If you have BPH (Enlarged Prostate) You Might Experience Erectile Dysfunction.
If you have any questions, to schedule a consultation, please contact us or call/text: 1-646-663-4044.
We have excellent reviews from patients and their partners. Information for out-of-state and international patients.
We offer affordable prices with or without insurance. Same-day virtual video appointments and in-person appointments are available.
The Link Between BPH and ED is Probably More Complex than we Appreciate.
It has been noted that men who have enlarged prostate and BPH are more likely to have ED. The question is why?
BPH is a significant health issue for men. It has a greater impact on health than is generally appreciated. The direct effect of BPH is to cause urinary symptoms, slow urinary stream, and frequent urination. It causes numerous quality of life issues such as poor sleep, social restrictions on travel because of the constant need to void. It can lead to urinary incontinence and depression.
It appears that the relationship is due to a common risk factor, age as well as the effect of BPH on sleep and hormonal milieu. Aging is associated with increased risk for ED as are hypertension, obesity, and diabetes. These conditions tend to have onset around the age when BPH becomes symptomatic – close to age 50-60.
Sleep, BPH, and ED Link
Frequent urination at night caused by BPH has been shown to disturb normal sleep patterns and leads to chronic day-time tiredness and poor-quality sleep. This has been shown in numerous studies. Abnormal hormonal function caused by inadequate sleep and tiredness can certainly cause and contribute to ED.
It has been shown in numerous studies that poor sleep patterns can also cause numerous hormonal abnormalities, including low testosterone, increased stress hormone levels such as cortisol, lower thyroid levels. This is probably the underlying mechanism for the reported association between BPH and ED.
In addition, many symptoms that can result from BPH can cause ED: tiredness, loss of vigor due to poor sleep patterns, depression, and withdrawal from partners due to urinary incontinence.
Fortunately, a number of effective treatment options are available for men with BPH and ED, including medical and surgical treatment.
Do Current Recommendations for Treatment of BPH Make Sense?
This brings into question the current management recommendations for BPH. Many men adapt to their urinary symptoms and are not bothered by them even when their AUA symptom score index (a measure of how BPH affects the quality of life) is pretty significant. There is a significant reticence among men about taking medications. Many would rather wake up 2-3 times per night than being treated with medications.
The question becomes whether we should proactively recommend treatment to prevent secondary health effects of BPH. The current treatment recommendation for BPH based on the presumption that BPH is mostly a quality of life issue is probably outdated. There is accumulating evidence that BPH has a significant health effect on men that extends beyond urinary function.
BPH Treatment with Minimal or No Sexual Side Effects
BPH is a significant medical problem and can have many negative repercussions. While some treatments for BPH have significant sexual side effects, men should not avoid getting urological care for BPH. We have a range of treatment options that have minimal or no sexual side effects. BPH itself can have a negative effect on sexual function and, in particular, ejaculation.
Natural Treatment for ED and BPH
Many men may actually experience improved sexual function after treatment for BPH. Certainly, while medical treatment is important, it is a good idea to integrate other modalities into the care plan. We know for a fact that weight loss and exercise can boost sexual function and improve libido and can help urinary function as well.
A good Mediterranean diet can actually prevent ED over the long-term; general medical care such as good control of blood pressure, cholesterol, and diabetes are important. Men with BPH should also see a primary care doctor for a general check-up. Some men may have low testosterone levels and may benefit from supplemental testosterone if they are symptomatic.
Side Effects of Medications for ED
Medications used for the treatment of BPH infrequently cause ED, but they do affect ejaculation. The risk of ED from taking medications such as Proscar and Avodart is less than 10%, but they can cause decreased production (volume) of semen, “dry up.” Alpha-blockers such as Flomax and Uroxatral can cause retrograde ejaculation, but curiously, on rare occasions, can cause priapism (unwanted prolonged erection) as a side effect.
Side Effects You Might Like
One of the newer medical treatment options for BPH is Cialis, which is also used for the treatment of ED. Viagra, Levitra, and Staxyn work in a similar way. This is certainly of interest to men who have problems with both BPH and ED – “kill two birds with one pill.”
Treatment Options with Minimal Side Effects
Another new and exciting FDA-approved treatment for BPH is Urolift. The Urolift procedure an effective treatment option for BPH, which involves an office-based insertion of a urethral trans-prostatic implant. Analysis of a randomized control trial revealed that there are no ejaculatory side effects and no erectile side effects; many men actually experienced a slight improvement in sexual function.
Other good treatment options for men who are concerned about sexual dysfunction from the treatment of BPH are minimally-invasive treatments that include the Rezum procedure. Rezum therapy has a very small risk of retrograde ejaculation of <5%; the risk is much lower with Rezum than with TURP.
Does TURP Cause ED?
Traditionally, it was noted that TURP was associated with sexual side effects, including retrograde ejaculation (semen goes into the bladder during orgasm instead of leaving the body) as well as ED. In fact, it’s one of the risk factors that is often discussed. However, it should be noted that men with BPH are at increased risk for ED. Many men undergoing TURP have significant problems with ED to start with.
During the surgery (TURP), we remove the obstructive tissue, which is confluent with the muscle fibers that propel semen forward during ejaculation. As a result, around 70% of men experience retrograde ejaculation after TURP or similar procedures (various lasers of the prostate). For procedures such as TURP and lasers of the prostate, retrograde ejaculation is an unavoidable side effect.
A procedure called transurethral incision of the prostate (TUIP) is an option for men with smaller prostate – it has lower retrograde ejaculation risk. Other minimally invasive procedures such as Urolift procedure and Rezum are associated with fewer sexual side effects (<5% risk of retrograde ejaculation).
TURP is also associated with ED. Whether TURP causes ED is not clear as some randomized controlled studies actually show improvement in erectile function after TURP and others show slightly worsened function (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC104331/).
Mechanisms of ED after TURP
There are two mechanisms for ED after TURP: (1) as men age, the rate of ED increases so for some men it’s incidental that they have TURP and their ED ‘flares up”; (2) the heat generated during TURP, especially if the resection is thorough or the prostate is small can damage the nerve fibers that run alongside the prostate gland and innervate the penis. This can lead to ED. The risk of ED attributable to TURP as distinct to aging is somewhere in the range of 15% based on data from randomized controlled studies.
Randomized studies show that after TURP, some men experience worsening erectile function, and some experience improvement.
Did you know? Dr. Shteynshlyuger has performed over 1,000 surgeries and procedures for enlarged prostate, including Rezum, Urolift, prostate enucleation, laser ablation of the prostate, and TURP. He performs over 100 prostate procedures a year.
Cost of Enlarged Prostate Treatment without Insurance
At New York Urology Specialists, we offer affordable treatment for men. Our prices are low for patients without insurance and for those who have high insurance copays, high deductibles, or insurance plans that do not cover treatment costs.
At New York Urology Specialists, we offer a flat-fee ‘all-cost-included’ Rezum procedure. The procedure is performed in our office under local anesthesia. Men from other states can save thousands of dollars over local hospital fees by coming to New York Urology Specialists for treatment. Please contact us for current prices and discounts for patients without insurance or with high insurance deductibles.
At New York Urology Specialists, we offer a flat-fee ‘all-cost-included’ Urolift procedure. The procedure is performed in our office under local anesthesia. Men from other states can save thousands of dollars over local hospital fees by coming to New York Urology Specialists for treatment.
Cost of Treatment and Insurance
At New York Urology Specialists, we offer affordable treatment for men. Our prices are low for patients without insurance and for those who have high insurance copays, high deductibles, or insurance plans that do not cover treatment costs.
We accept many health insurance plans. We would be happy to verify your eligibility and benefits and to provide you with detailed information on your health plan’s coverage. Financing options and credit options are available to help you pay for medical care.
Where to Get Prostate Treatment in NYC?
At New York Urology Specialists, we offer specialized treatment for enlarged prostate for men. Same-day virtual video appointments and in-person appointments are available.
Call/text today: 1-646-663-4044 or make an appointment online.
We perform a cystoscopy, urodynamic testing, prostate and bladder ultrasound in our office. We offer Urolift procedure, Rezum water-vapor procedure in our office, and laser enucleation of the prostate in a hospital setting. We treat urinary and erection problems. We offer confidential appointments.
Our appointment costs are affordable with or without insurance. We offer free insurance verification.
Read Real Stories of Men who Underwent Treatment of Enlarged Prostate (BPH) at New York Urology Specialists
We offer treatment for prostate problems, including slow urine stream, frequent urination at night, difficulty emptying the bladder, and other problems to patients within driving distance to our offices as well as from other states and countries. Our patients come from New York, New Jersey, Pennsylvania, Connecticut, and over 70 countries worldwide.
- 47-year-old Man Treated with Rezum Procedure After Unsuccessful Urolift
- 56-year-old Man with Urination at Night and Discomfort Treated with Urolift
- 66-year-old Man with Urination Problems – Tadalafil Does Not Work
- 69-year-old Man Treated with Rezum After Brachytherapy Radiation for Prostate Cancer
- 73-year-old Man with Frequent UTI and Pain – Finasteride and Alfusozin Do Not Work
- 86-year-old man Treated with Prostate Enucleation After Rezum
Why Choose New York Urology Specialists for Treatment of Enlarged Prostate Problems?
- All treatment is performed by a board-certified urologist experienced in treating men with symptoms of frequent urination, urinary urgency, urinary incontinence, and bladder pain using medical therapy, minimally invasive therapies, lasers, and open surgery.
- We are one of the few practices in the region to offer a full range of options for the treatment of urinary problems caused by an enlarged prostate in men.
- We offer treatment options for enlarged prostate, overactive bladder, UTI, and urinary incontinence in our office, which avoids the risks, costs, and recovery from general anesthesia.
- Extensive experience: Thousands of men have been treated successfully using medical therapy, surgery, and minimally invasive procedures such as Urolift procedure, Rezum surgery, Botox for overactive bladder, Interstim for frequent urination, and tibial neuromodulation.
- We offer diagnostic testing in our office, which avoids hospital costs.
- Confidential and Understanding Care. We understand that most of our patients desire privacy. We see patients with a variety of urological problems. Your reason for visiting us is entirely confidential.
- We are conveniently located within a 30-60 minute commute to men who are seeking BPH treatment in Manhattan, Brooklyn, Queens, Staten Island, Westchester, Long Island, Bronx, and New Jersey.
What do Prostate Problems Look Like?
You can find images of uroflow as well as before and after treatment images in our image gallery.
Scheduling Appointments for Enlarged Prostate Treatment at New York Urology Specialists
If you have any questions, to schedule a consultation, please contact us or call/text: 1-646-663-4044.
We have excellent reviews from patients and their partners. Information for out-of-state and international patients. Find out our office hours or directions to our office.
We offer affordable appointment prices with or without insurance. We offer weekday, weekend, and evening office hours.
Dr. Alex Shteynshlyuger is a board-certified urologist and specialist in the treatment of urinary problems in men. He is one of the few urologists who offers a full range of treatment options for BPH (enlarged prostate). He specializes in all aspects of care for men with an enlarged prostate and urinary problems, including frequent urination at night, difficulty emptying the bladder, urinary urgency, and incontinence. He has successfully treated thousands of men with urinary problems, including urinary retention, painful urination, and frequent urination.
Urinary Problems Are Treatable in Nearly Every Man and Woman
At New York Urology Specialists, our urologists are specially trained in the evaluation and treatment of urinary problems caused by enlarged prostate and BPH in men. We understand the challenges that urinary problems such as a slow stream, waking up at night, pain in the penis and perineum create for our patients, their relationships, and their self-esteem. We help you find a treatment for your urinary problems that fit your needs, lifestyle, and your preferences.
Urologists are doctors specializing in the treatment of men with symptoms caused by prostate enlargement, including frequent urination, poor urine flow, frequent UTI, blood in urine, urinary incontinence, urinary problems caused by an enlarged prostate, prior surgery, neuropathy, chemotherapy, and radiation. By virtue of our experience and skill, we are able to offer an effective treatment option for nearly every man and woman who desire an effective treatment for their urinary problems. We offer medical and surgical treatment for men’s prostate problems.
We specialize in minimally invasive, highly effective treatment for symptoms of bladder pain, urethral burning, pelvic discomfort, incomplete bladder emptying, urinary frequency, and urgency.
We Treat Some of the Most Complex Men’s Health Problems Including:
- Erectile dysfunction in men for whom oral pills do not work.
- Penile Pain During Sex
- Impotence in men with diabetes.
- Burning during urination
- Premature Ejaculation
- Frequent urination
- Urinary retention
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Schedule an Appointment with Dr. Shteynshlyuger:If you have any questions, to schedule a consultation, please contact us or call/text: 1-646-663-4044.
We have excellent reviews from patients and their partners. Information for out-of-state and international patients. Find out our office hours or directions to our office.
We offer affordable appointment prices with or without insurance.
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