Large Median Lobe of the Prostate Acting as Ball-Valve: Why Medications for BPH Do Not Help

by Alex Shteynshlyuger MD


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.


What is a Median Lobe of the Prostate and How Does it Matter?

The prostate gland in men has a few distinct components. The lateral lobes of the prostate, which tend to be the largest, are the most common cause of enlarged prostate symptoms in men.  Oral pills usually provide significant benefits to men with enlarged lateral lobes of the prostate.

The median lobe of the prostate is another part of the prostate that enlarges in some men. It can also cause blockage of the urinary flow.  The median lobe of the prostate tends to cause more severe symptoms. Oral medications such as Tamsulosin (Flomax), Alfuzosin, and Rapaflo do not help men with a significantly enlarged median lobe of the prostate.

A large median lobe of the prostate acting as Ball-Valve is a common reason why pills for enlarged prostate such as Flomax and finasteride (Proscar), silodosin (Rapaflo), and Uroxatral (alfuzosin) do not work well for some men. 

Symptoms of BPH but Medications Do Not Help

A commonly encountered situation is that men improve a little bit on medical therapy (Flomax, Uroxatral, Avodart, Proscar, Rapaflo) but not as much as an experienced urologist would expect.  When medications for enlarged prostate do not work, further evaluation is initiated.

Symptoms of a Large Median Lobe of the Prostate

Men with a prominently enlarged median lobe of the prostate often experience weak urine flow, frequent urination, urinary urgency, or may experience urinary retention.

Quite commonly, in this situation, the patient may have a very large prostate, which is beyond the effectiveness of medical therapy.  Another common situation is a prominent, large median lobe of the prostate protruding into the bladder and blocking the urine flow in a ball-valve fashion.

Timely Decision that Medications Cannot Help is Important For Men with a Large Median Lobe

Medical therapy is usually not effective for men with large obstructive median lobes.  In this situation, minimally invasive surgical therapy with prostate enucleation (HOLEP), a Greenlight laser of the prostate, or bipolar TURP is usually necessary to provide adequate relief of symptoms and long-term effectiveness. 

The Rezum procedure can help many men with a small and medium-sized median lobe of the prostate.  Smaller median lobes can be treated with a Urolift procedure.

While many patients are hesitant to commit to surgical treatment, sooner or later it becomes necessary in a situation where a large median lobe obstructs urine flow.  The most common regret that patients experience in this situation is that they did not have the procedure done sooner.

While medications are a good treatment option when they are effective, surgical therapy should be offered promptly to men who do not benefit from medical therapy after a thorough evaluation to exclude other causes of poor response to medications for BPH such as a coexistent overactive bladder, nocturia caused by low DDAVP, bladder cancer, and other causes.

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.

Where to Get Treatment for a Large Median Lobe of the Prostate with Bladder Protrusion in New York?

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.

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

Inexpensive Urologist Visit CostAt 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.

Read Real Stories of Men who Underwent Treatment of Enlarged Median Lobe of the 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.

Why Choose New York Urology Specialists for Treatment of Enlarged Median Lobe of the Prostate?

  • 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.


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Urinary Problems Are Treatable in Nearly Every Man and Woman

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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:

Schedule an Appointment with Dr. Shteynshlyuger:

Call/text today: 1-646-663-4044 or make an appointment online

Dr. Alex Shteynshlyuger is a fellowship-trained, board-certified urologist with expertise in the evaluation and treatment of urinary problems in men using modern effective and proven treatment methods including Botox for OAB, Interstim neuromodulation, Rezum for BPH, prostate enucleation for enlarged prostate, and Urolift procedure.  

He has successfully treated hundreds of men with BPH with symptoms of frequent urination during the day and excessive urination at night.

He is highly recommended by top primary care physicians in the New York area. If you or someone you know has been experiencing urological symptoms, make an appointment to take advantage of Dr. Shteynshlyuger’s expert advice. Please feel free to contact us with any questions.


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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