For reasons that remain unclear, the walnut-sized prostate gland grows gradually in most men as they age. This growth may cause symptoms like weak urine flow or trouble emptying the bladder. If these symptoms interfere with your daily activities, talk to your doctor. A physical exam and a few simple blood tests can help find the right treatment for you.
Enlarged prostate treatment focuses on managing your symptoms and preventing them from getting worse. Your care team will consider your health, the severity of your symptoms and your preferences when deciding what type of enlarged prostate treatment to recommend. Treatment options include “watchful waiting,” lifestyle changes, medicines and surgery.
If your enlarged prostate causes only mild symptoms, you and your urologist may decide to wait and watch (watchful management). You can do things to make it easier to pee. These include avoiding liquids and foods that are high in fat or sugar, and trying to go to the bathroom before you get tired or sit down. You can also practice double voiding, which means waiting a few moments after you think you’ve finished peeing before trying again. Practicing this can reduce the amount of urine that flows back into the urethra.
A urologist will examine your prostate with a tool called a digital rectal exam. This involves inserting the gloved digit of the provider into your rectum and feeling the edges and surface of the prostate for signs of a large or hard mass. The urologist will also ask about your symptoms and their severity.
Several types of less-invasive surgery are available for people with BPH who do not want to take medication or have tried self-care steps and found no improvement. One option is called transurethral resection of the prostate (TURP). This is done through the urethra with an instrument called a resectoscope. The urologist removes some tissue from the prostate, relieving pressure on the urethra and making it easier to urinate. This is performed in an outpatient setting with local anesthesia.
Another less-invasive surgery is called truncal intraprostatic vaporization (TUVP). In this procedure, the urologist uses an instrument called a cystoscope to enter the bladder through the urethra and into the prostate. The urologist then sends a tool with a lens, a light and a tool that creates an electrical current through the resectoscope into the prostate. This tool heats and destroys some of the prostate tissue. This makes it easier to urinate and prevents the blockage from coming back.
Other less-invasive procedures include photoselective vaporization of the prostate with holmium (HoLEP) or thulium (ThuLEP) laser, prostatic urethral lift and transurethral needle ablation with radiofrequency energy or water vapor thermal therapy. You and your urologist will discuss the benefits, risks and cost of each type of enlarged prostate treatment before recommending one. A urologist will usually recommend medication if you choose not to undergo surgery. Medicines can relieve your symptoms and slow or stop prostate growth. Examples of these medicines are alpha blockers, which relax the muscle at the base of the bladder; anticholinergics, which slow the movement of fluids in the body; and 5-alpha reductase inhibitors, which shrink the prostate.
