When to Consider Watchful Waiting for BPH


Because the course of benign prostatic hyperplasia (BPH) is unpredictable, watchful waiting is often best for men with minimal symptoms that are not especially bothersome—for the time being. Understand that symptoms caused by an enlarged prostate could stay the same for a long time, worsen, or even improve. Steady improvement is not likely, however.

With this treatment option, annual doctor visits are needed to review symptom status, conduct a physical examination, and perform a few simple laboratory tests.

During watchful waiting, men should adopt certain lifestyle measures to help relieve symptoms or prevent them from worsening. Here are some helpful tips if you choose this course of action for your BPH:

  • Do not take over-the-counter antihistamines or decongestants, which can worsen symptoms
  • Avoid delaying urination, which can lead to urinary retention
  • Limit the amount of fluid consumed at any one time, and don’t drink anything after 7 P.M.
  • Limit alcohol intake
  • Engage in regular physical activity
  • Avoid weight gain (especially around your middle)
  • Eat plenty of vegetables
  • Keep blood sugar under control

Some men find that avoiding beverages that contain caffeine and cutting back on spicy or salty foods helps relieve symptoms. Keeping warm can also be helpful. The association between lower urinary tract symptoms and cold weather is probably related to increased sympathetic activity (the sympathetic nervous system is more active in cold weather), which causes increased smooth muscle tone within the prostate and can contribute to many problems.