Enlarged Prostate: What to Know About Benign Prostatic Hyperplasia (BPH) Treatment Options

Did you know that the prostate continues to grow after puberty? This is a natural process, but it can grow larger than normal in some men — leading to annoying and uncomfortable symptoms since an enlarged prostate affects how the bladder stores and releases urine. It can also cause elevated PSA test results, but this mean you have prostate cancer.

In the video above, Dr. Ricardo Gonzalez, a urologist at Houston Methodist, explains that enlarged prostate, also called benign prostate hyperplasia (BPH), becomes more common as men age, but is very treatable.

"Symptoms include frequency and urgency of urination, waking up at night to urinate and difficulty starting the stream of urination," says Dr. Gonzalez. A urologist will work with you to find the right therapy that alleviates your symptoms, suits the size and shape of your prostate, and what your goals are.

(Related: What Are the Warning Signs of Enlarged Prostate?)

4 types of treatment options for BPH

If you're diagnosed with BPH, your doctor may recommend one or more of the following enlarged prostate treatment options:

Lifestyle changes

"Having a prostate healthy lifestyle is the same as keeping a heart healthy lifestyle," says Dr. Gonzalez. "So a healthy diet and exercise is good for both your heart and your prostate."

(Related: How to Make a Heart Healthy Diet Taste Better)

Important factors include:

• Limiting red meat and high-fat dairy
• Eating plenty of vegetables
• Consuming fish on a regular basis

"You can also avoid bladder irritants," recommends Dr. Gonzalez. "So caffeine, alcohol and spicy foods cab irritate the bladder and cause urinary frequency."

Medications

"There are two general categories of medications," says Dr. Gonzalez. "There are medications that treat urinary symptoms and there are medicines that shrink the prostate."

The former treat symptoms only, but work quickly. The latter type of medications take months to work and come with risk of sexual side effects in about 12% of men, but they can actually reduce prostate volume enough to help a man potentially avoid surgery.

Minimally invasive therapies

Minimally invasive surgical therapies, or MIST procedures, as Dr. Gonzalez refers to them, can be done in a physician's clinic and usually using just local anesthesia. They work best when medications are working for you, but you don't prefer to take medication every day.

Minimally invasive therapies for BPH include

• Prostatic urethral lift procedure
• Water vapor thermal therapy
• Implantable temporary nitinol device
• Anterior commissurotomy of the prostate

"These treatments are not equivalent to surgery, but have the benefit of being able to be done in the office and none of them are associated with worsening sexual function," adds Dr. Gonzalez.

Surgery

Typically done under anesthesia in the hospital, surgery is typically needed with medications aren't working to treat BPH. "The benefit of surgery is that it gives the most durable response without having to take medications," Dr. Gonzalez points out. No incisions are made for most benign prostate surgeries. Options include laser prostate surgeries (like green light vaporization and laser nucleation), trans urethral aquablation and robotic simple prostatectomy.

"Depending on the size of your prostate and your goals, we help tailor the right treatment to each man," says Dr. Gonzalez.

(Related: Enlarged Prostate Treatments: More Exist Than Ever Before)