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Johns Hopkins Health Alert

Treating Benign Prostatic Hyperplasia (BPH)-- One Option Is To Wait

Johns Hopkins Health Alerts | Prostate Disorders | Treating Benign Prostatic Hyperplasia (BPH)

  • During expectant management, you should adopt certain lifestyle measures to help relieve symptoms of mild Benign Prostatic Hyperplasia (BPH) and prevent them from worsening.

Doctors can’t predict how quickly an enlarged prostate will require treatment. Symptoms and objective measurements of obstruction in the urethra associated with benign prostatic hyperplasia (BPH) can remain stable for many years and may even improve over time in as many as a third of men. In one study from the Mayo Clinic, urinary symptoms did not worsen over a 3 1/2-year period in 73% of men with mild BPH.

Because the progression of and complications from BPH are unpredictable, expectant management —meaning that you are closely monitored but no immediate treatment is attempted—is best for men with minimal BPH symptoms that are not especially bothersome. With this treatment option for BPH, you only need to see your doctor about once a year to review the progress of symptoms and undergo a physical examination a few simple laboratory tests.

During expectant management, you should adopt certain lifestyle measures to help relieve symptoms of BPH and prevent them from worsening. For example, you should not take over-the-counter antihistamines and decongestants and should avoid delaying urination. If you have BPH you also need to be careful about your fluid intake by avoiding beverages that contain caffeine, limiting alcohol intake and the amount of fluid consumed at any one time, and avoiding beverages after 7 p.m.

Other helpful measures for these men with BPH include limiting spicy or salty foods, keeping warm, engaging in regular physical activity, and doing Kegel exercises (which involve squeezing and relaxing the pelvic floor muscles that support the bladder and surround the urethra).

Johns Hopkins Health Alerts | Prostate Disorders | Treating Benign Prostatic Hyperplasia (BPH)

Posted in Prostate Disorders on April 13, 2006
Reviewed March 2010

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Health Alerts registered users may post comments and share experiences here at their own discretion. We regret that questions on individual health concerns to the Johns Hopkins editors cannot be answered in this space.

The views expressed here do not constitute medical advice, and do not represent the position of Johns Hopkins Medicine or MediZine LLC, which has no responsibility for any comments posted on this site.


As a man with significant prostate enlargement I have to use intermittent catheterization -- that is, I use a catheter 3 times a day to empty my bladder. Recently I have had a series of urinary tract infections, after a period in which such infections were rare. I am extremely careful with the procedures to ensure that the catheter is sterile. I wonder if anytone else has had this problem, and might have suggestions?

Posted by: roy | May 9, 2006

I have had BPH for about 10 yrs. I was on Cardura for over a yr. Later I had The heating option which lasted about 2 yrs. I then had indigo lazer surgery which lasted 4-5 yrs. I had a penile implant in 1996 because of poor blood flow. My recent PSA test was 7.5 so I had a biopsy which was negative. I want to have the new PSA3 test which is approved in some european countries. Is there somewhere near Chicago I can have it done? A biopsy is risky for me with an implant. Help!

Posted by: gadget.flyer | December 10, 2006

I have been reading about Radio Frequency Therapy for treatment of BPH but I can only find information on one site

http://www.medtronic.com/your-health/enlarged-prostate/index.htm

Can anyone tell me if there are other sources of information/evaluation re this procedure?

Posted by: pat patrick | January 17, 2009

i have a tumor on one side of prostate, gleason score of 6,my psa is up and down as follows over a period of 9 months, 3.9,5.9,4.9,5.1 respectively, i've done a lot of research and i believe watchful waiting is the right thing for me right now, i believe in natural cures and refuse surgery, i take a teaspoon of tomato paste daily for the licopene,and i also eat raw cauliflower and brocolli three times a week because these put the cabosh on cancer cells. i also will eat a raw clove of garlic generally a few times a week,i used to eat raw garlic daily but talk about strong medicine,WOW, once i eat the garlic i drink down a glass of water to wash it down with, i don't drink anything after 7 pm. and stay away from spices,coffee,caffein,soda,and anything that irritates my prostate,what i'm currently doing is working wonders and i believe will have long term benefits,naturally!!

Posted by: tonyt | April 7, 2010



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