Do all men get BPH?

Prostate enlargement happens to almost all men as they get older. An enlarged prostate is often called benign prostatic hyperplasia (BPH). It is not cancer, and it does not raise your risk for prostate cancer.

mountsinai.org - Enlarged prostate Information | Mount Sinai - New York

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The treatment you choose will be based on how bad your symptoms are and how much they bother you. Your provider will also take into account other medical problems you may have.

Treatment options include "watchful waiting," lifestyle changes, medicines, or surgery.

If you are over 60, you are more likely to have symptoms. But many men with an enlarged prostate have only minor symptoms. Self-care steps are often enough to make you feel better. If you have BPH, you should have a yearly exam to monitor your symptoms and see if you need changes in treatment.

SELF-CARE

For mild symptoms:

Urinate when you first get the urge. Also, go to the bathroom on a timed schedule, even if you don't feel a need to urinate.

Avoid alcohol and caffeine, especially after dinner.

DO NOT drink a lot of fluid all at once. Spread out fluids during the day. Avoid drinking fluids within 2 hours of bedtime. Try NOT to take over-the-counter cold and sinus medicines that contain decongestants or antihistamines. These drugs can increase BPH symptoms. Keep warm and exercise regularly. Cold weather and lack of physical activity may worsen symptoms.

Reduce stress. Nervousness and tension can lead to more frequent urination.

MEDICINES

Alpha-1 blockers are a class of drugs that are also used to treat high blood pressure. These medicines relax the muscles of the bladder neck and prostate. This allows easier urination. Most people who take alpha-1 blockers notice improvement in their symptoms, usually within 3 to 7 days after starting the medicine. Finasteride and dutasteride lower levels of hormones produced by the prostate. These drugs also reduce the size of the gland, increase urine flow rate, and decrease symptoms of BPH. You may need to take these medicines for 3 to 6 months before you notice symptoms getting better. Possible side effects include decreased sex drive and impotence. Antibiotics may be prescribed to treat chronic prostatitis (inflammation of the prostate), which may occur with BPH. BPH symptoms improve in some men after a course of antibiotics.

Watch out for drugs that may make your symptoms worse:

SAW PALMETTO

Many herbs have been tried for treating an enlarged prostate. Many men use saw palmetto to ease symptoms. Some studies have shown that it may help with symptoms, but results are mixed, and more research is needed. If you use saw palmetto and think it works, ask your doctor if you should still take it.

SURGERY

Prostate surgery may be recommended if you have:

The choice of which surgical procedure is recommended is most often based on the severity of your symptoms and the size and shape of your prostate gland. Most men who have prostate surgery have improvement in urine flow rates and symptoms. Transurethral resection of the prostate (TURP): This is the most common and most proven surgical treatment for BPH. TURP is performed by inserting a scope through the penis and removing the prostate piece by piece. Simple prostatectomy: It is a procedure to remove the inside part of the prostate gland. It is done through a surgical cut in your lower belly. This treatment is most often done on men who have very large prostate glands. Other less-invasive procedures use heat or a laser to destroy prostate tissue. Another less-invasive procedure works by "tacking" the prostate open without removing or destroying tissues. None have been proven to be better than TURP. People who receive these procedures are more likely to need surgery again after 5 or 10 years. However, these procedures may be a choice for:

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Is BPH a serious condition?

BPH is not life-threatening, but it can be bothersome. There are also some complications that can occur. These include: Inability to urinate.

familydoctor.org - Benign Prostatic Hyperplasia (BPH) - familydoctor.org

BPH treatment

Treatment for BPH depends on what symptoms you have and how severe they are. Options include lifestyle changes, medicine, minimally invasive procedures, and surgery.

Lifestyle changes

If your symptoms are mild or only slightly bothersome, you can usually control them with simple changes. These include:

Reduce liquid intake, especially before bed or going out in public.

Avoid caffeine, alcohol, and over-the-counter medicines that make you urinate more.

Train your bladder to hold urine longer.

Exercise your pelvic floor muscles.

Prevent constipation.

Medicine

Your doctor can prescribe different medicines to treat BPH. Some of these improve urine flow or reduce blockages in the bladder. Others stop or shrink the growth of the prostate. Sometimes a combination of different medicines is used. Your doctor will recommend medicine based on your symptoms and condition.

Minimally invasive procedures

Minimally invasive treatment does not involve surgery. These treatments use heat to destroy prostate tissue that is pressing on the urethra. They can usually be done in the doctor’s office. This is done by inserting a catheter (a thin, flexible tube) through the urethra to reach the prostate. These treatments may require local, regional, or general anesthesia. These treatments relieve symptoms. They do not cure BPH. Your doctor will consider your symptoms and overall health when deciding what procedure you should have.

Surgery

Surgery is the most effective treatment for BPH. It is a last resort when other treatments fail. This is also the best way to diagnose and cure early cancer of the prostate. Surgery is usually done through the urethra, leaving no scars. Surgery does have risks. These include bleeding, infection or impotence. Risks are generally small.

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