Men's Pelvic Condition
Benign Prostatic Hyperplasia (BPH)
By Dr. Anthony J. Gordon, Doctor of Acupuncture | Last reviewed September 2026
You are up two or three times a night, the stream is slow to start and weak when it does, and you rarely feel fully empty. An enlarged prostate is only one factor. How the pelvic floor behaves and how the bladder and nerves communicate also shape how much BPH affects your day.
Prefer to talk it through? Call (516) 597-5400. Most new patients are seen within one to two weeks.
Overview
Understanding BPH and Urinary Symptoms
Benign prostatic hyperplasia is a non-cancerous enlargement of the prostate that becomes more common with age. Because the prostate wraps around the urethra, growth can narrow the channel and make urination slower and less complete. Over time, the bladder works harder to push urine past the obstruction and can become more reactive.
Symptoms, however, do not track neatly with prostate size. Some men with large prostates have few symptoms, while others with modest enlargement are up all night. Pelvic floor tone plays a role. If the muscles around the urethra do not relax fully during urination, flow slows further. A tense pelvic floor can also increase urgency and the sense of incomplete emptying.
Your urologist monitors the prostate, checks PSA and manages medications or procedures. Dr. Gordon works alongside that care by addressing pelvic floor tone and bladder-related nerve signaling, which can ease frequency, urgency and nighttime waking.
Benign Prostatic Hyperplasia (BPH) at a Glance
Also called
Enlarged prostate, benign prostatic enlargement
Who it affects
Men, increasingly common after age 50
Common symptoms
Frequency, urgency, weak or interrupted stream, dribbling, waking at night to urinate
Typical medical care
Monitoring, medications to relax or shrink the prostate, and procedures when needed
What Dr. Gordon addresses
Pelvic floor tone, bladder urgency signaling, sacral nerve regulation
The Gap in Care
Why BPH Symptoms Are Not Always About Prostate Size
Medical care for BPH focuses on the prostate itself, which is essential. When symptoms persist despite treatment, the muscles and nerves around the bladder are often worth a closer look.
What routine testing is looking for
- Prostate size on exam or ultrasound
- PSA levels
- Urine flow rate and leftover urine
- Infection or stones
What often keeps symptoms going
- Pelvic floor muscles that do not relax during urination
- An overactive urgency signal from the bladder
- Straining habits that tighten the pelvic floor further
- Evening fluid and caffeine patterns
- Nerve signaling between the bladder and spinal cord
These are assessed with a pelvic floor and nerve examination, which complements the prostate-focused care from your urologist.
Signs & Symptoms
Does This Sound Like You?
Symptoms vary from person to person. These are the patterns Dr. Gordon sees most often.
Waking at night to urinate
Getting up two or more times a night, which disrupts sleep.
Weak or slow stream
A stream that is slow to start, weak, or stops and starts.
Urgency and frequency
Needing to go often and sometimes urgently during the day.
Feeling of incomplete emptying
Still feeling like you need to go right after finishing.
Dribbling after urination
Leakage of a few drops after you think you are done.
Straining to empty
Needing to push or bear down to get urine moving.
Root Causes
The Four Drivers Dr. Gordon Looks For
Most people have more than one of these in play. Finding which one leads makes treatment more efficient.
Prostate enlargement
Growth of the prostate narrows the urethra. Your urologist manages this with monitoring, medication or procedures.
Pelvic floor tone
When the pelvic floor does not relax fully during urination, flow slows further. Straining makes the muscles tighten even more.
Bladder overactivity
A bladder that works against resistance for years can become more reactive, sending urge signals earlier and more often.
Nerve regulation
Sacral nerves coordinate bladder filling and emptying. Calming this signaling can reduce urgency and nighttime waking.
Your First Visit
How Dr. Gordon Evaluates Benign Prostatic Hyperplasia (BPH)
The initial evaluation runs 60 to 75 minutes. You leave with a clear picture of what is driving your symptoms, a written plan, a realistic timeline, and in most cases your first treatment.
Records and history review
Dr. Gordon reviews your urology notes, PSA history, flow studies, medications and how your symptoms have changed over time.
Pelvic floor and abdominal assessment
External assessment of the lower abdomen, pelvic floor and hips to check tone and coordination.
External pelvic floor assessment
The pelvic floor muscles are examined from the outside, with no internal exam. With you draped for comfort, gentle pressure around the perineum, sit bones, tailbone and inner thighs checks tone, tenderness and trigger points.
Voiding habits review
Dr. Gordon looks at your daily and nighttime pattern, fluid and caffeine timing, and any straining habits.
Plan and coordination
A clear plan, plus communication with your urologist or pelvic floor PT when that helps your care.
When to see a physician first
- Fever or chills with pelvic or urinary symptoms
- Inability to urinate
- Visible blood in the urine or semen
- Sudden, severe testicular pain or swelling
- A new lump in the testicle
- New numbness in the saddle area or loss of bladder or bowel control
If you have any of these, contact your doctor or go to the nearest emergency department.
Bring to your first visit
Records
Recent lab results, imaging reports and specialist notes. These can also be faxed ahead.
Treatment history
A short list of what you have tried and what did or did not help.
Clothing
Something comfortable and loose fitting.
Treatment
How Dr. Gordon Treats It
These are the tools Dr. Gordon uses most often for BPH, chosen from your exam findings.
Primary approach
Intrapelvic & Extrapelvic Dry Needling
Dr. Gordon holds ASE certification in both intrapelvic and extrapelvic dry needling. Treatment focuses on releasing tension in the pelvic floor and hip muscles so the pelvic floor can relax more fully during urination. The needles go in through the skin of the buttock, perineum or inner thigh, never through the vagina or rectum.
Learn about pelvic floor treatmentNerve focus
Neuro-Functional Acupuncture
Electro-acupuncture along sacral nerve pathways that help regulate the bladder, aimed at reducing urgency, frequency and nighttime waking.
See servicesBetween visits
Bladder Habits & Team Coordination
Practical guidance on fluid timing, voiding without straining and bladder habits, coordinated with your urologist's medical plan.
Referring provider? Contact the clinicWhat to Expect
A Typical Recovery Arc
Visits 1 to 3
Establish a baseline
Dr. Gordon assesses your pelvic floor and bladder pattern and begins treatment. Some men notice fewer nighttime trips early on.
Visits 4 to 8
Reduce urgency
Frequency and urgency often ease, and emptying may feel more complete.
Visits 9 and beyond
Maintain gains
Visits are spaced out, with a maintenance plan that works alongside your medical care.
Most patients are seen weekly or every other week during active care. Individual results vary with how long symptoms have been present and how reactive they are. Progress is reassessed at every visit.
Not sure how to describe it? Put your pain or discomfort into words before your visit
"Dr. Gordon is thoughtful, thorough and incredibly knowledgeable. He has significantly helped me with pain management and pelvic floor issues. I am grateful to have his expertise in my corner."
Dina Isola, Google Review
Benign Prostatic Hyperplasia (BPH) Questions
Answers About Benign Prostatic Hyperplasia (BPH)
Still unsure whether this is the right fit? Reach out before you book and Dr. Gordon will talk through your history with you.
No. Prostate size is managed by your urologist. Dr. Gordon's treatment focuses on pelvic floor tone and bladder nerve signaling, which influence how much your symptoms affect daily life.
No. Continue your medications as prescribed. Any change should be discussed with your urologist.
The pelvic floor needs to relax for urine to flow easily. If it stays tight, it adds resistance on top of the enlarged prostate, and straining makes it tighter still.
Some men notice changes in nighttime waking or urgency within a few visits, while others take longer. Dr. Gordon reassesses progress at every visit.
Most men start with a course of eight to twelve sessions, then move to periodic maintenance if it is helping.
They can be. Blood in the urine, inability to urinate, fever or rapidly worsening symptoms need prompt medical care, and regular prostate monitoring with your urologist is important.
Before You Book
General Questions
The clinic is an out-of-network practice. The initial evaluation is $300 and follow-up visits are $250. After each visit you receive a detailed superbill to submit to your PPO plan for possible reimbursement. FSA and HSA cards are accepted, and the clinic can run a complimentary benefits check before your first appointment. The check is a courtesy, so please confirm your coverage with your plan. See Insurance & Fees for details.
The first evaluation is 60 to 75 minutes and usually includes treatment. Follow-up visits run 45 to 60 minutes.
Yes. Call (516) 597-5400 or send a message through the contact page. This is especially helpful if your case is complex and you want to understand the approach before committing to a full evaluation.
1508 Union Turnpike, Suite 133, North New Hyde Park, NY 11040, with free parking on site. The clinic is an easy drive from Manhasset, Great Neck, Garden City, Lake Success, Floral Park and Mineola. Early morning, evening and weekend hours are available.
Most people feel a quick muscle twitch or a deep ache that lasts a few seconds. That twitch is a normal sign the trigger point is releasing. Mild soreness for 24 to 48 hours afterward, similar to a hard workout, is common. Depth, angle and stimulation are adjusted to your comfort.
Both use the same fine, sterile, single-use needles. Dry needling targets specific trigger points and tight bands in muscle based on your exam. Neuro-functional acupuncture targets nerve pathways, often with gentle electrical stimulation, to calm nerve sensitivity. For BPH, Dr. Gordon commonly uses both.
When performed by a trained, licensed provider with detailed knowledge of anatomy, it has a strong safety record. Tell Dr. Gordon if you take blood thinners, have a bleeding disorder, are pregnant or have a weakened immune system so he can plan accordingly.
It is a technique that reaches the deep pelvic floor muscles, including the levator ani, obturator internus and coccygeus, to release trigger points and restore normal muscle function. The needles go in through the skin of the buttock, perineum or inner thigh, never through the vagina or rectum. Dr. Gordon holds ASE certification in this technique, which few practitioners in New York have.
Yes. Your privacy and comfort come first. When undressing is needed for the area being treated, you are fully draped. Needles are placed through the skin only, and nothing is ever inserted into the vagina or rectum. You can pause or stop at any time.
Yes. Many men put off care for pelvic and genital symptoms because the topic feels awkward. Dr. Gordon keeps things straightforward and clinical, explains every step, and treats adults of all genders and identities in a respectful, welcoming setting.
It helps to have had a medical workup so serious causes have been checked. If you have not seen a urologist for these symptoms yet, call the clinic to talk through the best order of steps.
About Dr. Anthony J. Gordon
Dr. Anthony J. Gordon is a Doctor of Acupuncture licensed in New York and board certified. He holds ASE certification in intrapelvic and extrapelvic dry needling, along with advanced certifications in Functional Dry Needling and Neuro-Functional Acupuncture. With more than 18 years of clinical experience and over 3,000 complex cases treated, he focuses on pelvic, spinal and orthopedic conditions that have not responded to standard care, and works closely with each patient's physicians and physical therapists.
Read Dr. Gordon's full bioBook an Evaluation for Benign Prostatic Hyperplasia
Book an evaluation with Dr. Gordon and find out whether your pelvic floor and bladder signaling are adding to your BPH symptoms.
Early morning, evening and weekend appointments available. Free on-site parking.
Symptoms
Common Symptoms of BPH
Further Reading
Enlarged Prostate or Tight Pelvic Floor? Why Urinary Symptoms in Men Are Not Always the Prostate
From the blog: A weak stream, hesitancy and dribbling are often blamed on the prostate. How BPH and a tight pelvic floor differ, why many men have both, and who checks first.