If you’re a man over 40, chances are your prostate gland is beginning to enlarge. This is not dangerous. In fact, it’s not even a disease. It’s a normal part of male aging called Benign Prostatic Hyperplasia, or BPH.

BPH is the most common prostate condition starting in midlife. The Cleveland Clinic says:

• By age 60, about 50% of people with a prostate will have some signs of BPH.
• By age 85, about 90% will have signs of the condition.
• About half of all people with BPH will develop symptoms that require treatment.

BPH symptoms

BPH is not a problem, but it can lead to symptoms that become problems. Symptoms include difficulty starting to urinate, interrupted sleep due to need to urinate, bladder pressure or urinary urgency, incontinence (leaking, dripping), and incomplete bladder emptying.

These occur due to the way the gland grows larger. As it becomes bulkier, it compresses the urethra (passage through the center of the prostate) through which urine travels from the bladder to exit the body. Sometimes, the prostate enlarges unevenly; it can create a blockage at the neck of the bladder, making it difficult to start peeing. The symptoms are a sign of obstructed urine flow.

If symptoms increase and become chronic, they can interfere with quality of life. They can affect his work performance, social/athletic activities, even love relationships. Sounds depressing, doesn’t it?

BPH and depression

Dealing with the consequences of BPH is, in fact, a cause of depression. We know this thanks to a Nov. 2025 study entitled “Association between Benign Prostatic Hyperplasia and Depression and Anxiety.”^[i]

The authors analyzed data on 229,001 men in the United Kingdom’s biobank. Their paper reports that at baseline, BPH is linked with greater chance for long-term depression and anxiety; it predicts higher risk of depression at seven years, especially in men who are under age 60, employed, have high income, and are less active.

Treatment for BPH

Depression on top of urinary problems is no fun to live with. The depression that results is called situational depression because it’s attributable to BPH circumstances.

Here’s the good news. Treating BPH and reclaiming quality of life can certainly ease the situational depression linked with the urinary problems it’s causing. When urinary function returns to normal and symptoms vanish, the path is cleared to restore performance at work, resume social and physical activities, and reclaim the joys of love.

There are many ways to treat BPH. Certain types of medications can help reduce the prostate bulk. When medication isn’t effective, there are procedures to ease urinary blockage by enlarging the urethral passage, such as

• A traditional surgical “reaming out” called a TURP (Transurethral Resection of the Prostate)
• Certain laser light therapies done through the penis
• Steam ablation
• Insertion of a “lift” device to open the urethra by pulling prostate tissue away from it
• Insertion of a stent (tube) in the prostatic urethra

Focal laser ablation (FLA)

The Sperling Prostate Center offers an alternative, a unique minimally-invasive way to reduce prostate tissue where it’s pressing into the urethra. It’s called Focal laser ablation (FLA).

FLA is a targeted, MRI-guided treatment that selectively destroys an area of tissue close to where it is blocking or pressing upon the urethra. Dr. Sperling first evaluates the patient’s prostate using multiparametric MRI (mpMRI) to create high resolution 3D images. This reveals the most strategic location for precise tissue destruction.

Then, under real-time MRI guidance, a laser fiber is inserted into the anesthetized area targeted by Dr. Sperling. Instead of ablating the inside of the urethral passage as is done with other types of laser light or steam, the precision destruction of neighboring tissue simply shrinks bulky tissue. This approach creates a gradual, natural tissue reduction while preserving the majority of the gland. In turn, this preserves the prostate’s sexual function while restoring urinary function.

With the return of normal urination, a patient regains his quality of life, and depression is lifted. Don’t let BPH get you down. For more information on focal laser ablation to treat symptoms of BPH, contact our Center.

NOTE: This content is solely for purposes of information and does not substitute for diagnostic or medical advice. Talk to your doctor if you are experiencing pelvic pain, or have any other health concerns or questions of a personal medical nature.

References

[i] Guo J, Zhou L, He J, Pan X et al. Association between benign prostatic hyperplasia and depression and anxiety: a cross-sectional and prospective cohort study based on the UK biobank. Int J Psychiatry Clin Pract. 2025 Nov 5:1-10.