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By their 50s, half of all men have BPH. By your 80s, it鈥檚 90%. For men, BPH 鈥� also called benign prostatic hyperplasia or enlarged prostate 鈥� comes with the territory. BPH can trigger ongoing urinary problems, incontinence, and even chronic infections.

You can be free from the constraints and embarrassment of BPH! More than ever, it is possible to effectively treat and manage BPH. But which treatments are best for you? This guide will tell you.

You鈥檒l know before you say 鈥淵es.鈥�

When treating BPH, the most important consideration is which approach best addresses your condition, your expectations, and your reservations.

In this Guide, Harvard doctors present and assess today鈥檚 treatment options. From watchful waiting to medication to surgery, the guide explains the benefits, risks, and side-effects you can anticipate from each approach.

You鈥檒l appreciate how all things are considered 鈥� especially you. Which protocols can effectively reduce the symptoms that bother you most鈥� which have the fewest complications鈥� which offer you the most lasting improvement? You鈥檒l get the answers fully and clearly.

You鈥檒l find practical steps and proven measures. You鈥檒l read how simple changes in behavior can ease urinary symptoms. You鈥檒l discover two controllable risk factors. You鈥檒l learn about medications for the 鈥済oing鈥� problem鈥� the 鈥漡rowing鈥� problem鈥� and a new combination pill to solve both. You鈥檒l find the medication with the fewest sexual side effects鈥� and one that can more successfully reduce future need for surgery.

You鈥檒l discover advances that are erasing fears and extending relief. You鈥檒l be briefed on a durable surgical procedure that improves urine flow for 90% of patients. You鈥檒l read about an alternative for men taking blood thinners. The guide shines a light on today鈥檚 competing laser surgical options. You鈥檒l learn about three outpatient procedures鈥� the prospects for Botox BPH therapy鈥� and the six questions to ask before any BPH surgery.

Prepared by the editors of 天博体育 Publishing in consultation with Martin Kathrins, MD, Assistant Professor of Surgery, Harvard Medical School, Chief of Benign Urology and Director of the Men鈥檚 Health Center, Brigham and Women鈥檚 Hospital. 21 Pages. (2025)

About Harvard Medical School Guides

Harvard Medical School Guides delivers compact, practical information on important health concerns. These publications are smaller in scope than our Special Health Reports, but they are written in the same clear, easy-to-understand language, and they provide the authoritative health advice you expect from 天博体育 Publishing.

Causes and effects

In BPH, cells in the prostate gland divide and multiply. That鈥檚 what causes the gland to expand in size. Research has found that prostate volume averages about 25 cubic centimeters (cc) for men in their 30s, when BPH is rare. But it鈥檚 common for the gland to get bigger with time, reaching an average of 35 to 45 cc for men in their 70s.

Prostate enlargement doesn鈥檛 always cause urinary problems. Some men have relatively large prostates without having any symptoms. On the other hand, symptoms can occur even in men with a small or average prostate.

The prostate is made up of muscle tissue and a network of tiny tubes (ducts) lined with cells that produce prostatic fluid. During ejaculation, the prostate pushes that fluid through those ducts and into the urethra, where it mixes with sperm cells from the testes and exits through the penis. BPH is the result of cell overgrowth in the muscle as well as the lining of the ducts. Experts think it has to do with age-related changes in hormone levels.

 Certain factors are linked to a higher risk of BPH. These risk factors include increasing age, a family history of BPH, higher body weight, and lack of exercise. It鈥檚 not clear whether losing weight or exercising more actually prevents BPH, but these risk factors can identify men who are the most likely to develop prostate enlargement with bothersome urinary problems. (See 鈥淐an BPH be prevented?鈥� on page 20.)

The prostate wraps entirely around the urethra at the point where it exits the bladder.  As the prostate grows, it starts to press in on the urethra and restrict the flow of urine. As a result, it gets harder to empty your bladder. Over time, this can also lead to changes in how the bladder itself functions. In some cases, the impingement can get so extreme that you can鈥檛 urinate at all鈥攁 painful medical emergency that poses the risk of kidney damage.

• Help for BPH
• Causes and effects
• Symptoms
• Diagnosis
• Treatment: Watchful waiting
• Treatment: Medication
• Treatment: Surgery
• Can BPH be prevented?
• Resources

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