performing approximately 400 BPH procedures per year across all treatment types. Our board certified urologists bring fellowship trained expertise and thousands of combined cases to every patient encounter. We are the only private urology practice in the Green Bay area, which means your care is directed by your surgeon, not by a hospital system.
Tired of BPH symptoms running your life? Schedule a consultation today. Call our De Pere office at (920) 433-9400 or our Marinette office at (715) 732-3420. Telehealth appointments are available for an initial conversation.
Your BPH Evaluation: Understanding the Problem Before Choosing a Solution
Before recommending any treatment, we perform a thorough workup to understand exactly what is causing your symptoms and how your prostate is affecting your urinary function. This evaluation is done in our office and typically includes a validated symptom questionnaire to measure how much your symptoms are affecting your quality of life, a uroflow study (or UroFlow with UroFlowCuff) to objectively measure the strength and pattern of your urinary stream, a post void residual (PVR) measurement to check whether your bladder is emptying completely, a cystoscopy (a brief, in office look inside the urethra and bladder with a small camera) to evaluate for obstruction, and in some cases a transrectal ultrasound (TRUS) to measure the size and shape of the prostate.
This information is essential because the best treatment for a 30 gram prostate is very different from the best treatment for a 120 gram prostate. Likewise, the pattern of obstruction matters. A thorough evaluation up front means better outcomes and fewer surprises.
Medical Management: Starting with Conservative Options
For many men, the first step in managing BPH is medical therapy. Depending on your symptoms and prostate size, options may include alpha blockers such as tamsulosin (Flomax) or silodosin (Rapaflo), which relax the smooth muscle in the prostate and bladder neck to improve urine flow. Daily tadalafil (Cialis) can also be effective, particularly for men who experience both urinary symptoms and erectile dysfunction. For men with larger prostates, finasteride (Proscar) can gradually shrink the gland over several months.
We also discuss behavioral strategies such as timed voiding, fluid management, and reduction of bladder irritants, as well as over the counter supplements that some men find helpful. If medications are working well and you are satisfied with your symptom control, there may be no need to pursue a procedure. However, if medications are not providing adequate relief, are causing side effects, or if you simply prefer not to take a daily pill for the rest of your life, we have a full range of procedural options available.
Minimally Invasive Office Procedures
For men who want symptom relief without the recovery time of traditional surgery, we offer several minimally invasive options that can be performed right in our office.
Rezum (water vapor therapy) uses targeted steam injections to shrink excess prostate tissue. The procedure takes approximately 10 minutes, is performed under local anesthesia with optional sedation, and most men return to normal activity within a few days. A temporary catheter is placed for three to five days after the procedure. Rezum is designed to preserve ejaculatory and erectile function.
UroLift uses small implants to hold the enlarged prostate tissue out of the way, opening the urinary channel without cutting, heating, or removing tissue. It is the only BPH procedure that typically does not require a catheter afterward, though one is occasionally needed for a short time. UroLift also preserves ejaculatory function and can be performed in the office under local anesthesia.
Both of these procedures offer the advantage of a quicker recovery and a lower risk profile compared to traditional surgery, though they may be best suited for small to moderate sized prostates. Your workup results will help us determine whether an office based procedure is a good fit for you.
Surgical Options for Moderate to Severe BPH
When BPH symptoms are more severe, when the prostate is larger, or when minimally invasive options are not the best anatomical fit, we offer a full range of surgical procedures performed in the operating room at Emplify Health (Bellin) in Green Bay.
Aquablation is a newer, robot assisted procedure that uses a high pressure waterjet to remove prostate tissue. It is guided by real time ultrasound imaging, which allows precise tissue removal while preserving the structures important for ejaculatory function. Aquablation is effective for prostates of all sizes, including very large glands that may not be suitable for other minimally invasive options. Our surgeons have been performing Aquablation for over three years, and we are a high volume center for this procedure. Most patients go home the next morning.
TURP (transurethral resection of the prostate) remains the gold standard surgical treatment for BPH. It involves removing obstructing prostate tissue with an electrosurgical loop passed through the urethra. TURP is highly effective and has decades of proven long term results. It does carry a higher likelihood of retrograde ejaculation. Patients typically stay one night in the hospital.
PVP (GreenLight Laser) vaporizes excess prostate tissue using a high powered laser. Like TURP, it is a definitive treatment with excellent long term outcomes. It may be particularly well suited for men on blood thinners, as the laser provides excellent hemostasis. An overnight hospital stay is typical.
Optilume BPH Balloon is a newer treatment that uses a drug coated balloon to open the prostatic urethra. It is designed to preserve ejaculatory function and typically requires only a short catheter period of one to three days. Optilume is performed in the operating room but is generally an outpatient procedure.
Robotic Simple Prostatectomy is reserved for the largest prostates, typically those over 80 to 100 grams, where other approaches may not be adequate. This procedure removes the inner portion of the prostate through a robotic assisted minimally invasive approach. It requires one night in the hospital and a catheter for five to seven days, but provides definitive, long lasting relief for men with very large glands.
Our surgeons are also experienced in HoLEP (holmium laser enucleation of the prostate) and can discuss prostatic artery embolization (PAE) as an alternative approach, arranging referral if this is the best fit for your situation.
Comparing BPH Treatments at a Glance
| Procedure | Category | Catheter | Preserves Ejaculation | Hospital Stay | Setting | Anesthesia |
|---|---|---|---|---|---|---|
| Rezum (Water Vapor Therapy) | Minimally Invasive | Yes (3–5 days) | Yes | No | Office | Local / Sedation |
| UroLift | Minimally Invasive | Usually not | Yes | No | Office | Local / Sedation |
| Optilume BPH Balloon | Minimally Invasive | Yes (1–3 days) | Yes | No | OR | General |
| Aquablation | Definitive | Yes | Yes | One night | OR | General |
| TURP | Definitive | Yes | No | One night | OR | Spinal / General |
| PVP (GreenLight Laser) | Definitive | Yes | No | One night | OR | General |
| Robotic Simple Prostatectomy | Definitive | Yes (5–7 days) | No | One night | OR | General |
Preserving Sexual Function: A Priority in BPH Treatment
One of the most common concerns men bring to their BPH consultation is what will happen to their sexual function. It is an important question and one we take seriously. Different procedures carry different risks to ejaculatory function, and we discuss these in detail before any decision is made.
Procedures such as Rezum, UroLift, Aquablation, and the Optilume balloon are specifically designed to preserve ejaculatory function. Traditional surgical procedures like TURP and PVP carry a higher likelihood of retrograde ejaculation, where semen flows backward into the bladder rather than out during orgasm. This is not harmful to health but is permanent and a significant concern for many men.
Erectile function is generally not affected by BPH procedures. Because we offer the full range of options, we can match you with a treatment that addresses your urinary symptoms while respecting your priorities for sexual health. This is one of the key advantages of seeing a practice that does not limit itself to a single procedure.
Frequently Asked Questions About BPH Treatment
What is BPH?
BPH stands for benign prostatic hyperplasia, which is a noncancerous enlargement of the prostate gland. As men age, the prostate can grow and press against the urethra, causing urinary symptoms such as a weak stream, frequent urination (especially at night), urgency, incomplete emptying, and difficulty starting urination. BPH is extremely common, affecting roughly half of men by age 60 and up to 90% of men by age 85.
How do I know if my symptoms are from BPH?
The symptoms of BPH can overlap with other conditions, including prostate cancer, urinary tract infections, and overactive bladder. That is why a thorough evaluation is important. At Urology Associates, your workup may include a symptom questionnaire, uroflow study with post void residual measurement, cystoscopy (a brief look inside the bladder with a small camera), and possibly a transrectal ultrasound to measure your prostate size. A PSA blood test is also typically drawn. We use all of this information together to understand what is driving your symptoms and what treatment is most appropriate.
Can BPH be treated with medication?
Yes. Many men start with medical management, and for some, medications provide adequate relief. Common options include alpha blockers such as tamsulosin and silodosin, which relax the muscles around the prostate and bladder neck, daily tadalafil (Cialis), which can improve both urinary symptoms and erectile function, and finasteride, which can shrink the prostate over time. We also discuss behavioral modifications and supplements when appropriate. If medications are not effective or cause side effects, procedural options are available.
Which procedure is right for me?
There is no single best procedure for every patient. The right choice depends on your prostate size and shape, the severity of your symptoms, whether you want to preserve ejaculatory function, your tolerance for a catheter and recovery time, and your overall health. This is exactly why we offer the full range of BPH treatments rather than a single option. During your consultation, we will review your workup results and walk you through the options that make the most sense for your situation.
Will a BPH procedure affect my sexual function?
This is one of the most common concerns we hear, and it is an important part of the decision. Some procedures, including Rezum, UroLift, Aquablation, and the Optilume balloon, are designed to preserve ejaculatory function. Others, such as TURP and PVP, carry a higher likelihood of retrograde ejaculation (where semen flows backward into the bladder rather than out). Erectile function is generally not affected by BPH procedures. We discuss these considerations in detail before recommending any treatment.
What is Aquablation?
Aquablation is a newer, robot assisted procedure that uses a high pressure waterjet to remove prostate tissue. It is guided by real time ultrasound imaging, which allows precise tissue removal while preserving the structures important for ejaculatory function. Aquablation is effective for prostates of all sizes, including very large glands that may not be suitable for other minimally invasive options. Our team has been performing Aquablation for over three years and we are a high volume center for this procedure.
Do I need to stay in the hospital?
It depends on the procedure. Rezum and UroLift are performed in our office, and you go home the same day. Optilume is performed in the operating room but is typically an outpatient procedure. TURP, Aquablation, PVP, and robotic simple prostatectomy generally require one night in the hospital. We will make sure you know exactly what to expect before your procedure.
Meet Your BPH Specialists
BPH procedures at Urology Associates of Green Bay are performed by all four of our board certified urologists: Dr. Sean McAdams, Dr. Herbert J. Wiser, Dr. Nevada Hughes, and Dr. Hamayun Mian. Dr. McAdams completed fellowship training in endourology at Mayo Clinic and brings specialized expertise in minimally invasive and surgical management of BPH. Together, the team performs approximately 400 BPH procedures per year across all treatment types, making this one of the most experienced BPH programs in the region.
Cash Pay and Self Pay Options
We understand that many patients are on high deductible health plans or may not have insurance coverage that makes BPH treatment affordable. Urology Associates of Green Bay offers competitive cash pay pricing for BPH evaluations and procedures. We also work with employers who are looking for cost effective surgical options for their employees. If you are interested in cash pay pricing, please call our De Pere office at (920) 433-9400 or our Marinette office at (715) 732-3420 and ask to speak with our billing team.
Take the First Step Toward Better Sleep, Better Days, and Better Quality of Life
BPH does not have to control your life. Whether you are getting up three times a night, planning your day around bathroom access, or just tired of a weak, frustrating stream, we can help. We offer telehealth appointments for an initial conversation about your symptoms, though the full BPH workup will need to be done in the office. Call our De Pere office at (920) 433-9400 or our Marinette office at (715) 732-3420 to schedule.
Urology Associates of Green Bay. The most comprehensive BPH program in northeastern Wisconsin, built around getting you back to your life.