Enlarged Prostate in Seniors: Symptoms, Treatment and Daily Care Guide

How Is It Treated?

The treatment you choose will be based on how bad your symptoms are and how much they bother you. Your provider will also take into account other medical problems you may have.

Treatment options include “watchful waiting,” lifestyle changes, medicines, or surgery.

If you are over 60, you are more likely to have symptoms. But many men with an enlarged prostate have only minor symptoms. Self-care steps are often enough to make you feel better.

If you have BPH, you should have a yearly assessment to monitor your symptoms and see if you need changes in treatment.

SELF-CARE

For mild symptoms:

• Urinate when you first get the urge. Also, go to the bathroom on a timed schedule, even if you don’t feel a need to urinate.
• Avoid alcohol and caffeine, especially after dinner.
• Do not drink a lot of fluid all at once. Spread out fluids during the day. Avoid drinking fluids within 2 hours of bedtime.
• Try not to take over-the-counter cold and sinus medicines that contain decongestants or antihistamines. These medicines can increase BPH symptoms.
• Keep warm and exercise regularly. Cold weather and lack of physical activity may worsen symptoms.
• Reduce stress. Nervousness and tension can lead to more frequent urination.

MEDICINES

Alpha-1 blockers are a class of medicines, some of which have been used to treat high blood pressure. These medicines relax the muscles of the bladder neck and prostate. This allows easier urination. Most people who take alpha-1 blockers notice improvement in their symptoms, usually within 3 to 7 days after starting the medicine.

Finasteride and dutasteride lower levels of hormones produced by the prostate. These medicines also reduce the size of the gland, increase urine flow rate, and decrease symptoms of BPH. You may need to take these medicines for 3 to 6 months before you notice symptoms getting better. Possible side effects include decreased sex drive and

.

Antibiotics may be prescribed to treat chronic prostatitis (inflammation of the prostate), which may occur with BPH. BPH symptoms may improve in some men after a course of antibiotics.

Watch out for

such as decongestants, antihistamines, diuretics, and certain antidepressants.

SAW PALMETTO

Many herbs have been tried for treating an enlarged prostate. Many men use saw palmetto to ease symptoms. Some studies have shown that it may help with symptoms, but results are mixed, and more research is needed. If you use saw palmetto and think it works, ask your provider if you should still take it.

SURGERY

Prostate surgery may be recommended if you have:

• Incontinence
• Recurrent blood in the urine
• Inability to fully empty the bladder (urinary retention)
• Recurrent

  urinary tract infections

• Decreasing kidney function

• Bladder stones

• Bothersome symptoms not responding to medicines

The choice of which surgical procedure is recommended is most often based on the severity of your symptoms and the size and shape of your prostate gland. Most men who have prostate surgery have improvement in urine flow rates and symptoms.

(TURP): This is the most common and most proven surgical treatment for BPH. TURP is performed by inserting a scope through the penis and removing the prostate piece by piece.

: This is a procedure to remove the inside part of the prostate gland. It is done through a surgical cut in your lower belly. This treatment is most often done on men who have very large prostate glands.

Other

use heat or a laser to destroy prostate tissue. Another less-invasive procedure works by “tacking” the prostate open without removing or destroying tissues. None have been proven to be better than TURP. People who receive these procedures are more likely to need surgery again after 5 or 10 years. However, these procedures may be a choice for:

• Younger men (many of the less-invasive procedures carry a lower risk for impotence and incontinence than TURP, although the risk with TURP is not very high)
• Older people
• People with severe medical conditions, including uncontrolled

  diabetes

  ,

  cirrhosis

  , alcoholism,

  psychosis

  , and serious lung, kidney, or

  heart disease

• Men who are taking blood-thinning medicines
• Men who are otherwise at an increased surgical risk

What Are Support Groups?

Some men may find it helpful to take part in a

.

What Are Possible Complications?

Men who have had BPH for long time with slowly worsening symptoms may develop:

• Sudden inability to urinate (urinary retention)

• Urinary tract infections

• Urinary stones
• Damage to the kidneys
• Blood in the urine

BPH may come back over time, even after having surgery.

When to Contact a Medical Professional?

Contact your provider right away if you have:

• Less urine than usual

• Fever

  or

  chills

• Back, side, or abdominal pain
• Blood or pus in your urine

Also contact your provider if:

• Your bladder does not feel completely empty after you urinate.
• You take medicines that may cause urinary problems, such as diuretics, antihistamines, antidepressants, or sedatives. Do not stop or change your medicines without talking to your provider.
• You have tried self-care steps for 2 months and symptoms have not improved.

What Are Patient Instructions?

• Enlarged prostate – what to ask your doctor

• Prostate resection – minimally invasive – discharge

• Transurethral resection of the prostate – discharge