4 tips for coping with an enlarged prostate

At around the age of 25, a man's prostate begins to grow. This natural growth, called benign prostatic hyperplasia or BPH, is the most common cause of prostate enlargement. BPH does not lead to prostate cancer, though the two problems can coexist.

Although men with BPH might never realize they have an enlarged prostate, most often BPH does lead to at least bothersome symptoms, such as:

• a hesitant, interrupted, weak urine stream
• urgency, leaking, or dribbling
• a sense of incomplete emptying
• more frequent urination, especially at night.

Your doctor may ask you to complete a questionnaire designed to provide a score of how much BPH affects your life. Your score reflects the level of impact on your quality of life, helping you and your doctor determine an initial course of action.

If your symptoms are not particularly bothersome, your doctor may tell you that watchful waiting may be the best way to proceed. This involves regular monitoring to make sure complications aren't developing, but no treatment. For more troubling symptoms, most doctors begin by recommending a combination of lifestyle changes and medication.

Tips for relieving BPH symptoms

These simple steps can help alleviate some of the symptoms of BPH:

• Reduce stress by exercising regularly and practicing relaxation techniques such as meditation. Some men who are nervous and tense urinate more frequently.
• When you go to the bathroom, take the time to empty as much of your bladder as you can. This will reduce the need for subsequent trips to the toilet.
• To prevent dribbling after voiding, you can "milk out" residual urine in your penis. Place two or three fingers of one hand an inch behind your scrotum. Gently press upward. Keep applying this pressure as you move your fingers toward the base of the penis under the scrotum.
• Talk with your doctor about all your prescription and over-the-counter medications. Some, such as antihistamines and decongestants, may affect urination. Your doctor may be able to adjust dosages, change your schedule for taking these drugs, or prescribe different medications that cause fewer urinary problems.
• Avoid drinking fluids in the evening, particularly caffeinated and alcoholic beverages. Both can affect the muscle tone of the bladder and stimulate the kidneys to produce urine, leading to nighttime urination.
• On long airplane flights, avoid drinking alcohol, and try to urinate every 60 to 90 minutes.

Men and their physicians now have more medications and other treatment options to choose from. If one strategy doesn't do the trick, another can be recommended. And thanks to refinements in surgical procedures for BPH, men now have several effective choices, with even fewer side effects than ever before.

For more on advances in the diagnosis and treatment of prostate diseases, read the  Guide to Prostate Diseases  from Harvard Medical School.

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