Shrinking an enlarged prostate at home: 6 non-surgical remedies

Benign prostatic hyperplasia (BPH) is a very common condition in middle-aged and elderly men. According to statistics, approximately 50% of men over 50 and up to 80–90% of men over 80 show signs of an enlarged prostate to varying degrees. This condition can cause a range of discomforts such as frequent nighttime urination, difficulty urinating, weak urine stream, and incomplete bladder emptying, significantly affecting sleep, work, and quality of life.

Many people are concerned about how to treat benign prostatic hyperplasia to effectively reduce symptoms and prevent complications such as urinary tract infections, urinary retention, or bladder stones. The good news is that most cases can be well managed with lifestyle changes, appropriate diet, and medical treatments. In some cases, minimally invasive procedures or surgery can provide long-term effectiveness.

This article will help you understand the methods of treating benign prostatic hyperplasia, from home remedies to modern medical options, to proactively protect your health and safely improve urinary function.

Highlights of Benign Prostatic Hyperplasia Treatment

Lifestyle adjustments to reduce symptoms

Changing daily habits is one of the simple yet effective ways to support benign prostatic hyperplasia treatment and improve urination.

• Limit alcohol, coffee, strong tea, and caffeinated beverages as they can irritate the bladder, increasing the urge to urinate.
• Prioritize a diet rich in fiber from green vegetables, fruits, and whole grains to prevent constipation, a factor that can worsen prostate symptoms.
• Reduce foods high in saturated fats, processed foods, and fast food to support long-term prostate health.

Practice double voiding technique

This is a tip recommended by many doctors for people with benign prostatic hyperplasia.

1. Urinate as usual until the urine flow stops.
2. Wait for about 20–30 seconds.
3. Try to urinate again to empty the bladder as much as possible.

This method can help reduce residual urine, limit the feeling of incomplete emptying, frequent urination, and urgency.

Discuss treatment medications with your doctor

If symptoms affect daily life, patients should consult their doctor about medications for benign prostatic hyperplasia treatment.

• Alpha-blockers help relax muscles in the prostate and bladder neck, thereby improving urine flow.
• 5-alpha reductase inhibitors can help slow the growth and reduce the size of the prostate over time.

Medication use must follow the correct prescription to achieve treatment effectiveness and limit unwanted side effects.

Learn about minimally invasive procedures

When lifestyle changes and medication do not yield the desired results, doctors may suggest minimally invasive interventions.

• Transurethral microwave thermotherapy (TUMT) is a commonly used option.
• This method uses microwave energy to remove part of the overgrown prostate tissue.
• As a result, pressure on the urethra is reduced, helping to improve difficulty urinating, weak urine stream, and frequent urination.

The choice of appropriate treatment depends on the size of the prostate, the severity of symptoms, and the overall health condition of each patient.

Part 1: Home remedies for benign prostatic hyperplasia

Method 1: Reduce bladder-irritating beverages

If you are experiencing symptoms of benign prostatic hyperplasia such as frequent urination, urgency, or waking up frequently at night to urinate, you should limit beverages that can irritate the bladder.

• Reduce daily alcohol consumption.
• Limit coffee, caffeinated tea, and carbonated soft drinks.
• Avoid overusing products containing artificial sweeteners.

These types of beverages can make the bladder more sensitive, thereby worsening symptoms of nocturia, frequent urination, and difficulty controlling urination.

To support benign prostatic hyperplasia treatment, try to reduce your daily intake of coffee, caffeinated tea, and carbonated soft drinks, especially in the late afternoon and after dinner.

• Caffeine intake should be limited to less than 200 mg per day, equivalent to about 2 normal cups of coffee.
• Gradually cutting back on caffeine can help prevent fatigue or headaches from sudden cessation.

As for alcohol, the more you reduce it, the better it is for urinary and prostate health.

• Do not drink more than 2 alcoholic units per day.
• Total consumption should be less than 14 alcoholic units per week.
• Avoid drinking alcohol in the evening to reduce the risk of nocturia and sleep disruption.

Maintaining this habit long-term not only helps improve symptoms of enlarged prostate but also contributes to protecting cardiovascular and urinary system health.

Method 2: Drink water at the right time to reduce nocturia

One of the simple ways to improve symptoms of benign prostatic hyperplasia is to adjust the timing of water intake throughout the day. This habit can help reduce nocturia, promote better sleep, and limit the discomfort of waking up multiple times to urinate.

Limit heavy drinking before bedtime

• Reduce the amount of water, tea, fruit juice, and other beverages within 2 hours before bed.
• Empty your bladder completely before going to bed to ensure it's as empty as possible.
• Avoid drinking large amounts of water in the evening, especially if you frequently experience nocturia.

Going to bed with a bladder that doesn't contain too much urine can help reduce the number of times you wake up during the night and improve sleep quality.

Stay adequately hydrated during the day

Limiting water intake in the evening does not mean drinking less water throughout the day. People with an enlarged prostate still need to maintain appropriate water intake to support the function of the urinary system.

• Prioritize drinking water from morning to afternoon.
• Divide your water intake into several small portions throughout the day instead of drinking it all in the evening.
• Adult men should consume about 3.7 liters of fluid daily from water and water-rich foods.

Increase water intake when necessary

In some cases, the body needs more water than usual to avoid dehydration.

• Increase water intake during high-intensity exercise.
• Supplement with extra fluids on hot days or when sweating heavily.
• Monitor urine color; pale yellow urine is usually a sign that the body is adequately hydrated.

Maintaining a reasonable water drinking habit not only helps control symptoms of benign prostatic hyperplasia but also contributes to protecting kidney and urinary system health long-term.

Method 3: Eat more fiber to support prostate health

A diet rich in fiber and low in fat can help improve symptoms of benign prostatic hyperplasia, while also supporting a more efficient digestive system. This is one of the lifestyle changes encouraged by many experts for men seeking to treat benign prostatic hyperplasia safely and sustainably.

Increase fiber-rich foods

Constipation can increase pressure on the bladder and prostate, making symptoms like difficulty urinating, frequent urination, or incomplete bladder emptying more severe. Therefore, consuming enough fiber daily is very important.

• Eat plenty of fresh fruits, especially those that can be eaten with the skin, like apples and pears.
• Increase green vegetables in daily meals.
• Include beans, lentils, nuts, and whole grains.
• Prioritize natural, minimally processed foods.

Diversify vegetables and fruits daily

A varied menu not only helps provide fiber but also supplies numerous vitamins and antioxidants beneficial for prostate health.

• Try to eat a variety of different vegetables and fruits every day.
• Aim for at least one serving of citrus fruits like oranges, tangerines, grapefruits, or lemons.
• Some recommended fiber-rich foods include:
  • Broccoli.
  • Apples.
  • Pears.
  • Carrots.
  • Swiss chard.
  • Raspberries.
  • Strawberries.

Ensure adequate fiber intake

The fiber requirement for adult men typically ranges from 30–38 grams per day, depending on age.

• Prioritize obtaining fiber from natural foods.
• Limit reliance on fiber supplements unless absolutely necessary.
• Overuse of supplements can cause bloating or make constipation more difficult to manage for some individuals.

Choose lean protein sources

Besides fiber, protein sources also affect prostate health.

• Prioritize skinless poultry, fish, and other healthy protein sources.
• Limit red meat and meats high in saturated fats.
• Reduce consumption of fried foods, processed foods, and greasy foods.

Many studies show that a diet rich in lean protein combined with low fat can help reduce the risk of prostate inflammation and contribute to improving urinary tract health.

Maintain a healthy diet long-term

No single food can immediately shrink the prostate. However, maintaining a diet rich in fiber, low in fat, and nutritionally balanced over time can help control symptoms of enlarged prostate, support the process of treating benign prostatic hyperplasia, and improve quality of life.

Method 4: Exercise regularly to improve symptoms

Maintaining regular physical activity is one of the beneficial habits for men with benign prostatic hyperplasia. Although the exact mechanism of action is not fully determined, many studies show that individuals who exercise regularly generally control urinary symptoms better and have a higher quality of life.

Dedicate at least 30 minutes to physical activity daily

Aerobic exercises help enhance blood circulation, support weight management, and improve overall health.

• The goal should be at least 30 minutes of physical activity each day.
• Suitable forms of exercise include:
  • Brisk walking.
  • Cycling.
  • Swimming.
  • Light jogging.
  • Climbing stairs or aerobic exercises.

Maintaining regular physical activity can help alleviate symptoms associated with an enlarged prostate, especially nocturia and frequent urination.

Start at an appropriate level

For individuals who have been inactive for a long time, it's important not to over-exercise right from the start.

1. Begin with short walks of 10–15 minutes.
2. Gradually increase exercise time by 5–10 minutes each week.
3. Maintain a regular exercise routine instead of intense, short-term workouts.

This approach helps the body adapt better and reduces the risk of injury.

Increase intensity if you have a good fitness foundation

If you maintain an active lifestyle, you can choose higher-intensity aerobic exercises to enhance effectiveness.

• Swimming.
• Long-distance cycling.
• Running.
• Cardiovascular exercises combined with strength training.

These activities not only support prostate health but also help improve cardiovascular function and effectively manage weight.

Perform Kegel exercises

Kegel exercises help strengthen the pelvic floor muscles, a group of muscles important for controlling urination.

• Squeeze the muscles used to stop the flow of urine.
• Hold for a few seconds, then relax.
• Repeat several times a day as tolerated.

Many people with benign prostatic hyperplasia find that regular Kegel exercises can help reduce urinary urgency, leakage, and improve bladder control.

Maintain a healthy weight

Overweight or obesity can increase pressure on the bladder and urinary system, making symptoms more uncomfortable.

• Combine a healthy diet with regular exercise.
• Limit foods high in sugar, saturated fats, and processed foods.
• Monitor weight regularly to maintain a suitable body mass index.

Effective weight management is an important part of benign prostatic hyperplasia treatment, helping to reduce pressure on the urinary tract and support long-term symptom improvement.

Method 5: Empty your bladder more effectively with the double voiding technique

For individuals with benign prostatic hyperplasia, the feeling of incomplete emptying or needing to urinate frequently within a short period is quite common. The double voiding technique is a simple method that helps the bladder empty more thoroughly, thereby supporting the improvement of urinary symptoms.

Perform the double voiding technique

You can follow these steps:

1. Urinate as usual until the urine flow completely stops.
2. Relax and wait for about 20–30 seconds.
3. Try to urinate again to expel any remaining urine in the bladder.

During this process, avoid straining or using too much force, as this can put unnecessary pressure on the urinary system.

Benefits of this method

More effective bladder emptying can provide many benefits for those undergoing benign prostatic hyperplasia treatment.

• Reduce the feeling of incomplete emptying.
• Limit the number of urinations per day.
• Reduce the risk of residual urine in the bladder.
• Help reduce the risk of urinary tract infections.
• Improve comfort in daily activities.

When to apply this technique

This technique is particularly useful in situations where you may have limited access to a restroom for an extended period.

• Before going to bed.
• Before long trips.
• Before attending a long meeting or event.
• Before traveling by plane, bus, or train.

Emptying the bladder more thoroughly before these times can help reduce the sudden urge to urinate.

Managing urinary leakage

Some people with enlarged prostate may experience urinary incontinence or involuntary urine leakage.

• Absorbent pads or specialized underwear can be used to increase confidence in daily life.
• Change absorbent products regularly to maintain hygiene and prevent skin irritation.
• Monitor the degree of leakage to inform your doctor during follow-up appointments.

Talk to your doctor about bladder control exercises

If you frequently experience urgency or sudden urges to urinate, your doctor may recommend additional bladder training exercises.

• These exercises help increase your control over the urge to urinate.
• They help extend the time between bathroom visits.
• They can be combined with Kegel exercises for enhanced effectiveness.

Combining the double-voiding technique with appropriate care methods is a helpful solution to manage symptoms of prostate enlargement treatment, improve quality of life, and reduce daily inconveniences.

Method 6: Discuss current medications with your doctor

Not all cases of prostate enlargement symptoms originate from changes in the prostate gland. In some cases, current medications can worsen difficult urination, frequent urination, or urinary retention.

Monitor symptoms after starting a new medication

If urinary problems appear or worsen after starting a new medication, you should note the timing and discuss it with your doctor.

Some common signs include:

• Difficulty urinating or straining during urination.
• Weak urine stream.
• Feeling of incomplete bladder emptying.
• Frequent urination during the day or night.
• Sudden, uncontrollable urge to urinate.

Monitoring symptoms helps your doctor determine if your current medication is causing your enlarged prostate symptoms to worsen.

Some drug classes can affect urinary function

Certain medications used to treat other conditions can impact the bladder and urinary tract.

• Decongestants commonly used for colds or allergic rhinitis.
• Certain antidepressants.
• Some medications that constrict muscles in the bladder neck or affect urine excretion.

These medications can exacerbate symptoms related to benign prostatic hyperplasia, especially in middle-aged and older men.

Consult your doctor for appropriate adjustments

If you suspect that your current medication is affecting urination, discuss it directly with your treating physician.

• Your doctor can assess the extent of the medication's impact.
• Consider changing the dosage or choosing a more suitable alternative medication.
• Ensure continued good control of the treated condition while minimizing impact on the prostate and urinary system.

Do not stop medication on your own

Many people tend to stop medication as soon as side effects appear, but this can affect the treatment process.

• Do not stop prescribed medication on your own.
• Do not switch to another medication without professional guidance.
• Always consult your doctor before changing any medication you are taking.

Reviewing current medications is an important step in the process of treating prostatic hyperplasia, helping to identify the cause of worsening symptoms and choose a safer, more effective course of action.

Part 2: Effective medications for shrinking the prostate

Step 1: Early recognition of prostate enlargement signs

Early detection of prostate enlargement symptoms helps patients proactively seek examination and timely treatment, limiting the risk of complications affecting quality of life and urinary system health.

Pay attention to abnormal urinary symptoms

The following signs often appear when the prostate gland grows larger than normal and compresses the urethra.

• Frequent urination during the day.
• Waking up frequently to urinate at night.
• Weak or slow urine stream.
• Dribbling urine after urination.
• Difficulty starting urination.
• Straining or taking a long time to urinate.
• Feeling that the bladder is still full after urinating.

If these symptoms persist or worsen, you should seek medical attention promptly.

Do not ignore more severe signs

In addition to common symptoms, some cases may exhibit signs that require early medical evaluation.

• Recurrent urinary tract infections.
• Urinary retention, inability to urinate despite a strong urge.
• Blood in the urine.
• Pain or discomfort in the lower abdomen and bladder area.

These could be signs that the urinary system is experiencing problems that require timely intervention.

Proactively seek examination for accurate diagnosis

The symptoms mentioned above can be related to benign prostatic hyperplasia, but can also stem from many other conditions such as:

• Urinary tract infections.
• Bladder stones.
• Urinary tract stones.
• Bladder dysfunction.
• Certain kidney or urethral diseases.

Therefore, examination and necessary tests are the best way to determine the exact cause.

Prostate size does not reflect symptom severity

Many people assume that the larger the prostate, the more severe the symptoms, but this is not always the case.

• A slightly enlarged prostate can still cause severe difficult urination and nocturia.
• Conversely, some people have a large prostate but relatively mild symptoms.

Therefore, the degree of discomfort and impact on daily activities is the important factor to be assessed in the process of treating prostatic hyperplasia.

When should you see a doctor?

Schedule an appointment with a urologist if you frequently experience abnormal urinary symptoms or notice signs that are increasingly affecting your life. Early diagnosis helps choose the appropriate method for treating prostatic hyperplasia, effectively managing symptoms, and preventing long-term complications.

Step 2: Medications to improve difficult urination

When symptoms of prostatic hyperplasia begin to affect daily life, your doctor may prescribe medication to improve urine flow and reduce discomfort during urination. Proper use of medication can help control symptoms effectively without the need for interventional procedures.

Alpha-blockers help improve urine flow

Alpha-blockers are a class of drugs commonly used in the treatment of benign prostatic hyperplasia.

• The medication helps relax the muscles around the prostate and bladder neck.
• Facilitates easier urine flow.
• Helps reduce difficult urination, intermittent urination, and incomplete emptying.

Some common active ingredients that may be prescribed by your doctor include tamsulosin or similar drugs.

Adhere strictly to treatment instructions

To achieve the best results, patients need to use medication exactly as prescribed.

• Take the medication at the correct dosage and time as prescribed.
• Do not arbitrarily increase, decrease, or stop the medication.
• Inform your doctor if symptoms do not improve or if abnormal signs appear.

Regular monitoring helps your doctor evaluate treatment effectiveness and adjust the regimen when necessary.

Notes on side effects

Most patients tolerate the medication quite well, but some side effects may still occur.

• Dizziness or lightheadedness when changing positions suddenly.
• Fatigue or decreased blood pressure in some cases.

The good news is that many people notice improved urinary symptoms within a few weeks of treatment.

Other medications that may be considered

Depending on the specific condition, your doctor may prescribe additional medications to help control bladder activity.

• Mirabegron helps reduce overactive bladder symptoms.
• Anticholinergic medications can help reduce frequent urges to urinate and urgency.
• Some cases are prescribed diuretics during the day to adjust the timing of urine excretion.
• Desmopressin can be used to reduce the amount of urine produced at night in suitable patients.

Check for drug interactions before use

Patients often have to use multiple medications simultaneously to treat different conditions.

• Provide your doctor or pharmacist with a complete list of all medications you are taking.
• Ask about the risk of interactions between prostate medications and other drugs.
• Do not arbitrarily combine additional medications or dietary supplements without professional advice.

Choosing the right medication is an important part of the treatment of prostatic hyperplasia, helping to reduce urinary symptoms, improve quality of life, and limit the risk of long-term complications.

Step 3: Medications to shrink the prostate

For cases of large prostate enlargement, doctors may consider using 5-alpha reductase inhibitors (5-ARIs). This is one of the common methods for treating prostatic hyperplasia, helping to slow down the growth of the prostate and improve urinary symptoms in the long term.

Mechanism of action of the medication

5-alpha reductase inhibitors work by reducing the production of dihydrotestosterone (DHT), a hormone linked to excessive prostate growth.

• Limits the increase in prostate size.
• Helps shrink the prostate over time.
• Reduces pressure on the urethra.
• Improves symptoms of difficult urination, weak stream, and incomplete emptying.

In addition to helping reduce symptoms, the medication can also lower the risk of needing surgical intervention in the future for some patients.

Commonly used medications

The two most commonly used active ingredients in this group include:

• Finasteride.
• Dutasteride.

The choice of medication will depend on the patient's condition, prostate size, and the urologist's assessment.

Patience is required during treatment

Unlike some medications that provide quick symptom relief, 5-alpha reductase inhibitors usually take effect gradually.

• The prostate shrinks gradually over time.
• Treatment effectiveness may take several months to become evident.
• Patients need to take the medication regularly as prescribed.

Consistent treatment is a crucial factor for achieving optimal effectiveness in the process of treating prostatic hyperplasia.

Can be combined with alpha-blockers

In many cases, doctors may use combination therapy to enhance treatment effectiveness.

• Alpha-blockers help improve urine flow more quickly.
• 5-alpha reductase inhibitors help reduce prostate size in the long term.
• This combination can help control symptoms more effectively than using each medication alone.

Notes on side effects

Most patients use the medication safely and tolerate it well, but some unwanted side effects may still occur.

• Dizziness or lightheadedness.
• Some other side effects depend on the specific medication and the individual's constitution.

If abnormal or persistent uncomfortable symptoms appear, inform your doctor for appropriate advice.

Check for drug interactions

Before starting treatment, patients should provide complete information about all medications they are taking.

• Including prescription drugs, over-the-counter drugs, and dietary supplements.
• Ask your doctor or pharmacist about potential drug interactions.
• Do not arbitrarily combine or stop medications without professional guidance.

Proper use of suitable medications can help shrink the prostate, improve urinary function, and reduce the risk of complications in individuals with benign prostatic hyperplasia.

Step 4: Consider tadalafil if erectile dysfunction is present

For men suffering from both benign prostatic hyperplasia and erectile dysfunction, tadalafil may be a treatment option considered by doctors. This medication not only helps improve male sexual function but also has the ability to reduce some lower urinary tract symptoms associated with enlarged prostate.

Tadalafil can offer dual benefits

Tadalafil is an active ingredient commonly used in the treatment of erectile dysfunction. Many studies show that it can also help improve lower urinary tract symptoms in people with prostatic hyperplasia.

• Reduces the feeling of urinary urgency.
• Helps improve urine flow.
• Reduces the frequency of urination during the day and night.
• Improves quality of life for those experiencing both health issues.

This is why tadalafil is sometimes chosen for patients with both urinary symptoms and impaired erectile function.

Erectile dysfunction is not a prerequisite

Although tadalafil is well-known as a treatment for erectile dysfunction, in some cases of prostatic hyperplasia treatment, doctors may still consider using this medication even if erectile issues are not present.

However, the prescription should be based on a specific assessment of the patient's health, symptoms, and co-existing conditions.

Effectiveness may vary among individuals

The mechanism by which tadalafil improves urinary symptoms is still not fully understood. Furthermore, the time it takes for the medication to work also varies among patients.

• Some people notice symptom improvement quite early.
• Some cases require a longer time to evaluate treatment effectiveness.
• You should discuss the expected timeline and specific treatment goals with your doctor.

Notes on side effects

Tadalafil is generally considered relatively safe when used as directed. However, some side effects may still occur.

• Headache.
• Back pain.
• Mild muscle or joint discomfort in some cases.

If symptoms persist or become severe, the patient should inform their doctor for advice.

Check for drug interactions before use

This is an especially important step before starting treatment with tadalafil.

• Provide your doctor or pharmacist with a complete list of all medications you are currently taking.
• Inform them of any cardiovascular diseases, high blood pressure, or chronic conditions you have.
• Do not self-administer tadalafil without medical advice.

Tadalafil can interact with some medications, especially nitroglycerin and other cardiovascular drugs, increasing the risk of dangerous side effects.

Choosing the right tadalafil can help control both erectile dysfunction and prostatic hyperplasia symptoms, contributing to improved male health and long-term quality of life.

Part 3: Surgical methods for prostatic hyperplasia

Method 1: Transurethral Microwave Therapy (TUMT)

When medication and lifestyle changes do not yield the desired results, your doctor may suggest minimally invasive procedures to help treat prostatic hyperplasia. One common option is transurethral microwave therapy (TUMT).

What is TUMT?

TUMT (Transurethral Microwave Therapy) is a procedure that uses microwave energy to controllably destroy a portion of the enlarged prostate tissue.

• Microwave energy is delivered through the urethra.
• Prostate tissue compressing the urethra is gradually removed.
• Helps widen the urinary tract and reduce pressure on the urethra.

This is a minimally invasive method, often performed in a medical facility without the need for open surgery.

When should TUMT be considered?

Your doctor may consider TUMT if you experience symptoms that significantly affect daily life, such as:

• Difficulty urinating or straining to urinate.
• Urgency, difficulty controlling the urge to urinate.
• Interrupted urinary stream.
• Weak or intermittent urinary flow.
• Symptoms of benign prostatic hyperplasia that do not improve with medical treatment.

TUMT is typically suitable for mild to moderate prostate obstruction.

Advantages of TUMT

Compared to traditional surgeries, TUMT offers several notable benefits.

• Minimally invasive.
• Relatively short procedure time.
• Does not require extended hospital stays in many cases.
• Helps improve urinary symptoms caused by urethral obstruction.

As a result, patients can return to their normal activities sooner after receiving doctor's approval.

Limitations to note

Although effective in reducing urethral obstruction, TUMT is not a suitable solution for all cases.

• Does not completely resolve poor bladder emptying.
• Treatment effectiveness depends on the degree of prostatic hyperplasia and the individual's overall health.
• Some patients may still require other treatments in the future.

Therefore, thorough examination and evaluation before the procedure are essential.

Is the procedure painful?

Most patients can manage discomfort during the procedure.

• Doctors typically use local anesthesia.
• Oral pain relievers may be combined as needed.
• The level of discomfort is usually lower than many other invasive surgical methods.

TUMT is a worthwhile option in the process of treating prostatic hyperplasia, especially for those with mild to moderate urethral obstruction symptoms and who desire a minimally invasive intervention.

Method 2: Consider TUNA for improved urine flow

For individuals with benign prostatic hyperplasia symptoms that hinder urination, transurethral needle ablation (TUNA) may be a viable minimally invasive treatment option.

What is TUNA?

TUNA (Transurethral Needle Ablation) is a procedure that uses radiofrequency energy to create heat and selectively destroy overgrown prostate tissue.

• Specialized needles are inserted into the prostate through the urethra.
• Radiofrequency energy directly targets the tissue causing compression.
• The excess tissue will gradually shrink, helping to reduce pressure on the urethra.

As a result, urine flow can improve and urinary tract symptoms can be alleviated.

When should TUNA be considered?

Your doctor may suggest this method if you experience symptoms that affect your daily life, such as:

• Difficulty urinating.
• Weak urine stream.
• Intermittent urination.
• Incomplete bladder emptying.
• Frequent urination or urgency due to enlarged prostate.

TUNA is often applied in cases with clear symptoms but where more invasive surgery is not yet necessary.

Procedure

The procedure is usually performed in a hospital or specialized urology clinic.

• No long hospital stay is required in most cases.
• Local anesthesia is typically used to manage pain.
• The procedure time is relatively short.
• Patients can return home after stable monitoring.

This helps reduce recovery time compared to many traditional surgical methods.

Possible side effects

After the procedure, some temporary symptoms may appear during the first few weeks.

• Painful urination or discomfort when urinating.
• More frequent urination than usual.
• Mild irritation in the urinary tract.

These symptoms usually subside as the body recovers.

Advantages of the TUNA method

TUNA is considered one of the highly safe, minimally invasive treatment methods for individuals with prostatic hyperplasia.

• Low complication rate.
• Minimal impact on surrounding tissues.
• Relatively quick recovery time.
• Helps improve urine flow and reduce obstruction symptoms.

For many patients with symptomatic benign prostatic hyperplasia, this is an effective option when medication has not yielded the desired results.

Discuss thoroughly with your doctor before proceeding

Not every case is suitable for TUNA. The choice of treatment method should be based on:

• Prostate size.
• Severity of symptoms.
• Overall health status.
• Co-existing medical conditions.

Consulting with a specialist doctor will help you choose the appropriate, safe, and long-term effective prostatic hyperplasia treatment option.

Method 3: HoLEP Laser Treatment

For cases of significant prostatic hyperplasia causing urinary obstruction, doctors may suggest Holmium Laser Enucleation of the Prostate (HoLEP). This is a modern technique that removes enlarged prostate tissue without the need for external incisions.

What is HoLEP?

HoLEP (Holmium Laser Enucleation of the Prostate) is a procedure that uses Holmium laser energy to remove overgrown prostate tissue that is compressing the urethra.

• A laser fiber is inserted into the body through the urethra.
• The laser separates and removes the tissue causing urinary tract obstruction.
• No skin incision or external wound is needed.

As a result, urine flow is improved, and urinary symptoms can be significantly reduced.

When should HoLEP be considered?

This method is usually considered when:

• Prostatic hyperplasia is moderate or large.
• Medical treatment no longer yields the desired effect.
• The patient experiences dysuria, weak urine flow, or recurrent urinary retention.
• A long-term treatment solution for benign prostatic hyperplasia is needed.

The doctor will evaluate the prostate size and overall health status before prescribing the procedure.

Advantages of the HoLEP method

HoLEP is highly regarded by many urology specialists due to its outstanding benefits.

• No open surgery is required.
• Less bleeding compared to some traditional methods.
• High effectiveness in relieving urinary tract obstruction.
• Recovery time is often faster.
• Can be applied even in cases of large prostate size.

This is one of the modern methods increasingly used in treating prostatic hyperplasia.

Hospital stay and recovery time

Although the procedure time may be longer than some other interventional methods, patients usually do not need a long hospital stay.

• Most patients only need to stay in the hospital for about 1 night for monitoring.
• Can return to normal daily activities as directed by the doctor.
• Recovery time is generally shorter than many invasive surgical methods.

Important notes before the procedure

Before choosing HoLEP, patients should discuss thoroughly with their doctor about:

• The degree of prostatic hyperplasia.
• Underlying medical conditions.
• Anticoagulants or other medications being used.
• Treatment expectations and recovery time.

A comprehensive evaluation will help select the appropriate prostatic hyperplasia treatment method, optimize treatment effectiveness, and reduce the risk of post-intervention complications.

Is HoLEP suitable for everyone?

Not all patients need HoLEP. This method is usually considered when symptoms significantly affect quality of life or when conservative treatment measures are no longer effective. The final decision should be made based on consultation with a urologist and specific examination results.

Method 4: Considering prostate stent placement

In some severe cases of prostatic hyperplasia, when patients are not suitable for surgery or do not wish for long-term medication treatment, doctors may discuss prostate stent placement. This option is less commonly used but can still be suitable for certain patients.

What is a prostate stent?

A prostate stent is a small tube or mesh framework placed in the urethra to keep the urinary tract open.

• Helps reduce obstruction caused by prostate compression.
• Supports improved urine flow.
• Reduces feelings of dysuria or urinary retention.

The goal of this method is to maintain an open urinary pathway without the need for major surgery.

When can stent placement be considered?

Your doctor may consider this method if:

• Prostatic hyperplasia causes severe urinary obstruction.
• The patient does not want or cannot undergo surgery.
• Medication use has not yielded the desired effect.
• There are health factors that make other treatment methods unsuitable.

However, most doctors currently prioritize other treatment methods before considering stent placement.

Advantages of stent placement

For some patients, a stent can provide significant benefits.

• No major invasive surgery is required.
• Helps improve urine flow quickly.
• Can reduce urinary tract obstruction symptoms due to benign prostatic hyperplasia.

This can be an alternative solution in cases where treatment options are limited.

Risks and complications to note

Before deciding to proceed, patients need to be fully advised about the potential risks.

• The stent may migrate from its original position over time.
• Causes discomfort or irritation in the urinary tract.
• Increases the risk of urinary tract infections.
• Prolonged urinary symptoms may appear in some cases.

If the stent encounters problems after placement, management or removal can sometimes be more complex than anticipated.

Discuss thoroughly with your doctor before choosing

Each prostatic hyperplasia treatment method has its own advantages and limitations. Therefore, before stent placement, discuss with your doctor about:

• The degree of prostatic hyperplasia.
• Previously applied treatment methods.
• Individual complication risk.
• Expected long-term effectiveness.

A comprehensive evaluation will help choose the appropriate prostatic hyperplasia treatment option for each patient's health condition and actual needs.

Method 5: Considering surgery when other treatments are ineffective

If symptoms of prostatic hyperplasia persist despite lifestyle changes, medication, or minimally invasive procedures, your doctor may suggest more specialized surgical methods. Although many people are concerned when surgery is mentioned, these are often solutions that provide clear and long-lasting symptom improvement.

When is surgery needed?

Surgery is usually considered in cases of:

• Severe dysuria or recurrent urinary retention.
• Medication treatment is no longer effective.
• Complications such as bladder stones, recurrent urinary tract infections, or kidney damage.
• Quality of life significantly affected by urinary symptoms.

Before choosing the appropriate method, the doctor will carefully evaluate factors such as age, overall health status, prostate size, co-existing medical conditions, and future reproductive needs.

Simple Prostatectomy (Open Prostatectomy)

This method is mainly applied to cases of very large prostate size.

• The doctor removes the prostate tissue causing obstruction.
• Can be performed by open surgery or endoscopy.
• Often provides clear improvement in urine flow.

This method is more invasive than many other modern techniques.

Transurethral Resection of the Prostate (TURP)

TURP is considered one of the standard treatment methods for benign prostatic hyperplasia.

• An endoscope is inserted through the urethra.
• The prostate tissue causing compression is resected.
• Helps improve urine flow and reduce obstructive symptoms.

This technique has been widely used for many years with high treatment efficacy.

Prostatic Urethral Lift (PUL)

PUL is a less invasive method compared to tissue removal surgery.

• Small implants are placed in the prostate.
• Helps pull the prostate tissue away from the urethra.
• Reduces pressure on the urinary tract.

This method is often chosen for anatomically suitable cases.

Steam or High-Pressure Water Treatment

These are modern techniques that use thermal energy or water to remove excess prostate tissue.

• A probe is inserted through the urethra.
• Steam or high-pressure water acts directly on the target tissue.
• The prostate tissue will gradually be absorbed or eliminated by the body.

Some of these techniques are not yet widely available due to the need for highly specialized physician training.

GreenLight XPS Laser

This method uses laser energy to destroy obstructive prostate tissue.

• The laser is inserted through the urethra.
• Helps reduce compressive tissue without the need for open surgery.
• Often has a quick recovery time and less bleeding.

This is a suitable option for many patients who require less invasive treatment.

Prostate Artery Embolization (PAE)

PAE is an endovascular procedure that helps reduce prostate size without direct tissue removal.

• Microscopic particles are injected into the arteries supplying the prostate.
• Reduces blood flow to the prostate.
• The prostate will gradually shrink over time.

The procedure is usually performed under local anesthesia, and patients can go home the same day.

Choosing the Right Method with Your Doctor

No single method is suitable for everyone. Each technique has its advantages, limitations, and specific indications.

• Prostate size.
• Symptom severity.
• Overall health status.
• Desire to preserve physiological or reproductive function.
• Risk of complications and recovery time.

All these factors need to be carefully considered before making a decision. Detailed discussion with a specialist will help you choose the most appropriate prostate enlargement treatment option, optimizing treatment effectiveness and improving long-term quality of life.

Caution with Herbal Prostate Supplements

Many people seek natural methods to treat prostate enlargement and are often interested in herbal remedies or dietary supplements. However, before using any product, you need to research carefully and consult a healthcare professional to ensure safety.

Some Commonly Mentioned Herbs

Some herbal products are advertised as capable of supporting prostate health, including:

• Saw Palmetto.
• Pygeum (extract from African plum bark).
• Some combination herbal products for middle-aged and elderly men.

These products are often promoted with the aim of helping to alleviate symptoms such as nocturia, frequent urination, or difficulty urinating.

Efficacy Remains Highly Debated

Although some studies have noted potential benefits, current results are not yet entirely consistent.

• Efficacy may vary between individuals.
• There is not enough strong evidence to replace proven medical treatments.
• Some products may not deliver the advertised results.

Therefore, patients should not consider herbal remedies as the primary treatment for benign prostatic hyperplasia.

Notes on Quality and Safety

Not all herbal products on the market are of the same quality.

• Active ingredient content may vary between manufacturers.
• Some products may contain impurities or undisclosed ingredients.
• The risk of interaction with existing medications can still occur.

This is why patients need to be especially cautious when choosing health supplements.

Do Not Arbitrarily Replace Medications

If a doctor has prescribed medication or is monitoring treatment, do not arbitrarily stop medication to switch to herbal remedies.

• Continue to follow the prescribed treatment regimen.
• Inform your doctor about any supplements you are using.
• Monitor for any unusual signs after starting a new product.

Inappropriate combinations can reduce treatment effectiveness or increase the risk of side effects.

Consult Your Doctor Before Use

Before taking any herbs to support prostate enlargement treatment, consult your doctor or pharmacist.

• Evaluate the safety of the product.
• Check for potential interactions with existing medications.
• Determine if the product is suitable for your current health condition.

Natural methods can play a supportive role in some cases, but they should not replace medical examinations, monitoring, and treatment. To effectively manage enlarged prostate, patients should prioritize methods proven safe and effective, and consult a specialist before adopting any alternative therapy.

References

1. American Urological Association. (2023). Benign Prostatic Hyperplasia (BPH) Guideline. American Urological Association.
2. European Association of Urology. (2024). EAU Guidelines on Management of Non-neurogenic Male Lower Urinary Tract Symptoms, Including Benign Prostatic Obstruction. European Association of Urology.
3. National Institute for Health and Care Excellence. (2024). Lower Urinary Tract Symptoms in Men: Management. NICE Guideline.
4. National Institute of Diabetes and Digestive and Kidney Diseases. (2023). Enlarged Prostate (Benign Prostatic Hyperplasia). U.S. Department of Health and Human Services.
5. Mayo Clinic Staff. (2024). Benign Prostatic Hyperplasia (BPH): Symptoms and Causes. Mayo Clinic.
6. McVary, K. T., Roehrborn, C. G., Avins, A. L., Barry, M. J., Bruskewitz, R. C., Donnell, R. F., et al. (2011). Update on AUA Guideline on the Management of Benign Prostatic Hyperplasia. The Journal of Urology, 185(5), 1793–1803.
7. Gratzke, C., Bachmann, A., Descazeaud, A., Drake, M. J., Madersbacher, S., Mamoulakis, C., et al. (2015). EAU Guidelines on the Assessment of Non-neurogenic Male Lower Urinary Tract Symptoms Including Benign Prostatic Obstruction. European Urology, 67(6), 1099–1109.
8. Roehrborn, C. G. (2008). Benign Prostatic Hyperplasia: An Overview. Reviews in Urology, 10(Suppl 1), S3–S14.
9. Foster, H. E., Barry, M. J., Dahm, P., Gandhi, M. C., Kaplan, S. A., Kohler, T. S., et al. (2018). Surgical Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: AUA Guideline. The Journal of Urology, 200(3), 612–619.
10. Cornu, J. N., Ahyai, S., Bachmann, A., de la Rosette, J., Gilling, P., Gratzke, C., et al. (2015). A Systematic Review and Meta-analysis of Functional Outcomes and Complications Following Transurethral Procedures for Lower Urinary Tract Symptoms Resulting from Benign Prostatic Obstruction. European Urology, 67(6), 1066–1096.
11. National Health Service. (2024). Benign Prostate Enlargement. NHS England.
12. Merck Manual Professional Edition. (2024). Benign Prostatic Hyperplasia (BPH). Merck & Co., Inc.
13. Wei, J. T., Calhoun, E., & Jacobsen, S. J. (2005). Urologic Diseases in America Project: Benign Prostatic Hyperplasia. The Journal of Urology, 173(4), 1256–1261.
14. Wilt, T. J., MacDonald, R., Hagerty, K., Schellhammer, P., Kramer, B. S., & Roehrborn, C. (2008). 5-Alpha-Reductase Inhibitors for Prostate Disease. Cochrane Database of Systematic Reviews, 2008(2), CD007091.
15. Tacklind, J., MacDonald, R., Rutks, I., Stanke, J. U., & Wilt, T. J. (2012). Serenoa Repens for Benign Prostatic Hyperplasia. Cochrane Database of Systematic Reviews, 2012(12), CD001423.
    

Content editor: Leigh Kennedy Ly.

Information consulted and verified by expert: Michael Anderson.