WHAT TO DO

It is a very common disease, but about 50% of men with BPH do not have symptoms or disturbances, and thus do not require specific treatment. Once BPH has been diagnosed, the urologist will continue to monitor the situation in order to intercept any worsening of the condition in a timely manner. While it is not possible to act on the major risk factors of age or family history of BPH, there are other risk factors that can be modified, with some effort: overweight, sedentary lifestyle, diet low in fruits and vegetables and alcohol abuse. Even for men who develop the disturbing symptoms of this condition, it is possible to take some action to limit their severity or eliminate them altogether. These include avoiding coffee, alcohol, and other diuretic beverages that drive the body to expel fluids faster, inducing more frequent urination. Some drugs may also affect urination, and it would be best to avoid them whenever possible: antihistamines, decongestants (such as nasal sprays) and other anti-allergy medications. A useful strategy is to limit the consumption of liquids in situations where urinating can be embarrassing or complicated; however, this approach should only be used in specific situations, because overall daily fluid intake should not be less than 2.5-3 litres, to avoid the risk of urinary tract infections. It is also possible to train the bladder to contain more urine, for example by trying to hold it longer than usual before going to the bathroom, or using the double-voiding technique: after urinating, a second attempt at urination is made several minutes later. This increases the chance that the bladder has been emptied completely before leaving the bathroom.

Suggested readings

  • Wilt, T.J., N'Dow, J., Benign prostatic hyperplasia. Part 2—management, BMJ.
  • Muruganandham, K., Dubey, D., Kapoor R., Acute urinary retention in benign prostatic hyperplasia: Risk factors and current management, Indian J. Urol.
  • Elhilali, M., Vallancien, G., Emberton, M. et al., Management of acute urinary retention (AUR) in patients with BPH: A worldwide comparison, J. Urol.
  • Bradley, C.S. et al., Evidence for the Impact of Diet, Fluid Intake, Caffeine, Alcohol and Tobacco on Lower Urinary Tract Symptoms: A Systematic Review, J. Urol.
  • Fitzpatrick, J. et al., Management of acute urinary retention: a worldwide survey of 6074 men with benign prostatic hyperplasia, BJU Int.
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