Table of ContentsView AllTable of ContentsFirst-Line TreatmentBPH Therapies vs. SurgeryTreatment SuccessNondrug TreatmentsNext CourseSupporting Prostate Health
Table of ContentsView All
View All
Table of Contents
First-Line Treatment
BPH Therapies vs. Surgery
Treatment Success
Nondrug Treatments
Next Course
Supporting Prostate Health
The treatment of an enlarged prostate, otherwise known asbenign prostatic hyperplasia(BPH), typically involves medications like alpha-blockers and 5-alpha reductase inhibitors that help ease lower urinary tract symptoms such as urinary hesitancy, dribbling, straining, or feeling like you’re unable to empty your bladder.
Surgery is reserved for people with moderate to severe lower urinary tract symptoms, such as those withurinary retention(the inability to empty the bladder) or severeurgencyduring day or night. In certain circumstances, however, surgery can be the first-line treatment of BPH.
First-Line Benign Prostatic Hyperplasia Treatment Options
BPH is a progressive condition mainly affecting older males in which the enlargement of theprostate glandimpedes the flow of urine through theurethra(the tube through which urine exits the penis), causing an array of lower urinary tract symptoms (LUTS).
BPH cannot be cured but can effectively be managed with treatments. The primary aim of BPH treatment is to alleviate LUTS and improve urinary flow.
The standard first-line treatment of BPH involves different medications that improve urinary voiding (the emptying of the bladder). Less commonly, there are instances when prostate surgery may be a reasonable first-line option.
Who Treats BPH?
Medications
Several classes of drugs are commonly prescribed to people with BPH. These may be used on their own (monotherapy) or with other drugs (combination therapy).
Alpha-blockers license for the use of BPH include:
Possible side effects of alpha-blockers include headaches, weakness, nasal congestion,orthostatic hypotension(dizzy spells when standing), ejaculation problems, anderectile dysfunction.
Another class of drugs,5-alpha reductase inhibitors (5-ARIs), may be used on their own but are more commonly prescribed along with an alpha-blocker. They can help prevent the progression of LUTS and/or reduce the need for prostate surgery.
The two 5-ARI options approved for use in the United States are:
Side effects of 5-ARIs include aloss of libido(sex drive), ejaculation problems, and erectile dysfunction.
Other drugs may be added to the treatment plan for people with severe LUTS and/or to help counter the side effects of alpha-blockers and 5-ARIs. Among them are:
What Is Jalyn?Jalyn is a fixed-dose combination drug containing 1.5 mg of dutasteride and 0.4 mg of tamsulosin. The combination of an alpha-blocker and 5-ARI in a single capsule has been shown to improve drug adherence and sustain relief of moderate BPH symptoms in people at risk of progression.
What Is Jalyn?
Jalyn is a fixed-dose combination drug containing 1.5 mg of dutasteride and 0.4 mg of tamsulosin. The combination of an alpha-blocker and 5-ARI in a single capsule has been shown to improve drug adherence and sustain relief of moderate BPH symptoms in people at risk of progression.
Surgery
Prostate surgery is generally indicated for people with complications of BPH, includingpoor kidney function, recurrenturinary tract infections (UTIs), recurrentkidney stones, andgross hematuria(visible blood in urine). It may also be considered when conservative treatments for urinary retention fail.
According to the American Urological Society, there are circumstances in which surgery may be a reasonable early option for BPH treatment. This includes treating people who want to avoid taking drugs daily or those who have experienced intolerable side effects.
Individuals who initially present with BPH complications may also be referred to a urologist for surgery as a first-line treatment option.
Surgical options include:
Prostate gland surgery can cause side effects. Some, like blood in urine, pain with urination, or difficulty urinating, are temporary. Others like erectile dysfunction,urinary incontinence, andretrograde ejaculation(when you ejaculate into the bladder rather than out of your penis) may be longer-lasting or permanent.
Long-Term Risks of Prostate Surgery
The choice between medications or surgery for the treatment of BPH is a highly personal one. While upfront surgery offers better relief of LUTS, it is also more risky and has a higher rate of sexual side effects.
On the other hand, the prolonged use of BPH medicines can also cause sexual side effects in as many as 7% of users. While the drugs are less costly, they can delay surgical treatments. This delay can increase the risk of postoperative complications once surgery is performed.
Fortunately, newer and less invasive procedures like HoLEP, PUL, WVTT, or PAE have greatly reduced the risk of postoperative complications even among older adults with extremely large prostate glands.
In the end, there is no one-size-fits-all solution for BPH. The treatment needs to be individualized, taking into account multiple factors like your age, symptoms, pregnancy intentions, insurance coverage, co-occurring medical conditions, and the size and rate of growth of your prostate.
Speak with your urologist about any concerns you have about BPH treatments. There may be alternatives to explore that are more appropriate for you as an individual. If in doubt, do not hesitate to seek asecond opinionfrom a qualified specialist.
How Successful Is BPH Treatment?
When used on their own, the drugs are only modestly effective. By way of example, alpha-blockers, considered the backbone of medical therapy, are 50% effective in alleviating LUTS and 40% effective in improving urinary flow.
One of the problems is that people with BPH are often prescribed monotherapy when more effective combination therapies may be used. A 2016 study from the University of Montreal found that of 1,120 adults diagnosed with BPH, 87.6% were prescribed monotherapy either in the form of an alpha-blocker (69.9%) or a 5-ARI (26.6%).
Efficacy of Prostate Surgery
To date, surgery—mainly in the form of TURP—remains the gold standard of BPH treatment.Compared to medications, TURP is better able to sustain symptom relief, increase urinary flow, and reduce the need for retreatment.
Alternative (Nondrug) BPH Treatments
Herbal remedies are commonly marketed to people with an enlarged prostate, but few large-scale studies are available to support the health claims. With that said, several remedies have shown promise and may be beneficial to those who might otherwise avoid drug therapies.
Alternative options include:
There is some evidence of a benefit. A 2018 study inBJU Internationalfound that the combination of saw palmetto, selenium, and lycopene was “non-inferior” to Cialis 5 mg in improving BPH symptoms.
Another study published in the journalProstatein 2014 found that saw palmetto, selenium, and lycopene combined with Flomax was more effective than Flomax alone in alleviating LUTS in adults with BPH.
Enlarged Prostate Diet: What to Eat With BPH
Herbs for an Enlarged Prostate
Persistent Enlarged Prostate Symptoms: Next Course of Treatment
Even with gold standard treatments like TURP, roughly 1 in 20 people who undergo surgery will experience BPH regrowth, leading to a second surgery later in life.The risk of this appears to be the same regardless of the type of surgery used.
A 2023 study inProstate Cancer and Prostatic Diseaseinvolving 43,147 people surgically treated for BPH found that the retreatment rate was largely the same for TURP (5.3%), PUL (5.9%), WVTT (6.2%), and other common surgical interventions.
Causes of Overactive Bladder in Males
Other Ways to Support Prostate Health
Certain lifestyle changes can be beneficial to your health and well-being if living with BPH. The following should be a part of your treatment plan regardless of the severity of your condition:
Summary
Benign prostatic hyperplasia (BPH), or an enlarged prostate, is treated with medications like alpha-blockers and 5-alpha reductase inhibitors that reduce lower urinary tract symptoms, improve urinary flow, and help slow BPH progression.
Other prescription drugs like Cialis (tadalafil) and Myrbetriq (mirabegron) or herbal medicines like saw palmetto may be used to support treatment.
Surgery is generally advised when conservative treatments fail or complications (like recurrent UTIs) develop. It may also be used if a person wants to avoid daily drug treatment or has experienced intolerable side effects.
While surgery is more effective in alleviating BPH symptoms, it carries a higher risk of sexual side effects and requires treating again in 1 of every 20 cases.
23 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Sandhu JS, Bixler BR, Dahm P, et al.Management of lower urinary tract symptoms attributed to benign prostatic hyperplasia (BPH): AUA Guideline amendment 2023.J Urol. 2023;10.1097/JU.0000000000003698. doi:10.1097/JU.0000000000003698GBD 2019 Benign Prostatic Hyperplasia Collaborators.The global, regional, and national burden of benign prostatic hyperplasia in 204 countries and territories from 2000 to 2019: a systematic analysis for the Global Burden of Disease Study 2019.Lancet Health Longev.2022;3(11):E754-E776. doi:10.1016/S2666-7568(22)00213-6National Institute of Diabetes and Digestive and Kidney Diseases.Prostate enlargement (benign prostatic hyperplasia).Yu ZJ, Yan HL, Xu FH, et al.Efficacy and side effects of drugs commonly used for the treatment of lower urinary tract symptoms associated with benign prostatic hyperplasia.Front Pharmacol.2020;11:658. doi:10.3389/fphar.2020.00658Agency for Healthcare Research and Quality.Research protocol: newer medications for lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH).Olesovsky C, Kapoor A.Evidence for the efficacy and safety of tadalafil and finasteride in combination for the treatment of lower urinary tract symptoms and erectile dysfunction in men with benign prostatic hyperplasia.Ther Adv Urol.2016 Aug;8(4):257–271. doi:10.1177/1756287216650132Roehrborn CB, Perez IO, Roos EPM, et al.Efficacy and safety of a fixed-dose combination of dutasteride and tamsulosin treatment (Duodart) compared with watchful waiting with initiation of tamsulosin therapy if symptoms do not improve, both provided with lifestyle advice, in the management of treatment-naïve men with moderately symptomatic benign prostatic hyperplasia: 2-year CONDUCT study results.BJU Int.2015;116(3):450-459. doi:10.1111/bju.13033National Health Service (UK).Risks: transurethral resection of the prostate (TURP).Fogaing C, Asulihem A, Campeau L, Corcos J.Is early surgical treatment for benign prostatic hyperplasia preferable to prolonged medical therapy: pros and cons.Medicina (Kaunas).2021;57(4):368. doi:10.3390/medicina57040368Bishr M, Boehm K, Trudeau V, et al.Medical management of benign prostatic hyperplasia: results from a population-based study.Can Urol Assoc J.2016;10(1-2):55–59. doi:10.5489/cuaj.3058Bortnick EM, Simma-Chiang V, Kaplan SA.Long-term consequences of medical therapy for benign prostatic hyperplasia.Rev Urol.2019;21(4):154–157.Milonas D, Verikaite J, Jievaltas M.The effect of complete transurethral resection of the prostate on symptoms, quality of life, and voiding function improvement.Cent European J Urol.2015;68(2):169–174. doi:10.5173/ceju.2015.507Cai T, Cui Y, Yu S, et al.Comparison ofSerenoa repenswith tamsulosin in the treatment of benign prostatic hyperplasia: a systematic review and meta-analysis.Am J Mens Health.2020;4(2):1557988320905407. doi:10.1177/1557988320905407Arias-Chavez DJ, Mailloux-Salinas P, Aparicio JL, et al.Selenium in combination with a tomato lipid extract as a therapy for benign prostatic hyperplasia and its alterations in rats with induced BPH.J Cell Mol Med.2023;27(20):3147-3156. doi:10.1111/jcmm.17903Sadeghi A, Saedisomeolia A, Jalili-Baleh L, et al.FruHis significantly increases the anti-benign prostatic hyperplasia effect of lycopene: a double-blinded randomized controlled clinical trial.Front Nutr.2022;9:1011836. doi:10.3389/fnut.2022.1011836Morgia G, Vespasiani G, Pereo RM, et al.Serenoa repens + selenium + lycopene vs tadalafil 5 mg for the treatment of lower urinary tract symptoms secondary to benign prostatic obstruction: a phase IV, non-inferiority, open-label, clinical study (SPRITE study).BJU Int. 2018;122(2):317-325. doi:10.1111/bju.14209Morgia G, Russo GI, Voce S, et al.Serenoa repens, lycopene and selenium versus tamsulosin for the treatment of LUTS/BPH. An Italian multicenter double-blinded randomized study between single or combination therapy (PROCOMB trial).Prostate.2014;74(15):1471-80. doi:10.1002/pros.2286Kaplan S, Kaufman RP, Mueller T, et al.Retreatment rates and postprocedural complications are higher than expected after BPH surgeries: a US healthcare claims and utilization study.Prostate Cancer Prostatic Dis.2023. [Online ahead of print.] doi:10.1038/s41391-023-00741-8Lerner LB, McVary KT, Barry MJ, et al.Management of lower urinary tract symptoms attributed to benign prostatic hyperplasia: AUA guideline part II-surgical evaluation and treatment.J Urol. 2021;206(4):818-826. doi:10.1097/JU.0000000000002184Wolin KY, Grubb RL, Pakpahan R, et al.Physical activity and benign prostatic hyperplasia-related outcomes and nocturia.Med Sci Sports Exerc.2015;47(3):581–592. doi:10.1249/MSS.0000000000000444American Urological Association/Urology Care Foundation.Benign prostatic hyperplasia (BPH).Bradley CS, Erickson BA, Messersmith EE, et al.Evidence for the impact of diet, fluid intake, caffeine, alcohol, and tobacco on lower urinary tract symptoms: a systematic review.J Urol.2017;198(5):1010–1020. doi:10.1016/j.juro.2017.04.097De Jong Y, Pinckaers JH, Ten Brinck RM, Lycklama à Nijeholt AA, Dekkers OM.Urinating standing versus sitting: position is of influence in men with prostate enlargement: a systematic review and meta-analysis.PLoS One.2014;9(7):e1320 doi:10.1371/journal.pone.0101320
23 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Sandhu JS, Bixler BR, Dahm P, et al.Management of lower urinary tract symptoms attributed to benign prostatic hyperplasia (BPH): AUA Guideline amendment 2023.J Urol. 2023;10.1097/JU.0000000000003698. doi:10.1097/JU.0000000000003698GBD 2019 Benign Prostatic Hyperplasia Collaborators.The global, regional, and national burden of benign prostatic hyperplasia in 204 countries and territories from 2000 to 2019: a systematic analysis for the Global Burden of Disease Study 2019.Lancet Health Longev.2022;3(11):E754-E776. doi:10.1016/S2666-7568(22)00213-6National Institute of Diabetes and Digestive and Kidney Diseases.Prostate enlargement (benign prostatic hyperplasia).Yu ZJ, Yan HL, Xu FH, et al.Efficacy and side effects of drugs commonly used for the treatment of lower urinary tract symptoms associated with benign prostatic hyperplasia.Front Pharmacol.2020;11:658. doi:10.3389/fphar.2020.00658Agency for Healthcare Research and Quality.Research protocol: newer medications for lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH).Olesovsky C, Kapoor A.Evidence for the efficacy and safety of tadalafil and finasteride in combination for the treatment of lower urinary tract symptoms and erectile dysfunction in men with benign prostatic hyperplasia.Ther Adv Urol.2016 Aug;8(4):257–271. doi:10.1177/1756287216650132Roehrborn CB, Perez IO, Roos EPM, et al.Efficacy and safety of a fixed-dose combination of dutasteride and tamsulosin treatment (Duodart) compared with watchful waiting with initiation of tamsulosin therapy if symptoms do not improve, both provided with lifestyle advice, in the management of treatment-naïve men with moderately symptomatic benign prostatic hyperplasia: 2-year CONDUCT study results.BJU Int.2015;116(3):450-459. doi:10.1111/bju.13033National Health Service (UK).Risks: transurethral resection of the prostate (TURP).Fogaing C, Asulihem A, Campeau L, Corcos J.Is early surgical treatment for benign prostatic hyperplasia preferable to prolonged medical therapy: pros and cons.Medicina (Kaunas).2021;57(4):368. doi:10.3390/medicina57040368Bishr M, Boehm K, Trudeau V, et al.Medical management of benign prostatic hyperplasia: results from a population-based study.Can Urol Assoc J.2016;10(1-2):55–59. doi:10.5489/cuaj.3058Bortnick EM, Simma-Chiang V, Kaplan SA.Long-term consequences of medical therapy for benign prostatic hyperplasia.Rev Urol.2019;21(4):154–157.Milonas D, Verikaite J, Jievaltas M.The effect of complete transurethral resection of the prostate on symptoms, quality of life, and voiding function improvement.Cent European J Urol.2015;68(2):169–174. doi:10.5173/ceju.2015.507Cai T, Cui Y, Yu S, et al.Comparison ofSerenoa repenswith tamsulosin in the treatment of benign prostatic hyperplasia: a systematic review and meta-analysis.Am J Mens Health.2020;4(2):1557988320905407. doi:10.1177/1557988320905407Arias-Chavez DJ, Mailloux-Salinas P, Aparicio JL, et al.Selenium in combination with a tomato lipid extract as a therapy for benign prostatic hyperplasia and its alterations in rats with induced BPH.J Cell Mol Med.2023;27(20):3147-3156. doi:10.1111/jcmm.17903Sadeghi A, Saedisomeolia A, Jalili-Baleh L, et al.FruHis significantly increases the anti-benign prostatic hyperplasia effect of lycopene: a double-blinded randomized controlled clinical trial.Front Nutr.2022;9:1011836. doi:10.3389/fnut.2022.1011836Morgia G, Vespasiani G, Pereo RM, et al.Serenoa repens + selenium + lycopene vs tadalafil 5 mg for the treatment of lower urinary tract symptoms secondary to benign prostatic obstruction: a phase IV, non-inferiority, open-label, clinical study (SPRITE study).BJU Int. 2018;122(2):317-325. doi:10.1111/bju.14209Morgia G, Russo GI, Voce S, et al.Serenoa repens, lycopene and selenium versus tamsulosin for the treatment of LUTS/BPH. An Italian multicenter double-blinded randomized study between single or combination therapy (PROCOMB trial).Prostate.2014;74(15):1471-80. doi:10.1002/pros.2286Kaplan S, Kaufman RP, Mueller T, et al.Retreatment rates and postprocedural complications are higher than expected after BPH surgeries: a US healthcare claims and utilization study.Prostate Cancer Prostatic Dis.2023. [Online ahead of print.] doi:10.1038/s41391-023-00741-8Lerner LB, McVary KT, Barry MJ, et al.Management of lower urinary tract symptoms attributed to benign prostatic hyperplasia: AUA guideline part II-surgical evaluation and treatment.J Urol. 2021;206(4):818-826. doi:10.1097/JU.0000000000002184Wolin KY, Grubb RL, Pakpahan R, et al.Physical activity and benign prostatic hyperplasia-related outcomes and nocturia.Med Sci Sports Exerc.2015;47(3):581–592. doi:10.1249/MSS.0000000000000444American Urological Association/Urology Care Foundation.Benign prostatic hyperplasia (BPH).Bradley CS, Erickson BA, Messersmith EE, et al.Evidence for the impact of diet, fluid intake, caffeine, alcohol, and tobacco on lower urinary tract symptoms: a systematic review.J Urol.2017;198(5):1010–1020. doi:10.1016/j.juro.2017.04.097De Jong Y, Pinckaers JH, Ten Brinck RM, Lycklama à Nijeholt AA, Dekkers OM.Urinating standing versus sitting: position is of influence in men with prostate enlargement: a systematic review and meta-analysis.PLoS One.2014;9(7):e1320 doi:10.1371/journal.pone.0101320
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Sandhu JS, Bixler BR, Dahm P, et al.Management of lower urinary tract symptoms attributed to benign prostatic hyperplasia (BPH): AUA Guideline amendment 2023.J Urol. 2023;10.1097/JU.0000000000003698. doi:10.1097/JU.0000000000003698GBD 2019 Benign Prostatic Hyperplasia Collaborators.The global, regional, and national burden of benign prostatic hyperplasia in 204 countries and territories from 2000 to 2019: a systematic analysis for the Global Burden of Disease Study 2019.Lancet Health Longev.2022;3(11):E754-E776. doi:10.1016/S2666-7568(22)00213-6National Institute of Diabetes and Digestive and Kidney Diseases.Prostate enlargement (benign prostatic hyperplasia).Yu ZJ, Yan HL, Xu FH, et al.Efficacy and side effects of drugs commonly used for the treatment of lower urinary tract symptoms associated with benign prostatic hyperplasia.Front Pharmacol.2020;11:658. doi:10.3389/fphar.2020.00658Agency for Healthcare Research and Quality.Research protocol: newer medications for lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH).Olesovsky C, Kapoor A.Evidence for the efficacy and safety of tadalafil and finasteride in combination for the treatment of lower urinary tract symptoms and erectile dysfunction in men with benign prostatic hyperplasia.Ther Adv Urol.2016 Aug;8(4):257–271. doi:10.1177/1756287216650132Roehrborn CB, Perez IO, Roos EPM, et al.Efficacy and safety of a fixed-dose combination of dutasteride and tamsulosin treatment (Duodart) compared with watchful waiting with initiation of tamsulosin therapy if symptoms do not improve, both provided with lifestyle advice, in the management of treatment-naïve men with moderately symptomatic benign prostatic hyperplasia: 2-year CONDUCT study results.BJU Int.2015;116(3):450-459. doi:10.1111/bju.13033National Health Service (UK).Risks: transurethral resection of the prostate (TURP).Fogaing C, Asulihem A, Campeau L, Corcos J.Is early surgical treatment for benign prostatic hyperplasia preferable to prolonged medical therapy: pros and cons.Medicina (Kaunas).2021;57(4):368. doi:10.3390/medicina57040368Bishr M, Boehm K, Trudeau V, et al.Medical management of benign prostatic hyperplasia: results from a population-based study.Can Urol Assoc J.2016;10(1-2):55–59. doi:10.5489/cuaj.3058Bortnick EM, Simma-Chiang V, Kaplan SA.Long-term consequences of medical therapy for benign prostatic hyperplasia.Rev Urol.2019;21(4):154–157.Milonas D, Verikaite J, Jievaltas M.The effect of complete transurethral resection of the prostate on symptoms, quality of life, and voiding function improvement.Cent European J Urol.2015;68(2):169–174. doi:10.5173/ceju.2015.507Cai T, Cui Y, Yu S, et al.Comparison ofSerenoa repenswith tamsulosin in the treatment of benign prostatic hyperplasia: a systematic review and meta-analysis.Am J Mens Health.2020;4(2):1557988320905407. doi:10.1177/1557988320905407Arias-Chavez DJ, Mailloux-Salinas P, Aparicio JL, et al.Selenium in combination with a tomato lipid extract as a therapy for benign prostatic hyperplasia and its alterations in rats with induced BPH.J Cell Mol Med.2023;27(20):3147-3156. doi:10.1111/jcmm.17903Sadeghi A, Saedisomeolia A, Jalili-Baleh L, et al.FruHis significantly increases the anti-benign prostatic hyperplasia effect of lycopene: a double-blinded randomized controlled clinical trial.Front Nutr.2022;9:1011836. doi:10.3389/fnut.2022.1011836Morgia G, Vespasiani G, Pereo RM, et al.Serenoa repens + selenium + lycopene vs tadalafil 5 mg for the treatment of lower urinary tract symptoms secondary to benign prostatic obstruction: a phase IV, non-inferiority, open-label, clinical study (SPRITE study).BJU Int. 2018;122(2):317-325. doi:10.1111/bju.14209Morgia G, Russo GI, Voce S, et al.Serenoa repens, lycopene and selenium versus tamsulosin for the treatment of LUTS/BPH. An Italian multicenter double-blinded randomized study between single or combination therapy (PROCOMB trial).Prostate.2014;74(15):1471-80. doi:10.1002/pros.2286Kaplan S, Kaufman RP, Mueller T, et al.Retreatment rates and postprocedural complications are higher than expected after BPH surgeries: a US healthcare claims and utilization study.Prostate Cancer Prostatic Dis.2023. [Online ahead of print.] doi:10.1038/s41391-023-00741-8Lerner LB, McVary KT, Barry MJ, et al.Management of lower urinary tract symptoms attributed to benign prostatic hyperplasia: AUA guideline part II-surgical evaluation and treatment.J Urol. 2021;206(4):818-826. doi:10.1097/JU.0000000000002184Wolin KY, Grubb RL, Pakpahan R, et al.Physical activity and benign prostatic hyperplasia-related outcomes and nocturia.Med Sci Sports Exerc.2015;47(3):581–592. doi:10.1249/MSS.0000000000000444American Urological Association/Urology Care Foundation.Benign prostatic hyperplasia (BPH).Bradley CS, Erickson BA, Messersmith EE, et al.Evidence for the impact of diet, fluid intake, caffeine, alcohol, and tobacco on lower urinary tract symptoms: a systematic review.J Urol.2017;198(5):1010–1020. doi:10.1016/j.juro.2017.04.097De Jong Y, Pinckaers JH, Ten Brinck RM, Lycklama à Nijeholt AA, Dekkers OM.Urinating standing versus sitting: position is of influence in men with prostate enlargement: a systematic review and meta-analysis.PLoS One.2014;9(7):e1320 doi:10.1371/journal.pone.0101320
Sandhu JS, Bixler BR, Dahm P, et al.Management of lower urinary tract symptoms attributed to benign prostatic hyperplasia (BPH): AUA Guideline amendment 2023.J Urol. 2023;10.1097/JU.0000000000003698. doi:10.1097/JU.0000000000003698
GBD 2019 Benign Prostatic Hyperplasia Collaborators.The global, regional, and national burden of benign prostatic hyperplasia in 204 countries and territories from 2000 to 2019: a systematic analysis for the Global Burden of Disease Study 2019.Lancet Health Longev.2022;3(11):E754-E776. doi:10.1016/S2666-7568(22)00213-6
National Institute of Diabetes and Digestive and Kidney Diseases.Prostate enlargement (benign prostatic hyperplasia).
Yu ZJ, Yan HL, Xu FH, et al.Efficacy and side effects of drugs commonly used for the treatment of lower urinary tract symptoms associated with benign prostatic hyperplasia.Front Pharmacol.2020;11:658. doi:10.3389/fphar.2020.00658
Agency for Healthcare Research and Quality.Research protocol: newer medications for lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH).
Olesovsky C, Kapoor A.Evidence for the efficacy and safety of tadalafil and finasteride in combination for the treatment of lower urinary tract symptoms and erectile dysfunction in men with benign prostatic hyperplasia.Ther Adv Urol.2016 Aug;8(4):257–271. doi:10.1177/1756287216650132
Roehrborn CB, Perez IO, Roos EPM, et al.Efficacy and safety of a fixed-dose combination of dutasteride and tamsulosin treatment (Duodart) compared with watchful waiting with initiation of tamsulosin therapy if symptoms do not improve, both provided with lifestyle advice, in the management of treatment-naïve men with moderately symptomatic benign prostatic hyperplasia: 2-year CONDUCT study results.BJU Int.2015;116(3):450-459. doi:10.1111/bju.13033
National Health Service (UK).Risks: transurethral resection of the prostate (TURP).
Fogaing C, Asulihem A, Campeau L, Corcos J.Is early surgical treatment for benign prostatic hyperplasia preferable to prolonged medical therapy: pros and cons.Medicina (Kaunas).2021;57(4):368. doi:10.3390/medicina57040368
Bishr M, Boehm K, Trudeau V, et al.Medical management of benign prostatic hyperplasia: results from a population-based study.Can Urol Assoc J.2016;10(1-2):55–59. doi:10.5489/cuaj.3058
Bortnick EM, Simma-Chiang V, Kaplan SA.Long-term consequences of medical therapy for benign prostatic hyperplasia.Rev Urol.2019;21(4):154–157.
Milonas D, Verikaite J, Jievaltas M.The effect of complete transurethral resection of the prostate on symptoms, quality of life, and voiding function improvement.Cent European J Urol.2015;68(2):169–174. doi:10.5173/ceju.2015.507
Cai T, Cui Y, Yu S, et al.Comparison ofSerenoa repenswith tamsulosin in the treatment of benign prostatic hyperplasia: a systematic review and meta-analysis.Am J Mens Health.2020;4(2):1557988320905407. doi:10.1177/1557988320905407
Arias-Chavez DJ, Mailloux-Salinas P, Aparicio JL, et al.Selenium in combination with a tomato lipid extract as a therapy for benign prostatic hyperplasia and its alterations in rats with induced BPH.J Cell Mol Med.2023;27(20):3147-3156. doi:10.1111/jcmm.17903
Sadeghi A, Saedisomeolia A, Jalili-Baleh L, et al.FruHis significantly increases the anti-benign prostatic hyperplasia effect of lycopene: a double-blinded randomized controlled clinical trial.Front Nutr.2022;9:1011836. doi:10.3389/fnut.2022.1011836
Morgia G, Vespasiani G, Pereo RM, et al.Serenoa repens + selenium + lycopene vs tadalafil 5 mg for the treatment of lower urinary tract symptoms secondary to benign prostatic obstruction: a phase IV, non-inferiority, open-label, clinical study (SPRITE study).BJU Int. 2018;122(2):317-325. doi:10.1111/bju.14209
Morgia G, Russo GI, Voce S, et al.Serenoa repens, lycopene and selenium versus tamsulosin for the treatment of LUTS/BPH. An Italian multicenter double-blinded randomized study between single or combination therapy (PROCOMB trial).Prostate.2014;74(15):1471-80. doi:10.1002/pros.2286
Kaplan S, Kaufman RP, Mueller T, et al.Retreatment rates and postprocedural complications are higher than expected after BPH surgeries: a US healthcare claims and utilization study.Prostate Cancer Prostatic Dis.2023. [Online ahead of print.] doi:10.1038/s41391-023-00741-8
Lerner LB, McVary KT, Barry MJ, et al.Management of lower urinary tract symptoms attributed to benign prostatic hyperplasia: AUA guideline part II-surgical evaluation and treatment.J Urol. 2021;206(4):818-826. doi:10.1097/JU.0000000000002184
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