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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 June 2008

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Users and editors may post comments here at their own discretion. The views expressed do not constitute medical advice and do not represent the position of Johns Hopkins Medicine or University Health Publishing, which has no responsibility for its content.


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



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