Waking up several times a night to pee? Trouble starting or fully emptying your bladder? Those are common signs of benign prostatic hyperplasia (BPH). The good news: you don’t have to accept poor sleep or constant urgency. There are simple lifestyle fixes, effective drugs, and several procedures that make a big difference. This page explains what each option does, how fast it works, and the trade-offs so you can talk to your doctor with confidence.
Before treatment, doctors usually confirm BPH with a medical history, a digital rectal exam (DRE), urine test, and sometimes a PSA blood test or ultrasound. Symptoms are often measured with the IPSS score — it helps choose the right treatment.
Small changes often help right away: limit caffeine and alcohol, stop fluids 1–2 hours before bed, try double voiding (urinate, wait a few minutes, try again) and pelvic floor exercises. These don’t cure BPH, but they reduce symptoms while you explore other options.
Medications are the most common first step. Two main groups are used:
- Alpha-blockers (tamsulosin, alfuzosin): relax prostate and bladder neck muscles. They often improve flow within days to weeks. Side effects can include dizziness, tiredness, and fainting when standing up—so be cautious at first.
- 5-alpha-reductase inhibitors (finasteride, dutasteride): these slowly shrink prostate tissue by blocking hormonal conversion. Expect 3–6 months to see benefit. They lower PSA and cut long-term risk of needing surgery. Side effects include reduced libido, erectile problems, and smaller ejaculate for some men.
Combination therapy (an alpha-blocker plus a 5‑ARI) is common when symptoms are moderate to severe and the prostate is enlarged. Your doctor will weigh benefits, side effects, and other meds you take.
If medications don’t help or side effects are intolerable, there are minimally invasive and surgical options. UroLift lifts and holds enlarged tissue away from the urethra with implants — quick recovery and minimal sexual side effects. Rezum uses steam to ablate prostate tissue; it also has a short recovery time. Transurethral resection of the prostate (TURP) and newer laser procedures (HoLEP) remove obstructing tissue and work very well for larger prostates but need hospital care and a longer recovery. Prostate artery embolization is another option in select centers.
When to choose surgery? Consider it if you have recurrent urinary retention, repeated urinary tract infections, persistent blood in urine, bladder stones, or kidney damage from blockage. Talk with a urologist about risks, recovery time, and realistic outcomes.
Final tip: monitor symptoms and follow up. BPH often needs ongoing care, side effects can appear months later, and medications may interact with other drugs. Ask about the IPSS score, what to expect from each treatment, and a follow-up plan. If you want more plain-language guides on specific drugs or procedures, MailMyPrescriptions Pharmacy Guide has detailed articles you can read next.
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