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Enlarged prostate - after care

BPH - self-care; Benign prostatic hypertrophy - self-care; Benign prostatic hyperplasia - self-care

Your health care provider has told you that you have an enlarged prostate gland. Here are some things to know about your condition.

What to Expect at Home

The prostate is a gland that produces the fluid that carries sperm during ejaculation. It surrounds the tube through which urine passes out of the body (the urethra).

An enlarged prostate means the gland has grown bigger. As the gland grows, it can block the urethra and cause problems, such as:

  • Not being able to fully empty your bladder
  • Needing to urinate two or more times per night
  • Slowed or delayed start of the urinary stream and dribbling at the end
  • Straining to urinate and weak urine stream
  • Strong and sudden urge to urinate or a loss of urinary control

Lifestyle Changes

The following changes may help you control symptoms:

  • Urinate when you first get the urge. Also, go to the bathroom on a timed schedule, even if you do not feel a need to urinate.
  • Avoid alcohol and caffeine, especially after dinner.
  • DO NOT drink a lot of fluid all at once. Spread out fluids over the day. Avoid drinking fluids within 2 hours of bedtime.
  • Keep warm and exercise regularly. Cold weather and lack of physical activity may worsen symptoms.
  • Reduce stress. Nervousness and tension can lead to more frequent urination.

Medicines, Herbs, and Supplements

Your health care provider may have you take a medicine called alpha-1- blocker. Most people find that these drugs help their symptoms. Symptoms often get better soon after starting on the medicine. You must take this medicine every day. There are several medicines in this category, including terazosin (Hytrin), doxazosin (Cardura), tamsulosin (Flomax), alfusozin (Uroxatrol), and silodosin (Rapaflo).

  • Common side effects include nasal stuffiness, headaches, lightheadedness when you stand up, and weakness. You may also notice less semen when you ejaculate. This is not a medical problem but some men don't like how it feels.
  • Ask your provider before taking sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis) with alpha-1- blockers because there can sometimes be an interaction.

Other drugs such as finasteride or dutasteride may also be prescribed. These medicines help shrink the prostate over time and help with symptoms.

  • You will need to take these drugs every day for 3 to 6 months before your symptoms begin to improve.
  • Side effects include less interest in sex and less semen when you ejaculate.

Watch out for drugs that may make your symptoms worse:

  • Try NOT to take over-the-counter cold and sinus medicines that contain decongestants or antihistamines. They can make your symptoms worse.
  • Men who are taking water pills or diuretics may want to talk to their provider about reducing the dosage or switching to another type of drug.
  • Other drugs that may worsen symptoms are certain antidepressants and drugs used to treat spasticity.

Many herbs and supplements have been tried for treating an enlarged prostate.

  • Saw palmetto has been used by millions of men to ease BPH symptoms. It is unclear whether this herb is effective in relieving the signs and symptoms of BPH.
  • Talk with your provider about any herbs or supplements you are taking.
  • Often, makers of herbal remedies and dietary supplements do not need approval from the FDA to sell their products.

When to Call the Doctor

Call your provider right away if you have:

  • Less urine than usual
  • Fever or chills
  • Back, side, or abdominal pain
  • Blood or pus in your urine

Also call if:

  • Your bladder does not feel completely empty after you urinate.
  • You take medicines that may cause urinary problems. These may include diuretics, antihistamines, antidepressants, or sedatives. DO NOT stop or change your medicines without first talking to your doctor.
  • You have taken tried self-care steps and your symptoms have not gotten better.

References

Aronson JK. Finasteride. In: Aronson JK, ed. Meyler's Side Effects of Drugs. 16th ed. Waltham, MA: Elsevier; 2016:314-320.

Kaplan SA. Benign prostatic hyperplasia and prostatitis. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 120.

McVary KT, Roehrborn CG, Avins AL, et al. Update on AUA guideline on the management of benign prostatic hyperplasia. J Urol. 2011;185(5):1793-1803. PMID: 21420124 www.ncbi.nlm.nih.gov/pubmed/21420124.

McNicholas TA, Speakman MJ, Kirby RS. Evaluation and nonsurgical management of benign prostatic hyperplasia. In: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 11th ed. Philadelphia, PA: Elsevier; 2016:chap 104.

Samarinas M, Gravas S. The relationship between inflammation and LUTS/BPH. In: Morgia G, ed. Lower Urinary Tract Symptoms and Benign Prostatic Hyperplasia. Cambridge, MA: Elsevier Academic Press; 2018:chap 3.

  • Enlarged prostate

    Animation

  •  

    Enlarged prostate - Animation

    Not every man will have to deal with age-related issues like balding or weight gain. Whether you have these problems really depends on your health, and luck. But one problem just about every man will have to face, if he lives long enough, is an enlarged prostate. Let's talk about an enlarged prostate, also known as benign prostatic hyperplasia, or BPH. The prostate gland is part of your reproductive system, and its job is to add fluid to the sperm before ejaculation. The prostate is pretty small when you're young, but as you get older it grows and grows. Keep in mind, this growth isn't cancerous. But by design, the prostate is wrapped around the urethra, the tube that carries urine from your bladder out of your body. So as the prostate grows, it can begin to squeeze or pinch the urethra which often can make it harder for men with an enlarged prostate to urinate. If you have an enlarged prostate, the first notice that you're having trouble urinating. Instead of having a strong even flow, the urine only dribbles out like a leaky faucet; drip, drip, dribble, drip. Because you're not emptying your bladder fully each time, you keep feeling the urge to use the bathroom, even in the middle of the night. To check your prostate, your doctor or urologist will check your prostate gland by inserting a lubricated, gloved finger and feeling for any growth. Other tests may check your urine flow, and how much urine is left in your bladder after you go, as well as look for signs of an infection or prostate cancer. How is an enlarged prostate treated? Treatment often depends on how you feel. If you're not having any symptoms, your doctor may suggest just watching it, that's called watchful waiting. If you've got bothersome symptoms, medications can reduce the size of the prostate gland, and relax your bladder and prostate so you don't constantly feel the urge to go. For more serious symptoms, surgery can remove the extra prostate tissue. To help relieve the symptoms of an enlarged prostate, watch how much fluid you drink, especially before bedtime, or before going out. Minimize alcohol and caffeine, as well as over-the-counter decongestants and antihistamines. They can make your symptoms worse. Double voiding can help. After you've emptied your bladder, wait a moment and try to go again without straining or pushing. Some people take herbs like saw palmetto for an enlarged prostate. Although there's some evidence that these herbs can relieve BPH symptoms, many studies haven't found a benefit. Talk to your doctor before taking any herbal remedy, because they can cause side effects. Prostate enlargement isn't usually serious, but it can have a serious impact on your way of life, especially when you're always going to the bathroom. Remember that BPH is treatable. Work with your doctor to find the treatment that works best for you. If you've been caring for your symptoms for 2 months and not finding any relief, or you're having more serious symptoms like you're not urinating at all, or you have a fever or pain in your back or abdomen, call your doctor as soon as possible.

  • BPH

    BPH - illustration

    Benign prostatic hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland, commonly found in men over the age of 50.

    BPH

    illustration

  • Enlarged prostate

    Animation

  •  

    Enlarged prostate - Animation

    Not every man will have to deal with age-related issues like balding or weight gain. Whether you have these problems really depends on your health, and luck. But one problem just about every man will have to face, if he lives long enough, is an enlarged prostate. Let's talk about an enlarged prostate, also known as benign prostatic hyperplasia, or BPH. The prostate gland is part of your reproductive system, and its job is to add fluid to the sperm before ejaculation. The prostate is pretty small when you're young, but as you get older it grows and grows. Keep in mind, this growth isn't cancerous. But by design, the prostate is wrapped around the urethra, the tube that carries urine from your bladder out of your body. So as the prostate grows, it can begin to squeeze or pinch the urethra which often can make it harder for men with an enlarged prostate to urinate. If you have an enlarged prostate, the first notice that you're having trouble urinating. Instead of having a strong even flow, the urine only dribbles out like a leaky faucet; drip, drip, dribble, drip. Because you're not emptying your bladder fully each time, you keep feeling the urge to use the bathroom, even in the middle of the night. To check your prostate, your doctor or urologist will check your prostate gland by inserting a lubricated, gloved finger and feeling for any growth. Other tests may check your urine flow, and how much urine is left in your bladder after you go, as well as look for signs of an infection or prostate cancer. How is an enlarged prostate treated? Treatment often depends on how you feel. If you're not having any symptoms, your doctor may suggest just watching it, that's called watchful waiting. If you've got bothersome symptoms, medications can reduce the size of the prostate gland, and relax your bladder and prostate so you don't constantly feel the urge to go. For more serious symptoms, surgery can remove the extra prostate tissue. To help relieve the symptoms of an enlarged prostate, watch how much fluid you drink, especially before bedtime, or before going out. Minimize alcohol and caffeine, as well as over-the-counter decongestants and antihistamines. They can make your symptoms worse. Double voiding can help. After you've emptied your bladder, wait a moment and try to go again without straining or pushing. Some people take herbs like saw palmetto for an enlarged prostate. Although there's some evidence that these herbs can relieve BPH symptoms, many studies haven't found a benefit. Talk to your doctor before taking any herbal remedy, because they can cause side effects. Prostate enlargement isn't usually serious, but it can have a serious impact on your way of life, especially when you're always going to the bathroom. Remember that BPH is treatable. Work with your doctor to find the treatment that works best for you. If you've been caring for your symptoms for 2 months and not finding any relief, or you're having more serious symptoms like you're not urinating at all, or you have a fever or pain in your back or abdomen, call your doctor as soon as possible.

  • BPH

    BPH - illustration

    Benign prostatic hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland, commonly found in men over the age of 50.

    BPH

    illustration

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Review Date: 7/31/2019

Reviewed By: Sovrin M. Shah, MD, Assistant Professor, Department of Urology, The Icahn School of Medicine at Mount Sinai, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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