Category: Blog

For Many Men, an Enlarged Prostate Is the Answer

Receiving lab results showing an elevated Prostate Specific Antigen level can be an incredibly stressful experience. The immediate thought for many men is a concern about prostate cancer. While PSA testing is a vital tool for detecting early stage malignancies, the reality is that a high PSA number does not automatically mean cancer is present.

At North Star Prostate Center, we frequently see patients who have been referred due to high PSA levels. Our goal is to provide clear information and effective solutions. Understanding the various factors that influence PSA levels is the first step toward making informed decisions about your urological health. This article explores the non cancerous reasons for elevated PSA,

Understanding Prostate Specific Antigen

Prostate Specific Antigen is a protein produced by both normal and abnormal cells in the prostate gland. Its primary biological function is to liquefy semen, allowing sperm to swim freely. A small amount of this protein naturally leaks into the bloodstream, which is what a PSA blood test measures.

When the prostate gland is healthy and normal in size, the amount of PSA in the blood remains relatively low. However, when the architecture of the prostate is disrupted, more PSA can escape into the bloodstream. This disruption can be caused by cancer cells, which often lack the normal cellular boundaries that keep PSA contained, but it can also be caused by entirely benign conditions.

According to research, the specificity of PSA screening is relatively low, meaning that while the test is very good at detecting when something is abnormal with the prostate, it is not very good at specifying exactly what that abnormality is. In clinical practice, up to ninety percent of individuals with elevated serum PSA levels do not have prostate cancer.

Benign Prostatic Hyperplasia as a Primary Cause of Elevated PSA

One of the most common non cancerous causes of an elevated PSA is benign prostatic hyperplasia. BPH is a non malignant enlargement of the prostate gland that occurs naturally as men age. As the prostate grows, it can compress the urethra, leading to bothersome lower urinary tract symptoms such as frequent urination, a weak stream, and difficulty emptying the bladder.

The relationship between BPH and PSA is straightforward: a larger prostate has more tissue, and more tissue produces more PSA. Studies have consistently shown a strong correlation between prostate volume and serum PSA levels. In fact, research indicates that up to eighty six percent of individuals with benign prostatic hyperplasia may have elevated levels of serum PSA.

Because BPH is so prevalent affecting approximately fifty percent of men in their fifties and up to eighty percent of men over seventy it is a leading driver of elevated PSA results in older men. When evaluating a high PSA, healthcare providers must consider the size of the prostate gland. A metric known as PSA density, which divides the total PSA level by the volume of the prostate, is often used to help guide biopsy decisions in patients with BPH. A large prostate with a moderately elevated PSA may have a low PSA density, suggesting the elevation is due to BPH rather than malignancy.

If you are experiencing symptoms of an enlarged prostate, you can learn more about the condition by visiting our understanding BPH page.

Other Non Cancerous Causes of High PSA

In addition to BPH, several other benign conditions and everyday activities can cause a temporary or chronic spike in PSA levels.

Prostatitis and Urinary Tract Infections

Inflammation or infection of the prostate gland, known as prostatitis, can cause significant spikes in PSA levels. Acute bacterial prostatitis can result in extremely high PSA readings. While rare, medical case reports have documented PSA levels exceeding one thousand nanograms per milliliter purely from severe acute infection. This occurs because the severe inflammation disrupts the cellular barriers within the prostate, allowing large amounts of PSA to flood into the bloodstream. Similarly, a standard urinary tract infection can also cause a temporary elevation. In these cases, PSA levels typically return to normal after the infection is successfully treated with antibiotics.

Medical Procedures and Physical Trauma

Any physical manipulation of the prostate can cause a transient rise in PSA. This includes medical procedures such as a digital rectal exam, the placement of a urinary catheter, or a prostate biopsy. Even activities that put pressure on the perineum, such as vigorous bicycle riding, have been known to cause mild, temporary elevations. It is generally recommended to avoid these activities and delay PSA testing if a recent procedure or infection has occurred.

Age Related Changes

PSA levels naturally increase as men age, even in the absence of significant BPH or cancer. This is why urologists often use age specific reference ranges when interpreting PSA results. A PSA level that might be considered suspiciously high for a forty year old man may be completely normal for a seventy five year old man.

The Role of Free vs Total PSA

When a total PSA level is elevated, doctors often order a secondary test that measures the ratio of free PSA to total PSA. In the bloodstream, PSA exists in two forms: bound to proteins and floating freely.

Research has demonstrated that the ratio of free to total PSA is a valuable tool for differentiating between BPH and prostate cancer. Men with prostate cancer tend to have a lower percentage of free PSA, while men whose elevated PSA is caused by benign conditions like BPH typically have a higher percentage of free PSA. This ratio helps clinicians determine whether a prostate biopsy is truly necessary, thereby reducing the number of unnecessary and potentially harmful procedures.

Addressing Elevated PSA Caused by BPH

If a thorough medical evaluation determines that your elevated PSA is due to benign prostatic hyperplasia, the focus shifts from cancer screening to symptom management and improving your quality of life. At North Star Prostate Center, we specialize in advanced, minimally invasive treatments for an enlarged prostate.

One of the most effective modern treatments is Prostate Artery Embolization. PAE is a minimally invasive procedure performed by an interventional radiologist. It involves navigating a tiny catheter into the arteries that supply blood to the prostate gland and releasing microscopic particles to block the blood flow. Deprived of its blood supply, the overgrown prostate tissue shrinks over time.

Clinical studies have shown that PAE is highly effective at reducing the size of the prostate and alleviating lower urinary tract symptoms. Furthermore, because the procedure shrinks the volume of the prostate gland, it naturally leads to a reduction in PSA levels. Research has demonstrated a statistically significant decrease in prostate volume and PSA values following the PAE procedure. In a prospective clinical study, the mean PSA value dropped from 4.9 ng/dL before the procedure to 2.8 ng/dL twelve months after PAE.

PAE offers several advantages over traditional surgical options like Transurethral Resection of the Prostate. It is performed on an outpatient basis, requires only moderate sedation rather than general anesthesia, and carries a significantly lower risk of sexual side effects. You can read a detailed comparison on our PAE or TURP page.

Moving Forward with Confidence

An elevated PSA level is a signal that your prostate requires medical attention, but it is not a definitive diagnosis of cancer. Benign prostatic hyperplasia, prostatitis, and even the natural aging process are common, non cancerous reasons for high PSA readings.

If you have been told your PSA is elevated and you are experiencing symptoms of an enlarged prostate, a comprehensive evaluation is essential. By utilizing tools like PSA density and the free to total PSA ratio, healthcare providers can accurately diagnose the underlying cause and recommend the most appropriate course of action.

We are dedicated to providing innovative solutions for men suffering from BPH. If your elevated PSA is linked to an enlarged prostate, minimally invasive procedures like Prostate Artery Embolization offer a safe and effective way to reduce prostate volume, lower PSA levels, and restore your quality of life.

Living with the symptoms of an enlarged prostate (benign prostatic hyperplasia, or BPH) can be frustrating and disruptive to your daily life. If you’re waking up multiple times a night, planning trips around the bathroom stops, or struggling to empty your bladder, you’re not alone, and you don’t just “have to live with it.”

One minimally invasive option that helps thousands of men find relief is Prostate Artery Embolization (PAE). Here are five signs that you might be a good candidate for this innovative procedure. 

1. You’re making too many bathroom trips, especially at night. 

If you’re waking up more than once per night to urinate, this is a common indicator that your prostate is putting pressure on your bladder. PAE works by reducing blood flow to the prostate, shrinking it over time, and easing those nighttime trips. 

2. You have a weak urine stream or trouble starting

Straining to get started or noticing your urine stream is slow and inconsistent often points to prostate-related blockage. PAE can relieve this obstruction without the need for curing or removing tissue, allowing urine to flow more freely. 

3. You often feel like your bladder isn’t fully empty

That lingering sensation after urinating can be frustrating, and it’s more than just discomfort; incomplete emptying can raise your risk for infections and bladder issues. By shrinking the prostate, PAE helps reduce that residual pressure, helping you to empty your bladder more effectively. 

4. You’ve been told your prostate is enlarged

If your doctor or urologist has confirmed that you have an enlarged prostate (BPH) through an exam or imaging, and your symptoms are impacting your quality of life, PAE could be a treatment option. It’s especially worth considering if you’ve tried medications without enough relief or have experienced side effects. 

5. You want a less invasive alternative to surgery

Procedures like TURP (transurethral resection of the prostate) are effective, but they require anesthesia, hospital stays, and carry a higher risk of certain sexual side effects. PAE is performed through a small pinhole in the wrist or groin, typically in an outpatient setting, and most patients return to normal activities within a few days. 

If you’ve recognized these signs, it may be worth talking to an interventional radiologist about PAE. The procedure offers a safe, effective, and minimally invasive way to relieve BPH symptoms while preserving sexual functions and avoiding major surgery.

Want to Learn More?

North Star Prostate Center now offers Urology Care. You can learn right now if you have BPH and take the next step to enjoying life to its fullest! Hear some of our patients’ stories and treatment overview on our website. 

As men age, certain health conditions become more common, but not always openly discussed. One of the most widespread issues is Benign Prostatic Hyperplasia (BPH), which is a non-cancerous enlargement of the prostate. More than half of men over 50 experience symptoms of BPH, and the likelihood increases with age. While it isn’t life-threatening, BPH can have a major impact on daily life, from sleep disruption to reduced quality of life.

What is BPH?

BPH occurs when the prostate gland, located just below the bladder, gradually enlarges and begins pressing against the urethra. This narrowing of the urinary passage makes it harder for urine to flow normally, leading to frustrating symptoms that can’t be ignored.

What are the Common symptoms of BPH?

The symptoms of BPH are often referred to as Lower Urinary Tract Symptoms (LUTS). These include:

• Frequent urination, especially at night
• Difficulty starting urination
• Weak or interrupted urine stream
• Feeling that the bladder isn’t empty
• Suddenly, urgent need to urinate

Why Does BPH Happen?

The exact cause isn’t fully understood, but researchers suggest:

• Hormonal changes related to aging (such as a shift in testosterone and estrogen levels)
• Genetic predisposition: if a close relative has BPH, you’re more likely to develop it
• Lifestyle factors, such as obesity, lack of exercise, and chronic health conditions like diabetes. 

Impacts on Quality of Life

While not dangerous itself, BPH can lead to:

• Interrupted sleep from frequent bathroom trips
• Decreased productivity during the day
• Emotional stress, embarrassment, or avoidance of social situations
• In more severe cases, urinary tract infections, bladder stones, or kidney issues

How PAE can help your BPH Symptoms

Prostate Artery Embolization (PAE) is one of the most promising solutions for men who suffer from BPH. This is a non-surgical, image-guided procedure that is performed by an interventional radiologist. PAE works by reducing blood flow to the prostate, causing it to shrink and relieving urinary symptoms with faster recovery times and fewer side effects compared to traditional surgical options.

Why Awareness Matters

Many men dismiss urinary changes as a “normal part of aging” and don’t realize effective treatment exists. Urology Awareness Month is a perfect reminder: if you’re experiencing symptoms of BPH, it’s worth talking to your doctor and learning about all the options that are out there, including PAE. 

Reach out to North Star Prostate Center

As pioneers in Prostate Artery Embolization (PAE), our team performed the first PAE procedures in the nation and continues to lead the way in minimally invasive treatment. Our advanced techniques help men find relief from prostate conditions without the need for hospitalization or anesthesia, resulting in faster procedures, easier recoveries, and better outcomes. Every patient receives personalized care with a focus on comfort, safety, and long-term success. Are you unsure if you have BPH? Click here to learn more about how our urologist can help. 

If you’ve been diagnosed with benign prostatic hyperplasia (BPH), you are likely weighing your treatment options. Two of the most commonly compared procedures are Transurethral Resection of the Prostate (TURP) and Prostate Artery Embolization (PAE). Both of these procedures aim to help relieve urination discomfort caused by an enlarged prostate, but they differ significantly in how they work, recovery time, and potential side effects. 

PAE is changing the game by offering men a quicker recovery, fewer complications, and no need for general anesthesia or hospital stays. Below, we’ll explore the differences between TURP and PAE and help you determine which treatment may be right for you.

What is BPH? 

BPH is a noncancerous enlargement of the prostate gland that commonly affects men over the age of 50. It can cause interrupted sleep with frequent trips to the bathroom, a weak stream, and sudden urgency to urinate. Treating BPH can improve your quality of life and help prevent more long-term bladder damage, such as overactive bladder (OAB), kidney damage, and urinary tract infections (UTIs). 

Overview of TURP (Transurethral Resection of the Prostate)

TURP involves the surgical removal of prostate tissue through the urethra. This is typically done under general or spinal anesthesia and requires a hospital stay of 1-3 days with a longer recovery period. While TURP has a high success rate in symptom relief, it can come with notable risks, including bleeding, infections, and a higher chance of urinary incontinence or sexual side effects such as retrograde ejaculation. 

Overview of PAE (Prostate Artery Embolization)

PAE is a minimally invasive procedure that is performed by an interventional radiologist. It works by blocking blood flow to specific regions of the prostate, causing the glands to shrink naturally over a period of time. This procedure is done by a small incision in the wrist or groin, requires no general anesthesia, and patients typically go home the same day. 

Head-to-Head Comparison of TURP and PAE

Who is a Good Candidate for PAE?

PAE is a great option for men looking to avoid surgery, preserve sexual function, or return to normal life. Men who value minimal disruption and fewer side effects often find PAE to be the best choice for them. 

Why Are More Men Choosing PAE?

Men are choosing PAE as it is minimally invasive, has a lower risk of complications, and has a faster recovery. As more men learn about the benefits, it’s quickly becoming the preferred option for treating benign prostatic hyperplasia (BPH).

Choosing the Right Path for You

Every patient is different, and the best treatment should align with your health, lifestyle, and goals. While TURP remains an effective option, PAE offers a compelling, more modern alternative that men are now choosing as their first option. 

Take the Next Step

Think PAE might be right for you? Schedule a consultation today with our specialists at North Star Prostate Center. Take our Quiz to find out if you’re the right candidate for PAE. Hear from some of our patients’ stories and the treatment overview on our website.

Considering Prostate Artery Embolization? Here’s what it is.

Prostate Artery Embolization (PAE) is a minimally invasive procedure that offers relief from Benign Prostatic Hyperplasia (BPH) symptoms, commonly known as an enlarged prostate. BPH is one of the most common health problems for men between the ages of 51 and 60 years old. PAE works by reducing the blood flow to the prostate, which causes the gland to shrink and relieves pressure on the urethra. With a success rate of 75% to 90%, PAE is a highly effective treatment that is minimally invasive and requires no hospitalization. 

Common symptoms of BPH include:

• Frequent urination (especially at night)
• A weak stream or straining to urinate
• Sudden urges to urinate
• Inability to completely empty your bladder

Learn more about common symptoms of BPH on our About BPH page. 

How is the procedure performed?

The procedure is performed by an interventional radiologist using a small catheter that is inserted into the groin or wrist. Guided by real-time X-ray imaging, the radiologist navigates to the arterial supply and injects tiny particles to block blood flow. This reduction in blood supply causes the prostate to shrink, easing pressure on the urethra and relieving urinary symptoms. 

There is minimal downtime once the procedure has been completed. Typically, the procedure takes between 90 minutes and 3 hours to perform, and patients are discharged the same day as the procedure. 

Why Choose Prostate Artery Embolization?

Compared to traditional surgeries, PAE is a much less invasive procedure, requiring only a small nick in the skin. Recovery times are significantly shorter, with most men resuming normal activities within a few days. In many cases, there is no need for a urinary catheter. 

PAE combines safety, precision, and effectiveness. The procedure is an excellent choice for men who want lasting relief without compromising comfort, sexual function, and overall quality of life. 

Are you a candidate for PAE? Click here to find out.

Want to learn more?

Hear some of our patients’ stories and the treatment overview on our website, or explore the Society of Interventional Radiology’s guide on prostate artery embolization for more details.

Golden Valley, MN — North Star Prostate Center is pleased to welcome Dr. Michael Borofsky, MD, to its team of specialists. A nationally recognized urologist with extensive expertise in minimally invasive treatments for benign prostatic hyperplasia (BPH) and complex urinary disorders, Dr. Borofsky will play a key role in the center’s pioneering Prostate Artery Embolization (PAE) program.

“I’m excited to offer men struggling with urinary flow issues timely access to multidisciplinary care through the North Star Prostate Center. By bringing together leading experts in interventional radiology and urology—including Dr. Borofsky—we’re ensuring that each patient receives personalized, collaborative care tailored to their unique needs and goals.” – from Andy Manos, Practice Manager

Dr. Borofsky brings a specialty focus on urinary issues related to benign prostate enlargement and has a deep commitment to personalizing care for every patient. He understands the significant impact BPH symptoms can have on quality of life and works closely with patients to tailor treatment options based on their specific symptoms, goals, and preferences. His approach includes lifestyle modifications, minimally invasive therapies like PAE, or surgical intervention when appropriate.

Dr. Borofsky’s clinical focus is supported by a strong academic and research background. He has been involved in numerous clinical trials and has authored peer-reviewed publications and textbook chapters. His work has been presented at national and international meetings, and he is frequently invited to speak on the benefits of team-based care for BPH management. His research has explored topics such as surgical innovation, kidney stone prevention, BPH treatment outcomes, and integrated care strategies for urinary obstruction.

Dr. Borofsky completed his medical degree at the University of Michigan, followed by a surgical internship and urologic surgery residency at New York University. He later completed a fellowship in Endourology at Indiana University, one of the country’s premier centers for minimally invasive urologic care. He currently serves as the fellowship director of endourology at the University of Minnesota.

Dr. Borofsky is now accepting new patients, with a clinical focus on male lower urinary tract symptoms related to BPH, as well as the evaluation and minimally invasive management of kidney stones.

To schedule an appointment with Dr. Borofsky or learn more about North Star Prostate Center, visit www.northstarprostate.com or call (952) 697-7406.

About North State Prostate Center:

At North State Prostate Center, we are redefining prostate care through innovation, expertise, and compassion. As pioneers in Prostate Artery Embolization (PAE), our team performed the first PAE procedures in the nation and continues to lead the way in minimally invasive prostate treatment. Our advanced techniques help men find relief from prostate conditions without the need for hospitalization or anesthesia, resulting in faster procedures, easier recoveries, and better outcomes. Every patient receives personalized care with a focus on comfort, safety, and long-term success.

Thinking about Prostate Artery Embolization? Here’s how to prepare.

Prostate Artery Embolization (PAE) is a safe, minimally invasive procedure that treats benign prostatic hyperplasia (BPH), an enlarged prostate, by blocking blood flow to the overgrown tissue. Many patients choose PAE as an alternative to surgery or long-term medications due to its low complication rate and quick recovery. At North Star Prostate Center, our goal is to make your experience as smooth and comfortable as possible, starting with the right preparation.

Key Steps to Prepare for PAE

To ensure optimal results and minimize risks, here are the essential steps you’ll need to follow before your procedure:

• Fasting Guidelines:
  • Do not eat or drink anything for at least 8 hours before your scheduled procedure. This includes water, gum, and mints. Your care team will let you know exactly when to start fasting based on your appointment time.
• Medication Instructions:
  • Continue to take any essential medications, such as those for high blood pressure or heart disease, with just a small sip of water. Your physician may instruct you to pause blood thinners or antiplatelet medications (e.g., aspirin, Plavix, or Eliquis) 3–5 days beforehand, so be sure to follow their specific guidance.
• Personal Hygiene:
  • Shower the night before the procedure to lower the risk of infection at the groin access site, where the catheter will be inserted.
• Clothing Tips:
  • Choose loose-fitting, comfortable clothing, especially pants or shorts that are easy to remove and put back on. You’ll be asked to change into a hospital gown before the procedure.
• Transportation:
  • You’ll receive moderate sedation during the embolization, which means you won’t be able to drive yourself home. Please arrange for a family member or trusted friend to accompany you.

Navigating Insurance and Cost for PAE

We know financial planning can feel overwhelming, especially when navigating a newer procedure like PAE. That’s why our administrative team is here to support you from the beginning:

• Insurance Verification:
  • We’ll check your benefits and determine whether PAE is a covered service under your specific health plan.
• Prior Authorizations:
  • If required, we’ll handle the prior authorization process and provide supporting documentation, such as your imaging results and symptom history.
• Cost Transparency:
  • If PAE is not covered or if you’re on a high-deductible plan, we can walk you through self-pay options, payment plans, and financing resources to help you make an informed decision.

Our goal is to eliminate as many barriers as possible, so you can focus on healing and symptom relief, not paperwork.

General Tips for All Interventional Radiology Procedures

Many of the prep steps for PAE also apply to other IR procedures. Keep these tips in mind:

• Complete Medication List:
  • Bring a list of all medications you take—including prescriptions, over-the-counter meds, vitamins, and herbal supplements. Some can interfere with sedation or bleeding risk.
• Hydration Reminder:
  • In the days leading up to your procedure, stay well hydrated—drink plenty of clear fluids before your fasting window begins.
• Comfort Matters:
  • Our clinic offers optional relaxation aids, including noise-canceling headphones, calming music, and augmented reality (AR) glasses, to help you feel at ease during preparation and recovery.
• Ask Questions:
  • No question is too small. Write them down in advance and bring them with you. Our team is here to provide clarity and reassurance every step of the way.

You’re in Good Hands at North Star Prostate Center
Choosing PAE is a proactive step toward improving your quality of life. Our experienced interventional radiologists, nurses, and administrative staff are dedicated to making your procedure safe, comfortable, and successful. By following these preparation steps, you’re setting yourself up for the best possible outcome.

Want to learn more?

Hear from some of our patients’ stories and the treatment overview on our website, or explore the Society of Interventional Radiology’s guide on prostate artery embolization for more details.