Prostate Disease (BPH)

What is BPH?

BPH is an acronym for the condition known as Benign Prostatic Hyperplasia or what is commonly referred to as prostate enlargement. Oftentimes, patients confuse BPH with prostate cancer. As the name of this condition implies this is a benign condition and is not associated with malignant or cancerous prostate conditions.  The symptoms of BPH include slowing of the urinary stream, frequent urination, getting up at night to urinate, incomplete emptying of the bladder, urgency to urinate, hesitancy during urination and post void dribbling.

The Greenlight laser XPS/Moxy procedure is the latest and most sophisticated procedure for the treatment of enlarging prostate symptoms. Patients can experience the same excellent results that the traditional TURP procedure gives them with significantly fewer side effects. The procedure can be done on an outpatient basis and men can return to their normal activities sooner than with the TURP procedure.

Many men are concerned about any procedure on their prostate because they often confuse the risks of removing their entire prostate (radical prostatectomy) with this minimally invasive Greenlight Laser procedure. Instead, they opt to stay on medications that are associated with recurring costs, risks and only show minimal objective improvements in urination. Inadequate treatment of a man’s BPH symptoms with medications can lead to serious irreversible bladder and kidney damage.

Greenlight Laser Enucleation of the Prostate (GLEP or GreenLEP procedure)

The most effective way to treat enlarged prostates or severely large prostates is with an enucleation procedure.  GreenLight Laser Enucleation of the Prostate (GLEP) is a technique performed by Dr Karpman that ensures that the maximum amount of tissue overgrowth can be removed.  Dr Karpman’s technique is internationally recognized and has been published in the urologic literature.  This technique will give patients the most durable result compared to any other minimally invasive procedure your surgeon can perform.  The following is an instructional video of the actual GLEP procedure.


Aquablation of the Prostate

A new minimally invasive procedure called Aquablation of the prostate has gained FDA approval in December 2017.  Aquablation is a minimally invasive procedure that is image guided and driven by robotics.  Dr Karpman has been involved with the development of this technology since the earliest days.  Aquablation provides patients an effective way to remove tissue caused by the adenoma without using heat sources.  A pressurized water beam driven by a computer can precisely remove the majority of adenomatous tissue causing a patient’s urinary symptoms.  The following video demonstrates a real Aquablation procedure.

Aquablation 480p


A minimally invasive procedure called Urolift has recently received FDA approval and has become available for patients in the United States.  Urolift is a 10 minute procedure that can help men suffering from BPH symptoms relieve their symptoms if they have the right prostate geometry.  Urolift is the only BPH surgical procedure that does not affect a man’s ejaculatory function, preserving the fluid that normally is released during climax.

The following pictures represent the typical appearance of the prostate before and after the Urolift procedure.  The tissue is retracted out of the urethral lumen decreasing the impedance of flow in the prostatic urethra.


Urolift BA photos