Isreali doctors appear to have nailed the cause of benign prostate hyperplasia (BPH) - see abstract and links below. In short it is the failure of the venous drainage system (varicocele) that is the cause. For most men with BPH their varicocele is sub-clinical and bilateral. The treatment is essentially the same as for varicocele except extra care is taken to include the occlusion of the ISVs on both sides and of all the associated vertical venous bypasses and the retroperitoneal collaterals.

The research this paper is based on looks impressive and I have not found any challenges to it in the literature. Still, this appears to be relatively unknown in the US. It is fairly recent (published in 2008) but it is so important that you would think everyone would know by now. Intead many men are still submitting to extremely invasive prostate damaging treatments like TURP.

This post is mainly an FYI but I would like to hear comments from anyone that knows anything about this or has discussed this with a doctor. Some people travel to Isreal for treatment but the treatment is close enough to what US doctors do that it should be possible to do it here. Has anyone tried?

Reversal of benign prostate hyperplasia by selective occlusion of impaired venous drainage in the male reproductive system: novel mechanism, new treatment
Y. Gat1,2, M. Gornish1, M. Heiblum2 & S. Joshua3

The prostate is an androgen-regulated exocrine gland producing over 30% of
the noncellular components of the semen and promoting optimal conditions
for survival and motility of sperm in the vagina. Benign prostate hyperplasia
(BPH) is the most common benign neoplasm in men. Its aetiology is not clear,
and therefore, current medical treatments are directed towards the symptoms.
Though testosterone is known to be the promoter of prostate cell proliferation,
no causal relation between serum testosterone levels and BPH has been found.
In this study, we propose a novel and tested pathophysiological mechanism for
the evolution of BPH and suggest a tested and effective treatment. We found
that in all BPH patients, the one-way valves in the vertically oriented internal
spermatic veins are destroyed (clinically manifested as varicocele), causing
elevated hydrostatic pressure, some 6-fold greater than normal, in the venous
drainage of the male reproductive system. The elevated pressure propagates to
all interconnected vessels leading to a unique biological phenomenon: venous
blood flows retrograde from the higher pressure in the testicular venous drainage
system to the low pressure in the prostatic drainage system directly to the
prostate (law of communicating vessels). We have found that free testosterone
levels in this blood are markedly elevated, with a concentration of some 130-
fold above serum level. Consequently, the prostate is exposed to: (i) increased
venous pressure that causes hypertrophy; (ii) elevated concentration of free testosterone
causing hyperplasia. We have treated 28 BPH patients using a technique
that restores normal pressure in the venous drainage in the male
reproductive system. The back-pressure and the back-flow of blood from the
testicular to the prostate drainage system were eliminated and, consequently, a
rapid reduction in prostate volume and a regression of prostate symptoms took

Reversal of Benign Prostate Hyperplasia by Super-selective Intraprostatic Androgen Deprivation Therapy