Benign Prostatic Hyperplasia (BPH) Treatment Options — Expert Guide by Dr Yensani Prashanth Reddy
Benign Prostatic Hyperplasia (BPH) is a common condition affecting many men over 40. As a urologist, I have seen how bothersome lower urinary tract symptoms (LUTS) — such as frequent urination, weak stream, and nocturia — can reduce quality of life. Understanding BPH and the full range of BPH treatment options helps you choose care that restores comfort and function.
Understanding Benign Prostatic Hyperplasia (BPH)
Benign Prostatic Hyperplasia (BPH) refers to non-cancerous enlargement of the prostate gland. It most commonly affects men aged 40–50 and older. Symptoms may begin gradually and should be evaluated when they start to interfere with daily life.
Common symptoms and how BPH is diagnosed
Typical symptoms include: frequent urination, nocturia (night-time urination), difficulty initiating urination, weak urinary stream, urgency, and a sensation of incomplete emptying. To diagnose BPH, we use:
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Digital Rectal Exam (DRE) — tactile assessment of prostate size and texture.
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Urine tests — to exclude infection.
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PSA blood test — to measure prostate protein levels (elevated for several reasons).
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Urinary flow test & post-void residual (PVR) — to quantify flow and retained urine.
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Advanced imaging or urodynamic studies when indicated.
Treatment overview — a personalised approach matters
Selecting the right BPH treatment options depends on prostate size, symptom severity (LUTS), age, comorbidities and patient preference. Mild cases may do well with watchful waiting and lifestyle changes; moderate-to-severe cases often require medication or procedural treatment.
Medication options for BPH
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Alpha blockers (eg, tamsulosin, alfuzosin) — relax bladder-neck and prostate smooth muscle; symptom relief is often rapid. Side effects: dizziness, retrograde ejaculation.
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5-alpha reductase inhibitors (eg, finasteride) — reduce prostate volume over months; useful for larger prostates. Possible sexual side effects exist.
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Combination therapy — alpha blocker + 5-ARI for selected patients.
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Tadalafil — useful when erectile dysfunction and BPH coexist; can improve LUTS.
Minimally invasive and surgical treatments
When medications are insufficient or not tolerated, options include:
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TURP (Transurethral Resection of the Prostate) — the historical gold standard for obstructive BPH.
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TUIP (Transurethral Incision of Prostate) — best for smaller prostates.
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Laser therapies (HoLEP, PVP) — effective tissue removal with reduced bleeding and faster recovery.
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TUMT (Transurethral Microwave Thermotherapy) — outpatient thermal ablation for selected patients.
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UroLift (prostatic urethral lift) and water vapour thermal therapy — preserve sexual function, usually an outpatient procedure with quick recovery.
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Prostate artery embolisation (PAE) — a radiological option that reduces prostate volume by vascular occlusion.
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Robotic waterjet ablation / open prostatectomy — considered for very large prostates or complex anatomy.
I have treated patients at Wellness Hospitals with many of these techniques and have observed favourable outcomes with tailored approaches.
Potential side effects — what to expect
All interventions carry potential risks: retrograde ejaculation, temporary urinary incontinence, urinary tract infection, bleeding, and, in rare cases, sexual dysfunction. Minimally invasive procedures tend to reduce bleeding and shorten recovery.
Lifestyle tips that complement treatment Simple measures that often reduce symptom burden:
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Reduce fluid intake before bedtime to limit nocturia.
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Avoid caffeine and alcohol, which irritate the bladder.
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Empty your bladder when you feel the urge; avoid “holding it.”
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Exercise, maintain a healthy weight, and keep warm in cold weather.
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Review medications (decongestants, antihistamines) with your physician — they can worsen symptoms.
Preparing for your urology appointment
Bring a symptom diary (frequency, urgency, nocturia), list of medications/supplements, and questions: What tests are needed? Which BPH treatment options suit me? What side effects should I expect? How will treatment affect sexual activity?
Follow-up and long-term care
Follow-up varies by treatment — routine checks, PSA monitoring, medication adjustments, or repeat testing. I guide patients through recovery and ongoing management at Wellness Hospitals.
FAQs
- Can BPH turn into cancer?
No — BPH is not cancer, though both can coexist; screening is important.
- How long for the medication to work?
Alpha blockers: days to weeks. 5-ARIs: months.
- Is surgery the only option after medication failure?
Not always — minimally invasive procedures are effective alternatives with faster recovery.
Conclusion
BPH symptoms can significantly affect daily life, but modern, evidence-based treatments can provide lasting relief. If you’re experiencing urinary issues, consult a specialist. For personalised evaluation and advanced care, reach out to Dr Yensani Prashanth Reddy at Wellness Hospitals. Together, we will choose the right treatment to restore your comfort and quality of life.
Disclaimer
This content is for educational and informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider for personalised guidance. Do not delay seeking medical care based on this information. For emergencies or urgent concerns, contact a doctor or visit the nearest hospital immediately.