BPH Treatment: Practical Options for Prostate Enlargement

BPH (benign prostatic hyperplasia) means the prostate has grown and is crowding the urethra. That shows up as slow stream, urgent nights, or needing to go often. You don’t have to accept this as just getting older — there are clear options that work for different symptoms and goals.

Medical treatments that help fast and slow

There are two main medicine approaches. Alpha-blockers (tamsulosin, terazosin, alfuzosin) relax the muscles around the prostate and bladder neck. They often improve urine flow within days but can cause dizziness, low blood pressure, or retrograde ejaculation.

5-alpha-reductase inhibitors (finasteride, dutasteride) shrink prostate tissue over months. They work best if the prostate is noticeably enlarged. Expect sexual side effects in some men, and benefits take 3–6 months to show. Doctors sometimes combine both drug types for stronger relief.

For storage symptoms like urgency or incontinence, antimuscarinics or mirabegron can help. If you also have erectile dysfunction, tadalafil can ease both ED and BPH symptoms. Always check with your prescriber about interactions and side effects — many common blood pressure drugs or cold medicines can make urinary problems worse.

Procedures, when meds aren't enough, and simple fixes you can try

If meds don’t cut it, several procedures exist. TURP (transurethral resection of the prostate) is the traditional surgery and very effective but more invasive. Newer options include UroLift (tiny implants that lift the prostate away from the urethra), Rezum (steam to reduce tissue), and laser enucleation. UroLift often preserves sexual function, Rezum is quick with short recovery, and laser techniques are precise for larger glands. Your urologist can explain which fits your prostate size and priorities.

Acute urinary retention — when you can’t urinate at all — needs immediate care. A temporary catheter or urgent surgery may be needed.

Small lifestyle changes help a lot. Reduce evening fluids, cut caffeine and alcohol, double-void (try urinating twice in a short span), and avoid medicines that tighten the bladder neck like some antihistamines. Pelvic floor exercises can improve control. Some men try supplements like saw palmetto; evidence is mixed, so ask your doctor before starting anything.

Watch for red flags: blood in urine, fever, sudden inability to pee, or rapid worsening. Those need prompt medical attention. If symptoms are bothering your sleep, work, or mood, talk to a primary doctor or urologist — treatment can be tailored to your life and your goals.

Want help deciding which option fits you? Make a list of your symptoms, any medications you take, and what you want to avoid (like sexual side effects). Bring that to your appointment and ask about recovery time, risks, and likely benefits for your prostate size.