If you’re one of the millions of men in the United States dealing with an enlarged prostate—also known as Benign Prostatic Hyperplasia (BPH)—you’re not alone. BPH is a non-cancerous enlargement of the prostate gland that affects over 50% of men over the age of 50 and nearly 90% of men over 80. As vascular and embolization specialists, we’ve seen firsthand how disruptive the urinary symptoms of BPH can be—frequent urges to urinate, weak urine stream, incomplete bladder emptying, and more. These symptoms don’t just interfere with your sleep—they affect your quality of life.
We’re here to guide you through the best treatment options available in 2025, based on the latest clinical evidence and advancements in prostate care. From lifestyle changes and prescription medications to minimally invasive procedures like Prostate Artery Embolization (PAE) and traditional surgical treatments, this article breaks down what really works—and when each treatment makes sense—without overpromising results.
Understanding Benign Prostatic Hyperplasia (BPH)
BPH is a condition in which excess prostate tissue causes the prostate gland to grow in size, compressing the urethra and obstructing urine flow. While BPH is not the same as prostate cancer, the two can share symptoms and may coexist. The cause of BPH isn’t fully understood, but aging, hormonal changes, and certain risk factors—such as family history, obesity, and diabetes—are linked to its development.
Common Symptoms of BPH
- Weak urine stream
- Difficulty starting or stopping urination
- Frequent urination, especially at night (nocturia)
- Urgent need to urinate
- Incomplete bladder emptying
- Increased risk of urinary tract infections
When to Seek Treatment for an Enlarged Prostate
Mild symptoms of BPH can often be managed with watchful waiting or minor lifestyle changes like reducing caffeine, alcohol, and late-night fluid intake. However, if symptoms worsen or begin to interfere with your daily life, it’s time to consider medical intervention. Delaying treatment can lead to bladder damage, kidney diseases, and long-term complications.
Treatment Options for Enlarged Prostate
1. Lifestyle Changes (First-Line Management)
Simple changes can reduce symptom severity:
- Timed voiding to manage urgency
- Pelvic floor exercises
- Limiting fluids before bedtime
- Avoiding sinus medicines that can worsen symptoms
These are ideal for men with mild symptoms or early signs of BPH.
2. Medications
Two main classes of drugs are commonly prescribed:
a. Alpha Blockers
These relax the bladder neck and prostate muscle fibers, improving urine flow.
- Examples: Tamsulosin, Alfuzosin
- Quick symptom relief, typically within days
b. 5-Alpha Reductase Inhibitors
These reduce prostate size by shrinking prostate tissue over time.
- Examples: Finasteride, Dutasteride
- May take 3–6 months to see effects
c. Combination Therapy
Used in patients with severe symptoms or large prostates. However, these medications can cause erectile dysfunction, retrograde ejaculation, or reduced libido.
3. Minimally Invasive Procedures
These treatments aim to remove or reduce obstructive tissue without the need for invasive surgery.
a. Prostate Artery Embolization (PAE)
Performed by an interventional radiologist, PAE involves injecting microscopic particles into the arteries that supply the prostate, blocking blood flow and causing it to shrink. It’s a non-surgical, outpatient procedure with a low risk of sexual side effects.
Benefits of PAE:
- Preserves sexual function
- Minimally invasive
- Short recovery time
- Effective even in large prostates
Ideal for: Patients who are not good candidates for surgery or prefer a less invasive option.
b. UroLift (Prostatic Urethral Lift)
Inserts small implants to hold the prostate cells away from the urethra. Recovery is fast, but it’s typically suited for men with smaller prostates.
c. Rezūm Therapy
Uses steam to ablate excess prostate tissue. May result in temporary urinary symptoms but is less invasive than surgery.
4. Surgical Treatments
When symptoms are severe or other treatments fail, surgical procedures may be necessary.
a. Transurethral Resection of the Prostate (TURP)
Often considered the gold standard. Involves removing part of the prostate through the urethra. High success rate but carries a higher risk of complications like retrograde ejaculation.
b. Laser Enucleation or Vaporization
Uses high-energy lasers to remove or destroy obstructive prostate tissue.
Risks and Considerations for Each Treatment
- Alpha blockers may cause low blood pressure or dizziness.
- 5-Alpha reductase inhibitors may take months to work and have sexual side effects.
- PAE is not suitable for everyone and requires imaging to confirm eligibility.
- Surgical options come with higher complication risks but may be necessary for severely enlarged prostates.
Always review your medical history, current medications, and lifestyle with your provider before choosing a path forward.
Choosing the Best Treatment: What the Experts Say
There is no one-size-fits-all approach. Your best treatment depends on:
- Size of your prostate
- Severity of lower urinary tract symptoms
- Presence of other conditions like kidney disease or erectile dysfunction
- Willingness to undergo surgery or manage side effects
In recent years, Prostate Artery Embolization has become an increasingly preferred option for men seeking a minimally invasive, outpatient solution that avoids the sexual side effects often seen with medication or surgery. That said, other treatments—ranging from medication to TURP—may still be appropriate depending on your situation.
The Future of BPH Treatment
Emerging innovations in imaging, embolization techniques, and biologic therapies may soon allow for more targeted, personalized prostate care. Meanwhile, herbal remedies, dietary interventions, and alternative therapies are gaining attention, though more clinical evidence is needed to recommend them confidently.
Final Thoughts
Navigating treatment for benign prostatic enlargement can feel overwhelming, but understanding your options—and when to use them—makes all the difference. If you're wondering how to shrink your prostate, start by exploring lifestyle changes and non-invasive procedures. Whether you're just beginning or considering Prostate Artery Embolization, consult a specialist who understands both traditional and cutting-edge therapies. While no single treatment is "best" for everyone, the right strategy for you is out there
FAQ: Best Treatments for Enlarged Prostate
What is the most effective treatment for an enlarged prostate?
That depends on your symptoms and prostate size. TURP has high success rates, but Prostate Artery Embolization offers excellent results with fewer side effects for many men.
Can BPH be treated without surgery?
Yes. Alpha blockers, 5-alpha reductase inhibitors, and minimally invasive procedures like PAE or UroLift offer alternatives to surgery.
How long does it take for prostate medication to work?
Alpha blockers often work within days. 5-alpha reductase inhibitors may take 3–6 months.
Does PAE affect sexual function?
Unlike some surgical procedures, PAE has a low risk of causing erectile dysfunction or retrograde ejaculation.
Is BPH linked to prostate cancer?
BPH is not cancer and does not cause cancer, but both conditions can exist together. Always consult your doctor if symptoms change.
Can herbal remedies help?
Some men find relief with saw palmetto or beta-sitosterol, but evidence is mixed. Always talk to a specialist before starting.
What lifestyle changes can improve BPH symptoms?
Reduce caffeine and alcohol, avoid fluids before bed, and stay physically active. These changes help manage mild symptoms.
When is surgery necessary?
If medications or minimally invasive treatments don’t work and symptoms are severe, surgery may be required.
What is the recovery time for PAE?
Most patients resume normal activities within a few days. Full symptom relief may take weeks as the prostate shrinks.
How do I choose the right treatment?
Talk with a urologist or interventional radiologist to assess your symptoms, health history, and personal goals.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a licensed healthcare provider regarding your prostate health and treatment options.