Enlarged Prostate Treatment: What Works and What to Try First
If your pee has changed — slower stream, waking several times at night, or the constant feeling you didn’t finish — that’s often a sign of an enlarged prostate (BPH). It’s common: many men over 50 get symptoms that affect sleep and daily life. The good news is there are clear treatment paths that can reduce symptoms, avoid complications, and fit your lifestyle.
Medicines: Fast relief and longer-term control
Most men start with medications. Alpha-blockers (for example, tamsulosin) relax the muscles around the prostate and bladder neck and often improve flow within days to weeks. Side effects can include dizziness or low blood pressure, so be careful when standing up quickly. 5-alpha-reductase inhibitors (finasteride, dutasteride) shrink prostate tissue over several months and lower the chance you’ll need surgery later. One useful point: these drugs lower PSA roughly by half, so doctors adjust PSA checks if you take them.
Combining an alpha-blocker with a 5-alpha-reductase inhibitor can help men with larger prostates more than either drug alone. Talk to your clinician about expected timelines: immediate relief usually comes from alpha-blockers, while size reduction takes months.
Procedures: When pills aren’t enough
If symptoms stay troublesome or complications appear (recurrent infections, poor kidney function, bladder stones), procedures are the next step. TURP (transurethral resection of the prostate) is a long-standing surgical option that removes obstructing tissue and gives reliable symptom relief. Minimally invasive choices are growing: UroLift places small implants to open the channel and often preserves ejaculatory function; Rezum uses steam to ablate excess tissue and can be done in clinic with faster recoveries. Each option has trade-offs: recovery time, bleeding risk, and potential effects on ejaculation or erections. Match the procedure to what matters most to you.
For sudden urinary retention, a temporary catheter or urgent decompression is needed. After that, doctors will reassess longer-term options.
There are also tests that help guide decisions: symptom scores (like IPSS), urine tests, ultrasound to measure prostate size, flow rate studies, and PSA when appropriate. These tests show whether watchful waiting, medicine, or a procedure makes sense.
Some men try herbal supplements such as saw palmetto. Evidence varies, and supplements can interact with other drugs, so tell your doctor before starting them.
Know when to get urgent care: inability to pass urine, heavy bleeding, or fever with urinary symptoms needs prompt attention. For routine care, regular follow-up helps catch progression early. Treatment for BPH is personal — think about symptom relief, sexual side effects, recovery time, and how treatments fit your daily life. Talk openly with your doctor to pick the best path and set realistic expectations for results and timelines.
