The main treatment options for prostate enlargement are watchful waiting, treatment with medication or a surgical procedure.
"Watchful waiting" is a term given to a joint decision by doctor and patient to observe the symptoms of mild prostate enlargement and for the doctor to review and re-examine the patient at regular intervals. It is a conservative option suitable for mild symptoms and includes advice on lifestyle issues which affect urinary frequency and urgency. It comes with a slight risk of developing acute urinary retention, although regular check-ups minimise this possiility.
For mild to moderate prostate enlargement symptoms, treatment with oral medication is an option, There are two types of drugs available. One shrinks the size of the prostate gland, the other relaxes the muscle within it. Both improve urinary outflow. Side effects include: dizziness, headache, tiredness and a postural drop in blood pressure. Neither class of drug has been shown to prevent long-term complications from prostate enlargement.
Men with severe symptoms of prostate enlargement such as urinary retention, incontinence or blood in the urine, should see a specialist urologist for investigation with a cystoscope (the passing of a telescope into the bladder). If this confirms prostate enlargement, then a surgical operation called transurethral resection of the prostate (TURP) may be suitable.
This can be carried out without a surgical incision by inserting a resectoscope through the urethra. This contains a fibre-optic camera and a surgeon literally scoops away the enlarged gland while leaving its capsule intact. The possible side effects of a TURP are: bleeding, altered sexual function and urinary incontinence.
The key to the right treatment option is for the doctor and patient to share information about the relative risks and benefits of the different options. These must be balanced against the patient's personal weighting of the bother and severity of symptoms which prostate enlargement is causing him.