Urology · University Urology, PC · Knoxville, TN
Enlarged Prostate (BPH)
Benign prostatic hyperplasia (BPH) is the most common urologic condition in aging men. Weak stream, frequent urination, waking at night, and incomplete emptying are symptoms that respond well to treatment — and multiple excellent options now exist beyond medication.
About BPH
What Is BPH?
The prostate gland surrounds the urethra at the base of the bladder. As it enlarges with age, it can obstruct urine flow and irritate the bladder, causing a wide range of urinary symptoms. BPH is not prostate cancer and does not increase cancer risk, but the two conditions can coexist.
Obstructive Symptoms
Weak or slow urine stream · Hesitancy (difficulty starting) · Straining to urinate · Feeling of incomplete emptying · Dribbling after urination · Urinary retention (inability to urinate)
Irritative Symptoms
Urinary urgency · Frequent urination during the day · Nocturia (waking at night to urinate) · Urgency incontinence · Urinary tract infections
Treatment Options
BPH Treatment at University Urology
University Urology offers the most comprehensive BPH treatment menu in East Tennessee — including Aquablation, where Dr. Pickens is the highest-volume surgeon in the region.
Medications
Alpha-blockers relax prostate and bladder neck muscle. 5-alpha reductase inhibitors shrink the prostate over time. Combination therapy is often most effective for moderate-to-severe symptoms.
Aquablation
Robotic, image-guided waterjet resection of prostate tissue. Uniquely effective for large and complex prostates. University Urology is a pioneering practice with the highest-volume Aquablation surgeon in the region. Performed by Dr. Pickens.
UroLift
Small permanent implants lift and hold enlarged prostate lobes away from the urethra. No cutting, no heat, no removal of tissue. Preserves sexual function. In-office or same-day procedure.
iTind
A temporary implant that remodels the prostate channel over 5–7 days. Removed in the office. No permanent implant, no tissue removal, no retrograde ejaculation.
TURP
Transurethral resection of the prostate is a highly effective surgical option for larger prostates or when other options have failed. Performed at UTMC.
Prostatic Artery Embolization (PAE)
A minimally invasive radiologic procedure that reduces blood flow to the prostate, causing it to shrink. Performed by our interventional radiology colleagues in collaboration with University Urology.
Our Specialists
BPH Care at University Urology
All seven University Urology physicians and our advanced practice providers evaluate and treat BPH across all 11 East Tennessee locations. For complex or surgical BPH management — including Aquablation and advanced procedural options — Drs. Pickens and Riedinger take the lead.
Common Questions
Frequently Asked Questions
How do I know if I need treatment or just monitoring?
Symptom severity is measured with a validated questionnaire (AUA Symptom Score). Mild symptoms may be managed with watchful waiting and lifestyle modifications. Moderate-to-severe symptoms typically benefit from medical or procedural treatment. Urinary retention, recurrent infections, and bladder or kidney damage always require intervention.
Will BPH treatment affect my sexual function?
It depends on the treatment. Medications can sometimes affect ejaculation. Some procedures (TURP) cause retrograde ejaculation. Others (UroLift, iTind, Aquablation) are specifically designed to preserve sexual function. Your urologist will discuss the tradeoffs for your specific situation and treatment goals.
What is Aquablation and am I a candidate?
Aquablation uses a robotic, image-guided waterjet to remove prostate tissue precisely. It is especially effective for large prostates where other procedures have limitations. Candidates must meet specific prostate size and imaging criteria. Insurance coverage requires prior failure of medical therapy. See our BPH treatment page for details.
BPH Symptoms Affecting Your Life?
From medical management to Aquablation with the region’s highest-volume surgeon — University Urology offers the full spectrum of BPH treatment.