Breaking Down Your Enlarged Prostate Treatment Options

So, you’ve just been diagnosed with an enlarged prostate.

The good news? An enlarged prostate is very common, especially as you age. In fact, over 50% of men will have had an enlarged prostate by the time they turn 60 — and by age 85, that number increases to 90%.

The bad news? You are likely to experience symptoms such as trouble urinating, needing to urinate frequently, dribbling after urination ends, or the sensation of your bladder being full even when it is empty. 

Fortunately, there are several enlarged prostate treatment options for you to consider, so you won’t have to suffer with these symptoms. Keep reading for an overview of the condition, as well as four main treatment options that can help you find relief.

What is an enlarged prostate?

Part of the male reproductive system, the prostate is a small, muscular gland that sits below the bladder and surrounds the urethra. Benign Prostatic Hyperplasia (BPH), or an enlarged prostate, is a common urological condition that occurs when the cells in your prostate gland begin to multiply. An enlarged prostate causes the prostate gland to swell, which puts pressure on the urethra and prevents urine from passing. 

Symptoms of an Enlarged Prostate

You should notify or visit your doctor if you experience any of the following symptoms, as they could be an indication of an enlarged prostate.

Common BPH symptoms include:

  • Difficulty urinating or a weak urinary stream
  • Stopping and starting during urination
  • Significant dribbling after urination
  • Incomplete emptying of the bladder
  • Having to urinate again shortly after urination
  • Frequent urination, especially at night
  • Urgent need to urinate
  • Blood in urine

Enlarged Prostate Treatment Options

There are various surgical, as well as minimally-invasive, enlarged prostate treatment options that your urologist can recommend depending on your symptoms and how severe they are. Below are the four main treatment options. 

1. Watchful Waiting and Active Surveillance

Although this might not be the answer you were expecting, sometimes it is best to wait before starting any treatment immediately. This type of enlarged prostate treatment is for the patient who is either symptom-free or experiencing mild symptoms.

But don’t worry — your urologist won’t simply leave you to deal with your enlarged prostate on your own. Through regular checkups, your urologist will monitor your symptoms closely and look for any signs that the condition is posing a risk to your health or causing major inconveniences. 

If your condition worsens, your urologist will move forward with other treatment options. Until then, there are ways to control your enlarged prostate symptoms through lifestyle changes, such as reducing your stress level, exercising regularly, maintaining a healthy diet, and avoiding certain medications. 

2. Alpha Blockers

If watchful waiting and lifestyle changes are not enough, your doctor may recommend medication as the next step for your enlarged prostate treatment. Enlarged prostate drugs generally fall into two categories: alpha blockers and 5-alpha-reductase inhibitors.

Alpha blockers work by relaxing the prostate and bladder muscles to improve urine flow. Some common alpha blockers include alfuzosin, terazosin, doxazosin, prazosin, and tamsulosin. These drugs can be taken orally once or twice a day, and relieve symptoms almost immediately. However, although alpha blockers are effective at relieving symptoms, they do not actually reduce the size of your prostate. Therefore, alpha blockers are typically recommended for men with normal to moderately enlarged prostates. 

3. 5-Alpha-Reductase Inhibitors

By reducing the levels of dihydrotestosterone (DHT), 5-alpha-reductase inhibitors are able to partially shrink the prostate. In addition to shrinking the prostate, 5-alpha-reductase inhibitors can reduce the risk of acute urinary retention, as well as the need for prostate surgery. Because of this, these drugs are typically recommended for men with moderate to large prostates.

The two most common 5-alpha-reductase inhibitors are finasteride and dutasteride. These medications take much longer to work than alpha blockers, and it can take up to 6 months or more to see results. If you are trying to decide between alpha blockers and 5-alpha-reductase inhibitors, your urologist can speak with you about the pros, cons, and potential side effects for each medication.

4. Surgery

Since surgery is the most invasive approach to enlarged prostate treatment, it is typically reserved for patients with moderate to severe symptoms. There are many surgical treatment options for an enlarged prostate, which we will discuss below.

Transurethral Resection of the Prostate (TURP)

TURP is not only the most common surgical treatment option for an enlarged prostate, but it is also the most effective at reducing symptoms. During this procedure, your urologist will insert a small instrument into your urethra to remove the excess prostate tissue. TURP typically relieves symptoms quickly, and most men will have an improved urine flow soon after the procedure. If surgery is required, most urologists recommend TURP, as it is less traumatic and easier to recover from than other options. 

Transurethral Incision of the Prostate (TUIP)

During a TUIP, your urologist will insert a resectoscope into your urethra. Using this device, they will make one or two incisions on the inner surface of the prostate. These incisions reduce pressure on the urethra and allow urine to flow more freely. Symptom relief is slower with this procedure than a TURP, but the results are similar. 

Prostatectomy

Open prostate surgery, otherwise known as a prostatectomy, involves removing part or all of the prostate gland. A simple prostatectomy procedure is typically used to treat an enlarged prostate that doesn’t require removing the entire prostate. Instead, only the part of the prostate that is blocking urine flow is removed. A prostatectomy is the most intensive enlarged prostate treatment option and requires more recovery time than the TURP or TUIP procedures. 

Get Treated at Urology Specialists of the Carolinas

With a wide array of enlarged prostate treatment options available, the next step is to get in touch with one of our Urology Specialists to discuss the potential benefits and side effects of each option. Based on your degree of symptoms and the size of your prostate, your urologist can determine the best course of action and decide which treatment is best for you. Click the button below to schedule an appointment! 

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This content was originally published in January 2015 and was refreshed in February 2021.