Medically Reviewed By William C. Lloyd III, MD, FACS
Written By Hedy Marks MPH on November 16, 2022
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Your Treatment Choice Is a Personal Decision
An enlarged prostate can be a nuisance but you have many treatment options. It is not cancer and urgent decisions are not required. Treatment largely depends on the severity of your symptoms, size of your prostate, your age and health, and your personal preference. Not all men with an enlarged prostate require treatment. Talk to your doctor about your symptoms and together you can determine the best treatment for you.
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Watchful Waiting
Although an enlarged prostate can cause bothersome symptoms, you may not need treatment right away. Your doctor may recommend watchful waiting to monitor your symptoms and check your prostate yearly for changes. However, an enlarged prostate is a progressive condition. It can worsen and cause other health problems, such as urinary tract infections and bladder problems. Report any new or worsening symptoms to your doctor.
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Lifestyle Changes
Many men with enlarged prostates have minor symptoms they can manage with lifestyle changes. This includes going to the bathroom as soon as you feel the urge and whenever you have the chance, even if you don’t feel the need. Also, cut back on coffee and alcohol, don’t drink fluids too close to bedtime, avoid medicines like decongestants and antihistamines, and maintain a healthy lifestyle. Practicing Kegel exercises can help strengthen the muscles around your bladder.
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Herbs and Supplements
Many people swear by certain herbal treatments to relieve symptoms of an enlarged prostate. Saw palmetto extract, made from berries from the saw palmetto shrub, is probably the most well-known. Other alternative treatments include beta-sitosterol and Pygeum africanum herbal extract. Studies of alternative treatments for an enlarged prostate have had mixed results. Always talk to your doctor before you begin taking any herbal treatment. Some can increase your risk of bleeding or interfere with other medications.
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Medication
When you aren’t getting the relief you need, it may be time to ask your doctor about prescription medicine. Medicines include alpha blockers, such as tamsulosin (Flomax), and 5-alpha-reductase inhibitors, such as finasteride (Proscar) and dutasteride (Avodart). Alpha blockers relax the muscles around the prostate and bladder to help the flow of urine. The 5-alpha-reductase inhibitors directly shrink the prostate and slow its growth by inhibiting hormones responsible for prostate growth. These drugs may be taken together or alone, but certain patients should not take these drugs. Always consult both your doctor and pharmacist regarding the risks and potential side effects of any newly prescribed treatment.
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Minimally Invasive Treatments
Minimally invasive procedures may provide symptom relief without the risks and side effects of conventional surgery. These include transurethral microwave thermotherapy (TUMT), transurethral needle ablation (TUNA), and water-induced thermotherapy. They use different techniques to generate heat and destroy excess prostate tissue. Your doctor can perform these minimally invasive procedures in the office using local anesthesia.
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Prostatic Stents
A stent may be an option if surgery is not possible or doesn’t work, or if you need relief before surgery can be scheduled. A stent is a small plastic or metal device that your doctor inserts through the urethra into the narrowed area. When expanded, the stent pushes back the prostatic tissue, widening the urethra. This should relieve urinary obstruction and make going to the bathroom easier.
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Surgery
Surgery is often the best long-term solution for men with enlarged prostates. There are several types of surgery to treat an enlarged prostate, including transurethral resection of the prostate (TURP), transurethral incision of the prostate (TUIP), open surgery, and laser surgery. In all of them, your doctor removes prostate tissue that is restricting urine flow withinthe urethra. Talk to your doctor about the different surgical options to find out which one is best for you.
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Key Takeaways
For mild to moderate symptoms, lifestyle modifications with or without medicine may be all you need to manage your symptoms. However, if your symptoms significantly impact your quality of life or get worse, talk to your doctor about other treatment options. No one treatment is right for everyone. Knowing the facts about your options will help you come to the right decision.
7 Treatment Options for Enlarged Prostate
BPH/Enlarged Prostate
About The Author
Hedy Marks MPH
- Surgery. Urology Care Foundation.http://www.urologyhealth.org/urologic-conditions/benign-prostatic-hyperplasia-(bph)/treatment/surger...
- Prostate Enlargement: Benign Prostatic Hyperplasia. National Institutes of Health.National Institute of Diabetes and Digestive and Kidney Diseaseshttp://www.niddk.nih.gov/health-information/health-topics/urologic-disease/benign-prostatic-hyperpla...
- Benign Prostatic Hyperplasia (BPH) - Enlarged Prostate. UCLA Health.http://urology.ucla.edu/body.cfm?id=478&ref=21&action=detail
- Treatments Aboundfor Enlarged Prostate. Beth Israel Deaconess Medical Center.http://www.bidmc.org/YourHealth/Health-Notes/MensHealth/ProstateHealth/BPH-New-Treatments.aspx
- Enlarged Prostate (BPH) Treatments. Emory Healthcare. http://www.emoryhealthcare.org/urology/treatment-services/mens-health-treatments/enlarged-prostate.html
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2022 Nov 16
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