Starting around age 40, it is common for the size of the prostate to increase. In many men, this also ultimately affects their urination. Fortunately, this does not have any association with the risk for cancer, though it does cause the PSA, a blood test used for prostate cancer screening, to increase.
Common complaints due to this issue include a weak urinary stream, intermittent urinary stream, straining to urinate, frequent day or night voiding (nocturia), and incompletely emptying the bladder. There are a variety of treatments available to address this problem, from medications to minimally invasive office therapies.
One of the remedies available for BPH treatment includes saw palmetto, an over-the-counter (OTC) supplement, though there is little published data on its effectiveness. Another type of medication is alpha-blockers, such as Flomax®, which work by relaxing the smooth muscle of the prostate and thus opening up the outlet from the bladder. The last medication type available is 5-DHT blockers, such as Proscar® and Avodart®. These medications block an enzyme step in the use of testosterone, which causes the prostate to shrink.
There is also a variety of minimally invasive office therapies available. These include Transurethral Needle Ablation of the Prostate (TUNA) and Transurethral Microwave Thermotherapy (TUMT). Another procedure, Greenlight™ Photovaporization of the Prostate (PVP), offers results without all the hassles. Transurethral Resection of the Prostate, another excellent treatment, is considered the gold standard for BPH treatment. The last treatment available is Open Prostate Enucleation, which is used primarily for extremely large prostates.