What should you do - if anything - to treat an enlarged prostate gland?

May 25 2005

Called benign prostatic hyperplasia or hypertrophy (BPH), the condition affects most men as they age. About half of men with an enlarged prostate seek medical treatment because of bothersome urinary tract symptoms. These symptoms may include poor urine flow, straining to urinate, frequent urination and urinary urgency.

With the BPH diagnosis comes a variety of treatment possibilities -- ranging from conservative to more aggressive options. A new health decision guide on MayoClinic.com helps men sort through the treatment choices.

"There have been amazing advances in technology in the last decade that provide a broad range of ways to treat BPH," says Donald Novicki, M.D., a urologist at Mayo Clinic in Arizona, and medical editor for the decision guide. "Patients who are knowledgeable can better partner with their physician to make the best choice."

The BPH health decision guide provides a comprehensive look at prostate health, including information on diagnosis, treatment options and their risks and benefits. All of the information on the site is reviewed by Mayo Clinic physicians.

The guide is targeted for men who've been diagnosed with BPH and are deciding what to do. Highlights include:

A symptoms self-assessment: Visitors answer a few anonymous questions about their urinary symptoms. Responses are used to rate the severity of symptoms and how bothersome those symptoms are. Both are important factors in determining a treatment plan.

Treatment options: For years, the standard therapy for BPH was to surgically remove part of the prostate gland, a procedure called transurethal resection of the prostate (TURP). It's still the treatment to which all other options are compared, but TURP has its drawbacks. The guide covers pros and cons of TURP, as well as for watchful waiting, medications and an increasing number of minimally invasive therapies, some nearly as effective as TURP.

Meet the Mayo Clinic doctor: In video segments, Dr. Novicki answers frequently asked questions about BPH. He routinely counsels men who are deciding how -- or whether -- to treat their enlarged prostate.

Personal stories: Read the stories of three men. Each chose a different treatment option for BPH.

Emerging therapies: Newly approved therapies as well as those still in clinical trials are covered.

Alternative therapies: Explore the risks, possible benefits and uncertainties in using alternative remedies.

For BPH, no single treatment is best for everyone. "Bottom line, learn about your options," says Dr. Novicki. "Don't avoid seeking help for urinary symptoms because you're worried about the consequences of treatment. An often- mentioned worry is that treatment will affect sexual function. In fact, most treatments do not affect sexual function."

"Delaying needed treatment can have side effects too," says Dr. Novicki. "Later, it may be more complicated or even impossible to improve symptoms."