BPH; Benign prostatic hypertrophy (hyperplasia); Prostate - enlarged
The choice of a treatment is based on the severity of your symptoms, the extent to which they affect your daily life, and the presence of any other medical conditions. Treatment options include "watchful waiting," lifestyle changes, medication, 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 the progression of your symptoms and determine if any changes in treatment are necessary.
For mild symptoms:
Many herbs have been tried for treating an enlarged prostate. Saw palmetto has been used by millions of men to ease BPH symptoms and is often recommended as an alternative to medication. Some studies have shown that it helps with symptoms, but there is evidence that this popular herb is no better than a dummy pill in relieving the signs and symptoms of BPH. Further studies are needed. If you use saw palmetto and think it works, ask your doctor if you should still take it.
Prostate surgery may be recommended if you have:
The choice of a specific surgical procedure is usually 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. See prostate removal for a description of complications.
Other, less-invasive procedures are available. These use different forms of heat to destroy prostate tissue, including:
None of these techniques have been proven to be better than TURP. Patients who receive these less-invasive procedures are more likely to need surgery again after 5 or 10 years. However, these procedures may be a choice for:
Robot-guided prostatectomy is another newer technique. However, the technology is not widely available, and surgeon experience should be taken into consideration. In addition, there are no long-term studies of this surgery.
Another form of treatment is prostatic stents.
For more information, see prostate surgery.
See: BPH support groups
Men who have had long-standing BPH with a gradual increase in symptoms may develop:
Even after surgical treatment, a recurrence of BPH may develop over time.
Call your doctor right away if you have:
Also call your doctor if:
Bent S, Kane C, Shinohara K, et al. Saw palmetto for benign prostatic hyperplasia. NEJM. 2006;354:557-566.
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Lourenco T, Pickard R, Vale L, Grant A, Fraser C, MacLennan G, et al. Minimally invasive treatments for benign prostatic enlargement: systematic review of randomised clinical trials. BMJ. 2008;337:a1662.
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