There are different treatments for an enlarged prostate. The treatment your doctor suggests will depend on your health, your medical history, your symptoms, how serious they are, and how they affect your daily life.

A medical history is a record of your health, including any past or current illnesses, treatments, or surgeries. It helps your doctor understand your health and decide the best care for you.

Your medical history might include:

Any illnesses or conditions you’ve had, like diabetes or high blood pressure.
Medications you’re taking now or have taken in the past.
Allergies, especially to medications or foods.
Any surgeries or hospital stays.
Family health history, such as whether close relatives have had certain illnesses like heart disease or cancer.

By sharing this information, your doctor can get a clearer picture of your health and recommend the right treatments for you.

Managing your symptoms on your own

You can take steps to manage your enlarged prostate symptoms and even improve them. Here are some tips that might help:

Take your time when you go to the bathroom. Sit down and try to fully empty your bladder each time you urinate.
Try double voiding. After you finish urinating, wait a moment, then try again. This can help empty your bladder completely.
Use absorbent pads. Placing a pad in your underwear can soak up any leaks and help you feel more confident.
After you’ve urinated, gently press the area under your scrotum and slide your fingers along the bottom of your penis, from the base to the tip. This helps push out any remaining drops of urine, keeping your underwear dry.
When you feel a sudden need to urinate, try deep breathing to help calm the feeling and delay going.
Train your bladder to hold more. Gradually try to wait a bit longer before going to the bathroom. This helps your bladder get used to holding more urine.
Eat more fibre. Constipation can make symptoms worse, so eat more fibre to keep your bowel movements regular.
Try bladder training. Use relaxation and muscle exercises to help wait longer between bathroom trips. For example:
- Breathe in slowly through your nose for 4 seconds, hold for 4 seconds, then exhale slowly through your mouth for 6 seconds. This can help calm the need to go.
- Focus on something else, like counting backward or listening to calming music, to take your mind off the urgency.
- Squeeze the muscles you use to stop urinating, hold for 5 seconds, then relax for 5 seconds. Repeat 10–15 times. This helps strengthen your bladder muscles over time.
Keep a bladder diary. Write down when you go to the bathroom and note any symptoms you notice. This can help you and your doctor track changes and find the best way to manage your symptoms.

Watchful waiting

If your symptoms are mild and not bothering you much, you might choose to just simply keeping an eye on them for now.

A watchful waiting programme includes:

Talking with your doctor about your symptoms
A physical check-up
Blood and urine tests
Information and advice about your condition
Ongoing support to help manage your enlarged prostate

This helps you stay informed and get the care you need while keeping a close eye on your health.

During watchful waiting, mild to moderate symptoms of an enlarged prostate can often be managed with simple lifestyle changes, such as:

Drinking at least 1 litre of fluid every day.
Drinking less before bed or before long trips to avoid needing the toilet at those times.
Cutting back on alcohol, caffeine, fizzy drinks, and artificial sweeteners, which can irritate your bladder and make your symptoms worse.
Getting regular exercise (at least 2-3 times a week). Not moving enough can make it harder to urinate.
Eating a balanced and varied diet.
Keeping your lower abdomen warm and dry, as cold and damp can increase the urge to urinate.
If your urine sprays when you go to the toilet, try sitting down or using a cup to urinate and pour it into the toilet.
Talk to your doctor about any medications you're taking, as some, like ‘water tablets’ (diuretics), can make toilet problems worse.

You’ll also have regular check-ups to make sure things aren’t getting worse. If they are, your doctor will talk to you about treatment choices.

Medicines

If lifestyle changes don’t fully help with your symptoms, your doctor may suggest medicines. These can relax the muscles in the prostate or bladder, or shrink the prostate so it doesn’t press on the urethra. Sometimes, a mix of medicines is used.

If your symptoms are mainly about needing to urinate urgently or needing to go often during the day and night, your doctor may recommend medicines for the bladder or a combination that also helps the prostate.

Most medicines have mild side effects, and your doctor will explain these to you before you decide on treatment.

Medicines for an enlarged prostate work by relaxing the muscles in the prostate or bladder to help reduce the number of times you feel you need to urinate, or by stopping the prostate from growing. They come in different types, depending on how they work.

Alpha-blockers relax the prostate muscles, which helps urine flow better and reduces your symptoms. They are the most often recommended medicines for an enlarged prostate.
Beta-3 agonists are medications that relax the bladder. They are usually prescribed to treat overactive bladder (OAB) symptoms and can also help men with certain symptoms related to prostate enlargement.
5-alpha-reductase inhibitors (5ARIs) are medicines that stop the prostate from growing and may shrink it. They work best for prostates larger than 40 mL and are prescribed only for significant symptoms of prostate enlargement.
Muscarinic receptor antagonists (MRAs) are medicines that help calm abnormal bladder muscle movements. They are often used to treat overactive bladder (OAB) and can also help men with prostate enlargement symptoms like feeling a sudden urge to urinate. However, these medicines are usually not used if the bladder doesn’t empty completely after urinating.
Phosphodiesterase 5 inhibitors (PDE5Is) are medicines used to treat erectile dysfunction. They can also help with some symptoms of BPE.
Phytotherapy, which is also known as plant extracts or herbal medicine, is used to help with BPE symptoms. The EAU now recommends hexane-extracted of Serenoa repens, a medicine made from the saw palmetto plant, because it can provide some relief. Phytotherapy also has very few side effects.

Erectile dysfunction is when a man has trouble getting or keeping an erection firm enough for sex. It’s a common condition that can happen for many reasons, like stress, health problems, or aging.

Your doctor may recommend combining alpha-blockers with 5ARIs if:

your prostate is larger than 40 mL;
your prostate-specific antigen (PSA) level is 1.5 ng/mL or higher;
your symptoms are serious and you have a weak or slow stream of urine.

A healthy prostate is between 15 and 25 mL, which is about the same size as a golf ball.

Prostate-specific antigen (PSA) is a protein made by the prostate. The PSA level is the amount of this protein in your blood.

Surgery for an enlarged prostate

Most men with an enlarged prostate don’t need surgery, but it might be needed if other treatments haven’t worked or if your symptoms have worsened and affect your daily life. Your doctor will help you decide if surgery is right for you and explain your options.

When thinking about surgery, consider:

How your symptoms are impacting your life.
How well you’re handling your current medications.
If your enlarged prostate is causing kidney problems, infections, or if you can’t empty your bladder fully.
What surgeries are available at your hospital.
Your personal preferences.

There are different types of surgery for an enlarged prostate, all aimed at easing symptoms and improving urine flow. Surgery works well for most men but can have side effects, so it’s important to talk about these with your doctor before deciding if you want surgery.

Transurethral Resection of the Prostate (TURP)

Transurethral resection of the prostate is a surgery where doctors remove part of the prostate gland through the urethra (the tube that carries urine out of the body). During the surgery, a thin tube called a resectoscope is inserted through the urethra. It also has a camera so the surgeon can see the prostate clearly on a screen. The resectoscope has a small wire loop that uses an electrical current to remove parts of the prostate. This helps clear the blockage and make it easier to urinate. It is usually done with a general or spinal anaesthetic, so you won't feel any pain during the procedure.

A general anaesthetic puts you to sleep during the procedure, so you won’t be aware of anything happening.

A spinal anaesthetic is a shot given in your lower back to numb you from the waist down. You’ll still be awake and aware of what's going on around you, but you won’t feel any pain or discomfort. It usually lasts for 2-3 hours.

At the end of the surgery, a catheter is placed in your bladder to help drain urine. The catheter is inserted through the opening in the penis, down the urethra, and into the bladder. Since you’ll still be asleep or numb when the catheter is placed, you won’t feel discomfort.

You will not need to use the toilet to urinate while a catheter is in place as it drains urine out of the bladder, down the catheter tube and into a bag that your medical team will empty for you, as needed. The catheter also helps flush the bladder and urethra to prevent blood clots.

The catheter will be taken out soon after surgery, once you're able to urinate on your own. The nurse will remove it, and it’s a simple process with little discomfort.

You’ll likely be advised to avoid sexual activity for 2-3 weeks. When you do, you might experience something called "retrograde ejaculation", sometimes called a dry orgasm. This is a condition where semen goes into the bladder instead of through your urethra and out of your penis during an orgasm. It isn’t harmful and the semen will pass through the bladder when you urinate, but it can cause fertility issues.

If you notice little or no semen during orgasm, cloudy urine after sex, or if your partner is having trouble getting pregnant, you may want to talk to your doctor about a test for retrograde ejaculation.