Treatment options for benign prostate enlargement 


Lifestyle changes

Decision support tools

Avoid drinking liquids one to two hours before bedtime, limit consumption of alcohol and caffeine, and take regular exercise

  • Improves symptoms of mild to moderate benign prostate enlargement
  • No risk of side effects or complications
  • May not prevent further enlargement

Bladder training

Exercises to strengthen muscles and improve bladder capacity

  • Most men can go five to six hours before urination
  • No risk of side effects or complications
  • Not usually effective in cases of moderate to severe benign prostate enlargement
  • It will take several weeks before your symptoms improve


Hormone blocker

A medication called finasteride is used to block the effect of a hormone on the prostate, which reduces the swelling

  • Reduces prostate size by 20-30%
  • Moderate improvement in symptoms
  • Takes at least six months to gain maximum benefit
  • Can increase the risk of birth defects
  • Common side effects are impotence and "dry orgasm", or retrograde ejaculation, where little or no semen is ejaculated – this should improve with time
  • May also cause breast swelling or tenderness and testicular pain (uncommon)
Muscle relaxants

Medication called alpha blockers are used to relax bladder muscles, making it easier to urinate

  • Rapid improvement of symptoms
  • Side effects are uncommon and usually mild
  • Can cause dizziness, headaches, weakness and "dry orgasm"


Transurethral resection of the prostate (TURP)

Surgery to remove excess prostate tissue

  • Effective treatment for moderate to severe cases
  • Fast recovery time
  • Minimal pain after the operation
  • "Dry orgasm" very common and likely to be permanent
  • Can also cause impotence and urinary incontinence (uncommon, and usually temporary)
Transurethral incision of the prostate (TUIP)

Surgery to widen the urethra, making it easy to pass urine

  • Less risk of retrograde ejaculation after TUIP compared with TURP
  • Not effective for severe enlargement
  • Can still cause retrograde ejaculation
Prostatic urethral lift implants

Tiny implants are inserted through the urethra (the tube from the bladder to the tip of the penis). The implants hold the enlarged prostate away from the urethra so it isn't blocked

  • Helps relieve symptoms, such as difficulty starting to urinate, weak urine flow and the need to urinate at night
  • Reduced risk of sexual dysfunction and incontinence 
  • Causes less tissue injury, resulting in quicker recovery time
  • Unlikely to provide permanent symptom relief
  • As it's a new procedure, the long-term outcomes are unknown
  • Availability may be limited because it's a new procedure 
Open prostatectomy

Surgery to remove the outer portion of the prostate

  • Effective for severe enlargement
  • Higher risk of side effects than other types of surgery
  • Can cause retrograde ejaculation, urinary incontinence and impotence