Prostatomegaly means the prostate gland is bigger than usual. Doctors also call it an “enlarged prostate.” The word comes from “prostate” (the male gland below the bladder) and “megaly” (bigger than normal). In most adults, a normal prostate is about the size of a walnut and weighs around 20–30 grams. When the gland grows beyond this usual size, we call it prostatomegaly. The most common reason is benign prostatic hyperplasia (BPH), which is a non-cancerous growth that happens with age, but infections, inflammation, cysts, and cancer can also make the gland look or feel enlarged. Prostatomegaly is not a diagnosis by itself. It is a finding that needs a cause. It can be found by a doctor’s finger exam (digital rectal examination), by ultrasound, by MRI, or by other tests. The enlargement can be mild, moderate, or severe, and the size alone does not always match how bad the symptoms feel.
Prostatomegaly means your prostate gland has grown bigger than usual. Most of the time this happens because of benign prostatic hyperplasia (BPH), which is non-cancerous growth of prostate tissue that slowly squeezes the urethra (the tube that carries urine). As the tube gets tighter, you may notice weak urine flow, starting and stopping, dribbling, getting up at night to pee, or feeling you did not empty your bladder. The problem is common and treatable. Many people do well with lifestyle steps, medicines, or a short, minimally invasive procedure.
The prostate is a small gland that sits just below the bladder and in front of the rectum. The urethra (the urine tube) passes through the middle of the prostate like a straw through an apple. The prostate makes part of the semen fluid that helps sperm move and survive. Most of the urine flow problems in men with prostatomegaly happen because a bigger gland can squeeze or bend the urine tube. This can slow the flow, make starting hard, and leave urine behind in the bladder. Over time, the bladder muscle can get thicker and then weaker, so some men feel they must go often, urgently, or even wake many times at night to urinate.
Pathophysiology
Inside the prostate are cells that can multiply with age. Hormones such as dihydrotestosterone (DHT) tell these cells to grow, especially in the “transition zone,” the part that wraps around the urethra. With time, the gland becomes bigger and may push into the bladder like a small hill (intravesical protrusion). The bigger the blockage, the harder the bladder must squeeze. At first the bladder becomes thick and strong. Later it can get tired and weak. This process explains why some men with a large prostate have worse symptoms, while others with a modest enlargement feel fine: symptoms depend on both the size and the tightness of the passage, plus how well the bladder muscle still works.
Types of prostatomegaly
1) By cause (what is driving the enlargement).
Benign (non-cancer) growth: This is BPH and is by far the most common type, especially after age 50.
Inflammatory/infectious swelling: Prostatitis (bacterial or non-bacterial) can make the gland puffy and tender.
Cystic or structural changes: Prostatic cysts, ejaculatory duct cysts, and median lobe protrusion can increase measured size.
Cancer-related enlargement: Prostate cancer sometimes enlarges the gland or makes part of it feel firm or nodular.
Treatment- or procedure-related swelling: Recent catheterization, biopsy, radiation, or surgery near the prostate can cause temporary swelling.
2) By time course (how fast it appears).
Acute enlargement: Sudden swelling from infection, inflammation, or bleeding into the gland.
Chronic enlargement: Slow growth over years, most often from BPH.
3) By pattern (how it feels and where it grows).
Diffuse: The whole gland is larger.
Nodular: Lumps or nodules, common in BPH and sometimes cancer.
Median lobe–dominant: A “middle” lobe bulges into the bladder and behaves like a ball-valve, causing marked symptoms even if total size is not huge.
4) By degree (how big it is).
Mild: Slightly bigger than normal, often around 30–40 cc.
Moderate: Roughly 40–80 cc.
Severe: Over ~80–100 cc.
(These numbers are typical cut-offs used on ultrasound or MRI; they are guides, not hard rules.)
Causes and contributors of an enlarged prostate
1) Aging.
As men get older, the prostate receives years of growth signals. This long exposure makes gradual enlargement very common after age 50.
2) Dihydrotestosterone (DHT) build-up.
Inside the prostate, an enzyme (5-alpha-reductase) converts testosterone into DHT. DHT is a stronger signal that pushes prostate cells to grow.
3) Estrogen-androgen balance shifts.
With age, the ratio of estrogen to androgens changes. This balance can stimulate the supporting tissue of the prostate to grow and stiffen.
4) Family history and genetics.
If a father or brother has BPH at a younger age, your risk of earlier or larger enlargement is higher. Genes help set how sensitive the prostate is to hormones.
5) Metabolic syndrome.
Abdominal obesity, high blood pressure, high triglycerides, and insulin resistance are linked to larger prostates and more severe urinary symptoms.
6) Type 2 diabetes.
High insulin levels and chronic low-grade inflammation can drive prostate tissue to grow and can worsen bladder function.
7) Lack of physical activity.
Sitting for long periods and low daily movement are tied to worse urinary symptoms and may contribute to growth over time.
8) Diet high in animal fat and processed foods.
Diets rich in saturated fat and low in vegetables may promote inflammation and hormone changes that favor growth.
9) Chronic low-grade inflammation of the prostate.
Even without an obvious infection, inflamed tissue releases growth signals that can support enlargement.
10) Recurrent urinary or prostate infections.
Infections cause swelling and can trigger ongoing inflammatory cycles that make the gland bigger.
11) Prostatitis (acute or chronic).
Acute bacterial prostatitis can enlarge the gland quickly. Chronic prostatitis may produce persistent swelling and symptoms.
12) Prostate cancer.
Cancer is a different disease than BPH, but it can also enlarge the gland. Cancer requires separate testing and treatment decisions.
13) Androgen therapy (testosterone, anabolic steroids).
Extra androgens can increase DHT inside the prostate and encourage growth.
14) Certain medicines that tighten the outlet.
Decongestants (like pseudoephedrine) and some antihistamines tighten the muscle at the bladder neck. They do not “cause” growth but can mimic or worsen blockage and make the prostate seem like the problem.
15) Smoking.
Smoking harms blood vessels and increases systemic inflammation, which is linked to worse urinary symptoms and possibly larger prostates.
16) Sleep apnea.
Interrupted sleep and low nighttime oxygen can disturb hormones and raise nighttime urination, linking to worse symptoms and possibly to growth signals.
17) Low vitamin D status.
Low vitamin D is associated in some studies with larger prostate volumes and worse urinary symptoms, possibly through immune and hormone effects.
18) Ethnic and regional factors.
Risk and growth patterns differ across populations, likely due to gene-environment interactions and diet.
19) Pelvic floor dysfunction.
Tight or uncoordinated pelvic floor muscles can worsen emptying and symptoms. While not a direct cause of growth, it adds to the overall problem.
20) Structural variants (median lobe enlargement, cysts).
A median lobe that bulges into the bladder, or cysts within the prostate, can make the gland seem bigger and worsen blockage even when total volume is only moderate.
Common symptoms
1) Frequent urination.
You need to pass urine many times, especially during the day, because the bladder senses fullness sooner when the outlet is tight.
2) Nocturia (waking at night).
You wake up one or more times to urinate. Poor emptying and bladder irritation both play a role.
3) Urgency.
You feel a sudden, strong need to urinate, and it is hard to hold it.
4) Weak urine stream.
The flow looks thin and slow, like the pressure is low.
5) Hesitancy.
It takes time for urine to start, even when you feel the urge.
6) Intermittent stream.
The flow stops and starts rather than staying steady.
7) Straining.
You need to push with your belly muscles to keep the urine flowing.
8) Incomplete emptying.
You feel like there is still urine left after you finish.
9) Dribbling at the end.
A few drops leak after you think you are done.
10) Pain or burning with urination (especially if inflamed).
Inflammation or infection can make urination hurt.
11) Blood in urine or semen.
Fragile blood vessels can bleed when the prostate is inflamed, enlarged, or irritated.
12) Lower abdominal or pelvic discomfort.
A tight bladder and swollen prostate can cause a dull ache or pressure.
13) Acute urinary retention.
You suddenly cannot pass urine at all; the bladder becomes painfully full and needs urgent care.
14) Recurrent urinary infections.
Stagnant urine left behind is a good place for bacteria to grow, leading to repeat infections.
15) Effects on sexual function (some men).
Some men notice weaker ejaculation, painful ejaculation, or trouble with erections, often due to the shared nerves and muscles in the pelvic area and medicines used for treatment.
Diagnostic tests
A) Physical examination (how the body is checked)
1) General examination and vital signs.
The clinician checks temperature, blood pressure, pulse, and looks for fever or signs of infection or pain. This helps separate urgent infection from non-urgent enlargement.
2) Abdominal exam for bladder fullness.
The lower belly is felt and tapped for a stretched bladder. A very full, tender bladder suggests blockage and poor emptying.
3) Focused neurological screen.
Strength, sensation, reflexes, and anal tone may be briefly checked. Nerve problems can mimic or worsen urinary symptoms.
B) Manual tests (hands-on checks that guide the next steps)
4) Digital rectal examination (DRE).
A gloved, lubricated finger is gently placed in the rectum to feel the back of the prostate. The examiner notes size, shape, firmness, symmetry, and tenderness. A smooth, rubbery enlargement suggests BPH; a very tender gland suggests prostatitis; a hard, irregular area raises concern for cancer.
5) Pelvic floor muscle assessment.
During the DRE, the clinician can ask you to squeeze and relax. This checks muscle coordination that helps bladder emptying.
6) Post-massage expressed secretions (select cases).
For long-standing pelvic pain or suspected chronic prostatitis, a gentle prostate massage may be used to collect prostatic fluid for the lab. This is not done when acute infection is suspected.
C) Laboratory and pathological tests (what fluids and blood can show)
7) Urinalysis.
A urine dipstick and microscope check for blood, white cells, protein, sugar, and crystals. This screens for infection, blood, and kidney stress.
8) Urine culture.
If infection is suspected, the lab grows bacteria from urine to pick the right antibiotic.
9) Prostate-specific antigen (PSA) blood test.
PSA is a protein from the prostate. Higher PSA can come from BPH, inflammation, or cancer. Doctors interpret PSA by age, prostate size, rate of change, and other findings.
10) Free-to-total PSA ratio (when PSA is borderline).
The percentage of PSA that is “free” in the blood can help sort out benign enlargement from possible cancer when results are gray-zone.
11) Kidney function tests (creatinine, eGFR).
Poor emptying can stress the kidneys over time. These tests check how well the kidneys are filtering.
12) Inflammatory markers or STI tests (select cases).
If prostatitis is suspected, tests for white blood cells, C-reactive protein, or sexually transmitted infections may guide treatment.
13) Microscopy of expressed prostatic secretions or semen (select cases).
Under the microscope, white cells suggest inflammation; cultures may find bacteria. This is mainly for chronic pelvic pain or recurrent infection workups.
D) Electrodiagnostic and urodynamic (functional) tests (how the system works under pressure)
14) Uroflowmetry (flow test).
You urinate into a special machine that measures flow over time. A low peak flow suggests blockage or weak bladder muscle. The pattern helps tell which is more likely.
15) Pressure–flow urodynamics with pelvic floor EMG.
Thin catheters measure bladder pressure while you fill and void. Small sticky sensors or a fine needle measures pelvic floor muscle activity (EMG). Together they show if a tight outlet (prostate) or a weak bladder is the main problem.
16) Cystometry (bladder filling study).
This looks at how the bladder stores urine—its capacity, sensitivity, and stiffness. Overactive bladders show early strong urges; stiff bladders show high pressures.
17) Urethral sphincter EMG or bulbocavernosus reflex latency (selected cases).
These nerve-muscle tests check the timing and strength of the sphincter and reflex arcs. They are used in complex or neurogenic cases.
E) Imaging and visualization (what pictures can show)
18) Bladder ultrasound with post-void residual (PVR).
An ultrasound probe over the lower belly estimates how much urine is left after you void. High residuals point to blockage or weak bladder. This test is quick, painless, and very common.
19) Transrectal ultrasound (TRUS) of the prostate.
A slim ultrasound probe in the rectum measures prostate volume, shape, and special features like a bulging median lobe, cysts, or suspicious areas. It helps match size to symptoms and plan procedures if needed.
20) Renal and bladder ultrasound; cystoscopy or MRI in selected cases.
Ultrasound of the kidneys looks for swelling (hydronephrosis) from long-standing blockage. Cystoscopy uses a small camera through the urethra to look directly at the urethra, prostate channel, and bladder—useful before surgery or when bleeding or stones are suspected. MRI may be used if cancer is a concern or when anatomy needs detailed mapping.
Non-pharmacological (no-medicine) treatments
(Each item includes a simple description, purpose, and how it works.)
Bladder training
What: Practice waiting a bit after the urge and gradually extend time between bathroom trips.
Purpose: Reduce frequency and urgency.
How it works: Trains the bladder to hold more with less irritation so you are not “going just in case.”Timed voiding
What: Empty your bladder on a schedule (for example every 2–3 hours in the day).
Purpose: Prevent overfilling and urgency spikes.
Mechanism: Keeps bladder volumes steadier so the muscle is less irritable.Double voiding
What: Urinate, pause a minute, then try again.
Purpose: Improve emptying and reduce dribbling.
Mechanism: The short wait allows the bladder neck to relax and releases any “leftover” urine.Evening fluid management
What: Cut down fluids 2–3 hours before bed and avoid late salty snacks.
Purpose: Reduce nocturia.
Mechanism: Less fluid and less nighttime urine production means fewer sleep interruptions.Limit bladder irritants
What: Reduce caffeine, alcohol, energy drinks, very spicy or acidic foods, and artificial sweeteners if they worsen symptoms.
Purpose: Calm urgency and frequency.
Mechanism: These items stimulate the bladder or increase urine output.Review and adjust symptom-worsening medicines (with your clinician)
What: Decongestants (like pseudoephedrine), some antihistamines, strong anticholinergics, and opioids can worsen flow or retention.
Purpose: Avoid preventable blockage.
Mechanism: These drugs tighten the bladder neck or reduce bladder contractions.Pelvic floor physical therapy
What: Learn to relax overactive pelvic muscles and coordinate them during urination.
Purpose: Smoother flow and less urgency.
Mechanism: Reduces “functional” tightening around the urethra.Healthy weight and waist reduction
What: Aim for gradual, sustainable weight loss if overweight.
Purpose: Improve LUTS and overall health.
Mechanism: Less metabolic inflammation and less abdominal pressure on the bladder.Regular aerobic activity
What: Brisk walking, cycling, or swimming most days.
Purpose: Fewer symptoms and better sleep.
Mechanism: Exercise improves autonomic balance and reduces systemic inflammation.Manage constipation
What: Fiber, fluids, and gentle stool softeners if needed.
Purpose: Less straining on the pelvic floor and bladder.
Mechanism: A full rectum can press on the bladder and worsen urgency.Warm sitz baths or showers
What: Sit in warm water 10–15 minutes.
Purpose: Short-term comfort for pelvic tightness.
Mechanism: Heat relaxes pelvic and prostate smooth muscle tone.Stop smoking
What: Quit tobacco.
Purpose: Better bladder health and fewer nighttime awakenings from cough.
Mechanism: Smoking irritates the bladder and worsens vascular health.Treat sleep apnea (if present)
What: Screening and CPAP use.
Purpose: Reduce nighttime urine production and awakenings.
Mechanism: CPAP lowers atrial natriuretic peptide surges that drive nocturia.Mindful hydration
What: Drink enough, but spread intake through the day; avoid “chugging.”
Purpose: Less urgency spikes.
Mechanism: Steady intake prevents sudden bladder filling.Keep the pelvis warm
What: Avoid long periods on cold surfaces; dress warm.
Purpose: Reduce reflex prostate/bladder neck tightening.
Mechanism: Cold can trigger smooth muscle contraction.Urinate sitting (if helpful)
What: Men with weak stream sometimes empty better sitting.
Purpose: Improve comfort and emptying.
Mechanism: Pelvic floor and abdominal muscles often relax more fully.Voiding posture and patience
What: Take time, relax shoulders and abdomen, avoid straining.
Purpose: Reduce incomplete emptying.
Mechanism: Less bearing down, more coordinated flow.Keep a bladder diary
What: Record times, volumes, drinks, and triggers for 3–7 days.
Purpose: Target problem patterns and track progress.
Mechanism: Data-driven tweaks to habits produce measurable gains.Pain and stress reduction
What: Gentle stretching, breathing exercises, yoga, or CBT if anxiety worsens symptoms.
Purpose: Calm urgency and pelvic tension.
Mechanism: Stress tightens pelvic muscles and bladder reflexes.UTI prevention basics
What: Good hydration, don’t hold urine too long, manage diabetes well.
Purpose: Avoid infections that worsen LUTS.
Mechanism: Regular flushing and good sugar control reduce bacterial overgrowth.
Evidence-based drug treatments
(Each includes class, usual dose & timing, purpose, how it works, and common side effects. Doses are typical adult doses; your prescriber will individualize.)
Tamsulosin
Class: α1A-selective blocker.
Dose/time: 0.4 mg once daily (may increase to 0.8 mg), same time each day after food.
Purpose: Quick relief of weak stream and hesitancy.
Mechanism: Relaxes smooth muscle in the prostate and bladder neck to open the urethra.
Side effects: Dizziness, low blood pressure, ejaculatory changes, fatigue; tell your eye doctor before cataract surgery (floppy iris risk).Alfuzosin (ER)
Class: Uro-selective α1 blocker.
Dose/time: 10 mg once daily after the same meal.
Purpose: Improve flow and symptoms with low blood-pressure effects for many.
Side effects: Dizziness, headache, fatigue; rare hypotension.Silodosin
Class: Highly α1A-selective blocker.
Dose/time: 8 mg once daily with food (4 mg if kidney function is reduced).
Purpose: Strong symptom relief.
Side effects: Retrograde or reduced ejaculation, dizziness, stuffy nose.Doxazosin
Class: Non-selective α1 blocker.
Dose/time: Start 1 mg nightly; titrate to 4–8 mg daily.
Purpose: Flow relief; may also lower blood pressure.
Side effects: Orthostatic dizziness, fatigue; start low and go slow.Terazosin
Class: Non-selective α1 blocker.
Dose/time: Start 1 mg nightly; titrate to 5–10 mg nightly.
Purpose: Symptom relief.
Side effects: Similar to doxazosin; watch for lightheadedness, especially at dose changes.Finasteride
Class: 5-α-reductase inhibitor (type II).
Dose/time: 5 mg once daily; takes 3–6 months for full effect.
Purpose: Shrinks larger prostates and lowers risk of urinary retention or surgery.
Mechanism: Lowers DHT inside the prostate to reduce tissue growth.
Side effects: Decreased libido, erectile or ejaculatory issues in some; can lower PSA by ~50% after 6 months, so PSA interpretation must be adjusted by your clinician.Dutasteride
Class: 5-α-reductase inhibitor (type I and II).
Dose/time: 0.5 mg once daily.
Purpose: Similar to finasteride; helpful in clearly enlarged glands.
Side effects: Like finasteride; may cause breast tenderness; PSA falls similarly.Tadalafil (daily)
Class: PDE-5 inhibitor.
Dose/time: 5 mg once daily at the same time.
Purpose: Improves LUTS and may help erectile function.
Mechanism: Increases nitric oxide signaling, relaxing smooth muscle in bladder neck and prostate.
Side effects: Headache, flushing, nasal stuffiness, reflux, back pain; avoid with nitrates.Mirabegron
Class: β3-agonist (bladder relaxer).
Dose/time: 25–50 mg once daily.
Purpose: Reduces urgency/frequency when storage symptoms are prominent, often added to an α-blocker.
Side effects: Mild BP rise, headache, constipation; check interactions if on many meds.Solifenacin (or another antimuscarinic like tolterodine/oxybutynin ER)
Class: M3-preferring antimuscarinic.
Dose/time: 5–10 mg once daily.
Purpose: Calms an overactive bladder component.
Mechanism: Blocks acetylcholine signals that trigger bladder spasms.
Side effects: Dry mouth, constipation, blurry vision; avoid if you retain a lot of urine unless monitored.
Common combinations used by clinicians:
α-blocker + 5-ARI (e.g., tamsulosin + dutasteride) for bigger prostates with bothersome symptoms: quick relief + shrinkage over months.
α-blocker + mirabegron or α-blocker + antimuscarinic when urgency/frequency remain despite better flow.
Tadalafil can be used alone or with an α-blocker (monitor blood pressure).
Dietary and molecular supplements
β-Sitosterol
Dose: ~60–130 mg/day (often as mixed plant sterols).
Function: May modestly improve flow and symptom scores in some men.
Mechanism: Plant sterol that can reduce prostate inflammation and improve urine dynamics; does not shrink prostate.Pygeum africanum (African plum bark)
Dose: 50–100 mg/day of standardized extract.
Function: Slight improvement in nocturia and residual urine in some studies.
Mechanism: Anti-inflammatory and anti-edema effects on prostate tissues.Pumpkin seed oil or extract (Cucurbita pepo)
Dose: 1–2 g oil/day or standardized extracts as labeled.
Function: May ease nocturia and improve quality of life.
Mechanism: Likely reduces inflammation and modulates androgen pathways mildly.Rye grass pollen extract (Cernilton)
Dose: 60–120 mg/day.
Function: Modest symptom relief in some small trials.
Mechanism: Anti-inflammatory and smooth muscle relaxation effects.Saw palmetto (Serenoa repens)
Dose: 160 mg twice daily of standardized extract (or equivalent daily dose).
Function: Evidence is mixed; many high-quality trials show no meaningful benefit over placebo, though some individuals report improvement.
Mechanism: Weak 5-α-reductase inhibition and anti-inflammatory actions.Lycopene (tomato pigment)
Dose: 10–30 mg/day from food or supplements.
Function: General prostate antioxidant support; symptom effects are uncertain but safe as part of diet.
Mechanism: Quenches oxidative stress in prostate tissue.Green tea catechins (EGCG)
Dose: ~200–400 mg/day of EGCG (watch caffeine and liver safety).
Function: Anti-inflammatory; may mildly help storage symptoms.
Mechanism: Reduces inflammatory signaling and oxidative stress.Quercetin
Dose: 500 mg twice daily (often studied in chronic pelvic pain; BPH data limited).
Function: Anti-inflammatory; may reduce pelvic discomfort for some.
Mechanism: Inhibits inflammatory pathways and mast cells.Omega-3 fatty acids (EPA/DHA)
Dose: Around 1 g/day combined EPA+DHA (from fish or capsules).
Function: Systemic anti-inflammation; symptom effect modest.
Mechanism: Shifts eicosanoid balance toward less inflammatory mediators.Vitamin D
Dose: Often 1000–2000 IU/day; individualize by blood levels.
Function: Supports immune balance and muscle function; not a direct BPH cure.
Mechanism: Modulates cell growth and inflammation.
Important cautions: Supplements can interact with blood thinners and other medicines. Quality varies by brand. Stop and contact your clinician if you notice bleeding, jaundice, severe stomach upset, or new symptoms.
Regenerative / stem-cell drugs”: what you should know
There are no approved immune-booster or stem-cell drugs for BPH. Some approaches are under research only. Below are experimental ideas you may see online; these should not be used outside properly monitored clinical trials.
Mesenchymal stem cells (MSCs) – experimental injections or infusions; no standard dose; proposed to reduce fibrosis and inflammation. Evidence is limited; unknown long-term safety in the prostate.
Adipose-derived stem cells (ADSCs) – similar concept using fat-derived cells; no accepted dosing; clinical value unproven.
Bone-marrow mononuclear cells – tested in small studies for other pelvic conditions; not established for BPH.
Extracellular vesicles / exosomes – lab-prepared vesicles from cells; experimental for tissue modulation; dosing and safety uncertain.
Platelet-rich plasma (PRP) – growth-factor-rich plasma; sometimes marketed for pelvic issues; not proven for BPH relief; protocols vary, and risks include pain or infection.
Biologic anti-inflammatory medicines (e.g., cytokine-targeted drugs) – not indicated for BPH; risks may outweigh any unproven benefit.
Bottom line: If someone markets a “stem-cell” or “immune” drug for BPH outside a regulated clinical trial, be cautious and ask your urologist first.
Common procedures and surgeries
TURP (Transurethral Resection of the Prostate)
What: A scope through the urethra shaves out the inner prostate to open the channel.
Why: Gold-standard for moderate-to-large prostates with bothersome symptoms or complications (retention, infections).
Recovery/Risks: Catheter for 1–3 days; bleeding, temporary burning, retrograde ejaculation are possible.HoLEP (Holmium Laser Enucleation of the Prostate)
What: A laser removes the obstructing prostate tissue en bloc and it’s morcellated in the bladder.
Why: Works for small to very large prostates; durable with low re-operation rates.
Recovery/Risks: Often overnight stay; temporary stress urinary leakage can occur but usually improves.PUL (Prostatic Urethral Lift, “UroLift”)
What: Tiny implants pull prostate lobes away to widen the urethra without cutting tissue.
Why: For selected men with medium-sized prostates who want to preserve ejaculation and have a quick recovery.
Recovery/Risks: Irritation and urgency for days; may be less effective in very large glands or with a big median lobe.Rezūm Water-Vapor Therapy
What: Needle injects steam into prostate tissue; the treated tissue shrinks over weeks.
Why: Minimally invasive option for many sizes including some median lobes.
Recovery/Risks: Temporary catheter; burning/urgency for 1–3 weeks as tissue resorbs.Simple Prostatectomy (Open, Laparoscopic, or Robotic)
What: Surgeons remove the bulky inner prostate (not the entire gland like in cancer surgery).
Why: For very large prostates where endoscopic options are less suitable.
Recovery/Risks: Longer recovery; bleeding, infection, and incontinence risks are higher than minimally invasive options but results can be excellent.
Other options you might hear about: GreenLight laser vaporization, TUIP (bladder neck incision) for small prostates, and prostatic artery embolization performed by interventional radiology in select cases.
Smart prevention strategies
Maintain a healthy weight and stay active.
Keep diabetes, blood pressure, and cholesterol under control.
Limit evening fluids and alcohol; avoid binge drinking.
Reduce caffeine and energy drinks.
Treat constipation and do not strain on the toilet.
Do not hold urine for very long when you have the chance to go.
Quit smoking.
Review medicines that worsen symptoms with your clinician.
Treat sleep apnea if you snore, gasp, or feel unrefreshed.
Get routine checkups so changes are caught early.
When to see a doctor—right away vs soon
Right away / urgent: You cannot urinate at all (acute urinary retention), have fever and chills with urinary pain, see blood clots in urine, have severe back/flank pain or vomiting, or feel confused or very weak.
Soon (within days to weeks): Your stream is getting worse, you wake up many times at night, you feel you never empty, you have burning urination, or you are starting new medicines that might tighten the bladder neck.
Ongoing care: If you are on a 5-ARI (finasteride/dutasteride), schedule follow-ups to monitor PSA and side effects. Before cataract surgery, tell the eye surgeon if you ever used an α-blocker.
What to eat and what to avoid
Base your meals on plants – vegetables, fruits, legumes, whole grains, and nuts support vascular and metabolic health that helps the bladder and prostate.
Add tomato products – tomato paste, sauce, or cooked tomatoes give you lycopene.
Choose healthy fats – olive oil, avocados, and nuts; fish twice weekly for omega-3s.
Get adequate fiber – oats, beans, chia, and vegetables prevent constipation.
Hydrate smartly – sip through the day; slow down in the evening.
Limit caffeine – coffee, tea, and colas can worsen urgency; find your personal threshold.
Moderate alcohol – especially beer or late-evening drinks that increase nighttime urine.
Go easy on very spicy or acidic foods if they trigger urgency for you.
Watch salt – high sodium pulls water and can raise nighttime urine.
Be supplement-savvy – if you try a prostate supplement, pick one product at a time, track your symptoms for 6–8 weeks, and stop if no benefit.
Frequently asked questions
1) Is an enlarged prostate cancer?
No. BPH is not cancer and does not turn into cancer, but both can exist together, which is why PSA and appropriate cancer screening are important.
2) Does prostate size equal symptom severity?
Not always. Some small prostates cause big symptoms if the tissue sits like a tight ring; some large prostates cause few symptoms. Testing and exam guide treatment.
3) Will BPH keep getting worse?
It is usually slowly progressive, but many men stabilize or improve with lifestyle changes and medicines. A larger gland and higher PSA raise the chance of progression.
4) How long before medicines help?
α-blockers often help in days to weeks. 5-ARIs shrink the gland and take 3–6 months for full benefit. Combination therapy offers quick relief plus long-term protection.
5) Will medicines affect sexual function?
They can. α-blockers may cause ejaculatory changes; 5-ARIs can reduce libido or cause erectile issues in a minority. Tadalafil can help both LUTS and erections.
6) I’m on a blood thinner—can I still have a procedure?
Yes, but planning is needed. Some minimally invasive options are preferred; your urologist and cardiologist will coordinate peri-procedural management.
7) What is the best procedure?
The “best” choice depends on your prostate size, shape (median lobe?), goals (keeping ejaculation), health, and surgeon experience. TURP and HoLEP are highly effective; UroLift and Rezūm suit selected cases.
8) Can Kegel exercises help?
They can when guided correctly. For voiding, relaxation of the pelvic floor is key. A pelvic floor therapist teaches both relaxation and strengthening where appropriate.
9) Does drinking more water help?
Steady hydration helps bladder health, but timing matters. Front-load fluids earlier in the day and ease up in the evening.
10) Do I need PSA if I have symptoms?
PSA is often part of the workup to help assess risk of cancer and roughly reflect prostate size. Your clinician will decide based on age, risks, and preferences.
11) Are herbals safe?
“Natural” does not always mean safe. Some interact with anticoagulants or cause stomach/liver side effects. Discuss any supplement with your clinician.
12) Can BPH damage my kidneys?
Severe, long-standing obstruction can raise back-pressure and harm kidneys. That is why persistent high PVR, retention, or hydronephrosis requires prompt care.
13) Will weight loss really help?
Yes. Even modest weight and waist reduction can lower urgency and nocturia by improving metabolic health and bladder function.
14) Can I keep ejaculation after treatment?
Yes, with careful choice. PUL (UroLift) is designed to preserve antegrade ejaculation; other procedures may reduce or eliminate it. Discuss this priority up front.
15) When should I think about surgery?
If lifestyle and medicines do not control symptoms, or if you have complications like retention, recurrent infections, stones, bleeding, or kidney changes, it is time to discuss a procedure.
Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, geological location, weather and previous medical history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. Regular check-ups and awareness can help to manage and prevent complications associated with these diseases conditions. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. We always try to ensure that the content is regularly updated to reflect the latest medical research and treatment options. Thank you for giving your valuable time to read the article.
The article is written by Team RxHarun and reviewed by the Rx Editorial Board Members
Last Updated: August 17, 2025.
Thyromegaly
