Symptoms that bring men in from north Atlanta and intown
A weak urine stream may be slower than it used to be, may stop and start, or may take a while to get going. Trouble urinating can also mean a long wait before anything starts, or a sense that you have to strain. Night trips add up. Some men notice they stand longer at the toilet, or that they feel they have not finished. These changes can come from an enlarged prostate, and they can also come from the bladder, medicines, or other health conditions, which is why we look rather than assume.
If you live in Sandy Springs, Buckhead, Brookhaven, or Dunwoody, the Johnson Ferry Road clinic sits just inside I-285 and is often the campus we book first. If Irvin Way is closer, you can begin in Decatur. Call 678-344-8900 and we will tell you the earliest opening we can offer.
How we evaluate a weak stream or night waking
We ask how long this has been going on, how many times you get up, what you drink in the evening, and which medicines you take. An exam is often part of the first visit, and we may measure how well the bladder empties and, when it would change the plan, the size of the prostate. Those details help us talk about medicine first, or about a procedure, with something more specific than a generic list.
If you cannot pass urine at all, that is an emergency: call 911 or get to an emergency department so the bladder can be drained. After that urgent step, call us and we will plan the next visit at Sandy Springs or Decatur.
Treatment options we already offer
Many men start with a carefully chosen medicine. When medicine is not enough, or you would rather not stay on it, our urologists already offer UroLift, Aquablation, ThuLEP or HoLEP, and TURP. We will explain, in plain words, how those options differ and which of them, if any, fits the prostate we are looking at and the goals you care about, including recovery and sexual function. For a fuller comparison, see our enlarged prostate page and our article What is Aquablation therapy?.
Advanced Urology also offers prostate artery embolization, often called PAE, at its Decatur and Alpharetta locations. We mention those two campuses because that is where the practice provides this procedure. We will talk about whether PAE belongs in your plan after we have examined you, and we will not use this page to claim a particular result. You can read the official prostate artery embolization page, and, for the north side of Atlanta, the official Alpharetta / Roswell office listing, both on advancedurology.com.
At Sandy Springs, Vahan Kassabian, MD; Herman Bagga, MD, FACS; and Marc Greenstein, DO, care for men with these symptoms, and many procedures happen in the surgery center in the same building. At Decatur, the official office page lists physician assistants on the on-site team; a later procedure is scheduled at a surgery center in the practice.
Vahan Kassabian, MDUrologist; Director of Prostate Center 
Herman Bagga, MD, FACSUrologic surgeon 
Marc Greenstein, DOUrological surgeon; Director, Surgery Center Sandy Springs
A short talk from Dr. Greenstein on BPH
Dr. Marc Greenstein, who practices at our Sandy Springs clinic and directs the surgery center there, recorded this official talk on BPH, the usual name for an enlarged prostate. Watch it as background for a visit about a weak stream or night trips, then come in so we can look at your own exam and any prior tests.
Questions men ask about a weak urine stream and peeing at night
Is trouble urinating or a weak urine stream something I should ignore?
Not if it is new, getting more frequent, or coming with a weaker stream, trouble urinating, or a feeling that you do not empty. Getting up at night has several causes, and the visit is where we sort out whether the prostate, the bladder, or something else is driving them.
Do I have to have a procedure?
No. Plenty of men stay on medicine, or even on a close-watch plan, when that still makes sense. We offer procedures when they would help, and we will say so if waiting is still reasonable.
What is the difference between UroLift, Aquablation, and a laser procedure, in brief?
UroLift holds tissue away from the urine channel with small implants and does not cut tissue out. Aquablation uses a waterjet to remove blocking tissue. HoLEP and ThuLEP use a laser to remove tissue. TURP is a more classic trimming of the tissue through the urine channel. We will tell you which of those, if any, fits your prostate. Our enlarged prostate page stays with that comparison at more length.
Can I start at the Decatur office?
Yes. The first conversation can happen at 2711 Irvin Way. If a procedure is later recommended, we will tell you whether it is planned at the Sandy Springs surgery center or at another Advanced Urology surgery center.
Will this visit also look at my PSA?
If you have a recent PSA, bring it. If you do not, we will talk about whether checking one belongs in your plan. A weak stream and a high PSA are related conversations, not the same test. See our elevated PSA page if a number is what started this.
When should I go to the emergency department?
If you cannot pass urine at all, if bleeding is heavy, or if a high fever arrives with urinary symptoms, call 911 or go to an emergency department now. For a stream that has slowed or night trips you can plan around, call 678-344-8900 and we will get you on the schedule.
You can also read Advanced Urology's enlarged prostate (BPH) overview. Related pages on this site include overactive bladder and Why do I keep waking up to pee at night?.
Prostate artery embolization (PAE) is done at Decatur and Alpharetta. Our PAE page explains the procedure, and the official details stay on Advanced Urology's PAE page.
What the video covers
On this Sandy Springs page the official video we link is titled Dr. Greenstein on BPH. This Sandy Springs summary stays with that public title and does not add other claims.