Sometimes mild symptoms get better on their own. Many people believe that a healthy lifestyle and diet with less processed foods rich in fibre, fruit, vegetables will cause the prostate to enlarge less, by decreasing oestrogens and increasing testosterone levels both of which affect prostate size. Some herbal products like saw palmetto are even available commercially. In any case, it is always good to adopt a healthy lifestyle whether these measures make a noticeable difference or not.
If your symptoms get worse, your doctor may suggest drug treatment.
Finasteride and dutasteride block conversion of testosterone to dihydrotestosterone, which makes the prostate enlarge.
The side effects of finasteride are rare and mild and usually affect sexual function. The side effects cease when the medication is stopped. The prostate may enlarge again when the medicine is stopped, so your doctor may suggest another treatment.
Another kind of medicine, called alpha-blockers, can also help relieve the symptoms of BPH. Alpha-blockers have been used for a long time to treat high blood pressure, but they can also help the symptoms of BPH, even in men with normal blood pressure. Some of these drugs are terazosin, doxazosin, tamsulosin and alfuzosin.
The side effects of alpha-blockers include dizziness, fatigue and lightheadedness due to lowered blood pressure. Doctors therefore start with a low dose first.
A referral to a urologist (a surgeon of the urinary-genital system) may be neccessary to explore surgical treatment options.
A urologist will perform an ultrasound exam of the prostate by inserting a well-lubricated probe into the anus. This will measure the size of the prostate gland, check for cancer if suspected and assess the need for surgery. Biopsy of the prostate is done though the rectum if cancer is suspected.
A urologist can also perform an ultrasound of the bladder to see how much urine is retained after urinating, due to the obstruction by the prostate. One treatment option is a minimally invasive treatment. Most of these treatments use heat such as microwave or laser to destroy prostate tissue applied through the urethra.
Surgery is considered the most effective treatment and is used in men with symptoms that persist after other treatments are tried. This is also the best way to diagnose and cure early cancer of the prostate. Surgery is usually done via a tube passed through the urethra, thus leaving no abdominal scars (Transurethral resection of prostate – TURP).
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