Should I Treat My BPH? Understand Your Low-Impact Approaches

An enlarged prostate is common as men age—but treatment isn’t always necessary.

If you’ve been diagnosed with benign prostatic hyperplasia (BPH) or are experiencing urinary symptoms, one of the first and most important questions to ask isn’t which treatment to choose, but whether you need intervention beyond monitoring or symptom management at all.

Indeed, science’s understanding of BPH has advanced sufficiently that medical intervention may not be required. Rather, lifestyle adjustments, medications, and some therapies can alleviate BPH symptoms enough for you to enjoy the lifestyle you choose. Recognizing the cause-and-effect of BPH is your first step to getting there.

Understanding BPH: Causes, Symptoms, and Management Tips

BPH occurs when prostate tissue enlarges enough to compress the urethra, the tube that carries urine from the bladder. Because the urethra runs through the center of the prostate, this pressure can interfere with normal urination.

BPH is non-cancerous and highly common. The prostate gland tissue just naturally begins to grow in many men reaching their 40s or 50s. For some, it’s slower than for others, but at least half of all men older than 60 are believed to have enlarged prostates.

Common symptoms of BPH include:

• A frequent, sometimes urgent, need to urinate that can cause leakage.
• Straining to start urination.
• A weak urine stream.
• Having to stop and start several times when urinating (intermittency).
• Having to urinate more than twice overnight (a condition called nocturia).
• Feeling your bladder is full even after going.

However, importantly, not all men experience the symptoms of an enlarged prostate.

When BPH May Not Require Treatment

As mentioned above, not all men experience symptoms. In addition, many men experience mild or manageable symptoms that do not interfere significantly with daily life. In these cases, immediate treatment may not be necessary.

A common first approach is watchful waiting—a period during which you and your doctor monitor any symptoms over time to see whether they worsen or remain stable or work together to mitigate risk factors (such as obesity or a sedentary lifestyle). During this phase, lifestyle adjustments can play a meaningful role in symptom control.

Lifestyle strategies that may help reduce BPH symptoms include:

• Increasing physical activity.
• Weight reduction.
• Reducing caffeine and alcohol consumption.
• Limiting how much you drink before bedtime and outings.

When Medication May Be Helpful

Should your symptoms progress and begin to interfere with quality of life, medications are often the next step in treatment.

These medications aim to manage and reduce symptoms by relaxing bladder muscles, shrinking the prostate, or reducing the amount of urine your body makes.

When BPH Requires More Than Symptom Management

In some cases, if your prostate tissue grows enough, BPH can go from being a manageable condition to a potentially serious health threat. Related disorders of BPH include:

• Nocturia (loss of sleep) – Chronically disrupted sleep leads to sleep deprivation, which might bring on mood changes, activity impairment, and an increased risk of falling.
• Urinary tract infections (UTIs) – If your enlarged prostate presses your urethra to the point that your bladder cannot completely empty itself (urinary retention), the chance of a UTI rises because bacteria have time to grow in the trapped urine.
• Bladder stones – Long-term urine retention might lead to bladder stones. This is because the minerals and other substances in your urine become highly concentrated and bind into crystals on the inner surface of your bladder.
• Bladder damage – Repeated straining from BPH, as well as urine retention, might compromise bladder function. For example, pouches called diverticula can form on the bladder wall, capture and hold urine, and raise the risk of bladder damage and stones.
• Kidney damage – In the rare circumstances that urine is so blocked that it consistently backs up from the bladder into the kidneys, you could suffer from a kidney infection, kidney stones, or function impairment.

Red-flag symptoms include blood in your urine, severe pain in your lower abdomen or genitals, and a complete inability to urinate. In these cases, contact a doctor immediately.

Minimally Invasive BPH Treatment Options

If symptoms persist despite lifestyle changes and medication, or if complications develop, procedural intervention may be appropriate. Fortunately, several modern options can reduce prostate obstruction without traditional surgery.

These approaches include:

Prostate arterial embolization (PAE) ­– In this incision-free procedure, blood is blocked from the enlarged prostate tissue, so it shrinks. The doctor feeds a slim flexible tube through a puncture in your groin or wrist, identifies the prostatic arteries carrying blood to tissue, and then sends tiny beads through the tube into those arteries. The beads become lodged and restrict blood flow. Learn more about the PAE procedure here.

UroLift – Another incision-free approach to BPH treatment, this procedure involves implanting tiny devices into the prostate, on either side of the urethra, which push the tissue away from the channel. The urologist inserts the implants using a narrow flexible device that carries a small needle, which inject the implants into the tissue. You can find more information about UroLift here.

Aquablation Therapy – This treatment pathway employs a non-surgical robotic system to aim precise, high-pressure water jets at the enlarged prostate tissue to cut away the excess. The doctor uses ultrasound imaging to outline the tissue areas needed to be removed, then applies the robotic system to follow the guide and apply the heat-free jets. Read our web page about Aquablation Therapy.

Your chances of developing BPH can be high depending on your age and lifestyle, but the chances of needing a surgical treatment are getting lower. Should BPH symptoms occur, keep a journal of the signs and consult a urologist for guidance.

If you have more questions about BPH and its diagnosis, visit our BPH page. To find out if PAE is right for you, schedule an appointment by calling 509.747.3147.