Mayo Clinic: I was diagnosed with benign prostatic hypertrophy
last year, and my doctor said at the time that there was no
need for immediate treatment. Is it OK to wait to see a doctor
again until symptoms appear, or would that be too late? Does
treatment for it mean I will need surgery?
benign prostatic hypertrophy, or BPH, doesnít cause any
symptoms, itís fine to postpone treatment. If you begin to
notice urinary symptoms, though, talk to your doctor.
Typically, treatment is based on how bothersome symptoms are
and how much they affect your daily activities. Surgery may be
necessary to treat BPH in some cases, but medication generally
is used first and is often effective in successfully managing
enlargement of the prostate gland thatís not related to
cancer. Itís a common condition in men as they age. BPH may
cause symptoms such as a frequent or urgent need to urinate,
difficulty starting urination, weak urine stream, a stream
that stops and starts, increased urination at night, or
inability to empty the bladder completely.
tends to progress over time as the prostate grows larger. Not
everyone diagnosed with BPH develops symptoms, though, and the
size of the prostate is not necessarily linked to specific
symptoms. For example, some men with only slightly enlarged
prostates may have significant symptoms, while other men with
substantially enlarged prostates have only minor urinary
symptoms. In some cases of BPH, symptoms eventually stabilize
and may even improve over time.
for BPH is focused on managing symptoms, so delaying treatment
until symptoms appear wonít negatively affect the outcome of
that treatment. Some men with only mild symptoms opt not to
have any treatment.
steps, such as limiting beverages in the evening, scheduling
regular bathroom breaks throughout the day, limiting alcohol
and caffeine, exercising regularly and eating a healthy diet,
can be useful in controlling mild BPH. If symptoms begin to
interfere with your daily routines, itís likely your doctor
will recommend treatment for BPH.
is the most common treatment for mild to moderate BPH. Your
doctor may prescribe a drug from a class of medications called
alpha blockers. They relax bladder neck muscles and muscle
fibers in the prostate, making urination easier. Another group
of medications, called 5-alpha reductase inhibitors, can be
used to shrink your prostate by preventing hormonal changes
that cause prostate growth. In some cases, taking an alpha
blocker and a 5-alpha reductase inhibitor at the same time can
be helpful if those medications alone arenít effective.
symptoms become severe, or if medication is not enough to
manage your symptoms, a surgical procedure may be recommended.
A variety of procedures can be used to treat BPH. Most of them
involve removing or destroying excess prostate tissue.
side effects from prostate surgery depend on the type of
procedure you have. In general, complications may include
temporary difficulty with urination, urinary tract infection,
bleeding, semen flowing backward into the bladder instead of
out through the penis during ejaculation, erectile
dysfunction, and, very rarely, loss of bladder control.
time, however, you donít need to make any treatment
decisions. Monitor your condition, and if you begin to notice
any urinary symptoms, talk to your doctor. The two of you can
then decide how best to manage BPH going forward.