BPH treatment options: how to treat an enlarged prostate with lifestyle changes, medication, or surgery

Benign Prostatic Hyperplasia (BPH), also known as an enlarged prostate, is a common condition that affects many men as they age. 

Fortunately, BPH is treatable, and there are a wide range of options – from lifestyle changes to medications and surgical procedures.

Lifestyle changes to manage BPH naturally

For men with mild symptoms of an enlarged prostate, simple lifestyle adjustments can make a big difference. 

• Reduce caffeine and alcohol, especially at night

• Empty your bladder completely when urinating

• Limit fluid intake at night to reduce nighttime trips to the bathroom

• Exercise regularly to support urinary and prostate health

• Eat  foods rich in fruits, vegetables, and whole grains

• Do not hold urine. Go when you feel the urge

• Avoid medications like decongestants and antihistamines, which may worsen BPH symptoms

Medications to treat BPH symptoms

Your doctor may recommend medications to treat BPH. These drugs can relax the prostate or shrink it over time:

1. Alpha-blockers

These medications relax the muscles around the bladder neck and prostate to improve urine flow:

• Tamsulosin (Flomax)

• Alfuzosin (Uroxatral)

• Silodosin (Rapaflo)

2. 5-Alpha reductase inhibitors

These drugs block the hormone that causes prostate growth:

• Finasteride (Proscar)

• Dutasteride (Avodart)

3. Combination therapy

For moderate to severe BPH, your provider may prescribe both an alpha-blocker and a 5-alpha reductase inhibitor for better long-term results.

Minimally invasive procedures for BPH 

Several less invasive procedures are available for moderate to severe BPH:

• Prostatic urethral lift (UroLift®): small implants hold the enlarged prostate tissue away from the urethra.

• Water vapor thermal therapy (Rezum™): steam is used to shrink excess prostate tissue.

• Transurethral microwave thermotherapy (TUMT): microwave energy to destroy overgrown tissue.

• Prostatic artery embolization (PAE): blocks blood flow to the prostate, causing it to shrink.

• Aquablation® therapy: arobotic-assisted high-pressure water jet removes prostate tissue with high precision.

Surgery for severe BPH

Surgery is typically reserved for men with severe BPH symptoms or very large prostates that don't respond to other treatments. Options include:

• Transurethral sesection of the prostate (TURP): removes excess tissue using a scope inserted through the urethra.

• Transurethral incision of the prostate(TUIP ): small cuts are made to widen the urethra and improve flow.

• Transurethral electrovaporization: uses high heat to vaporize excess tissue.

• Laser therapy (GreenLight™, HoLEP): lasers remove or vaporize overgrown prostate tissue with precision and minimal bleeding.

• Open simple prostatectomy: used for very large prostates, this involves surgically removing the tissue through an incision.

Choosing the right treatment for BPH

The best way to treat an enlarged prostate depends on your symptoms, prostate size, and overall health. 

Why treating an enlarged prostate matters

While BPH isn't cancer, it can lead to serious problems if left untreated, including:

• Bladder stones

• Urinary tract infections

• Bladder damage

• Kidney damage

Benign Prostatic Hyperplasia (BPH) is a common part of aging, but that doesn’t mean you have to live with uncomfortable or disruptive symptoms. From simple lifestyle adjustments to medications, minimally invasive procedures, and surgery, there are a wide range of effective treatment options available. The right approach depends on your symptoms, prostate size, and overall health. By working with a healthcare provider, you can create a personalized plan to relieve symptoms, protect urinary function, and improve your quality of life.