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The prostate is a gland in men that sits low in the abdomen, and when it gets enlarged it squeezes the urethra. This causes slow flow, difficulty starting to urinate, dribbling, and a weak stream. It is very common for men to get enlarged prostates after the age of 60. This condition is called Benign Prostatic Hyperplasia, or BPH, which is a noncancerous enlargement of the prostate. If you have urinary trouble, see your doctor to be checked for BPH. BPH is very common, but prostate cancer – though much less common – can also enlarge your prostate and cause urinary symptoms. It’s important to have your prostate checked regularly starting at age 50 (or earlier if a relative had prostate cancer). There are several simple changes that you can make to your bathroom habits to help minimize your symptoms. Some things to try include:  Go twice. Try to empty your bladder twice each time you go to the bathroom. Relax and take your time. Try taking some deep breaths while you wait for your urine to start flowing. Give yourself plenty of time and don’t worry if it takes a while. Try reading a magazine or a book while you wait. Sit down to urinate. If you usually urinate standing up, then sitting down might help to relax you and make it easier for you to urinate. Turn on the faucet. The sound of running water may also help you to go. If this isn’t an option, then try to imagine the sound of running water. Stay hydrated. You might be frustrated with your low urine flow and want to avoid urinating as much as possible, but not drinking enough water can make matters worse. Drink water throughout the day and avoid drinking it late in the evening so you won’t have to get up as much during the night. Avoid dehydrating substances. Anything that may lead to dehydration can make it harder for you to urinate. Avoid alcohol and any medications that can dehydrate you or make urination difficult. Ask your doctor if you are not sure what medications may cause problems for you. Purchase saw palmetto extract as a supplement from your drug store or health foods store. Saw palmetto is a palm-like plant that has been used medicinally for decades.  Some men find this supplement improves their symptoms of BPH, though it’s not scientifically proven to help. Discuss using any medications or supplements with your doctor beforehand. Buy saw palmetto extract in 160mg capsules and take one twice a day, unless directed otherwise by your doctor. Check the label carefully and be sure to get a product that contains “85-95% fatty acids and sterols.” Alpha-blockers are most commonly prescribed for men with mildly distressing symptoms. These can cause low blood pressure and dizziness when going from sitting to standing, so be careful when you start taking these medications. They include tamsulosin (Flomax), terazosin (Hytrin), doxazosin (Cardura), alfuzosin (Uroxatral), and silodosin (Rapaflo).  Your doctor may also prescribe an alpha-reductase inhibitor (a type of anti-androgen) like finasteride (Proscar) or dutasteride (Avodart) for larger prostates.  If you take Viagra or another medication for erectile dysfunction, do not take terazosin or doxazosin unless directed to do so by a doctor. There are several medical procedures that either remove or destroy some of the prostate by going through your urethra. You will be sedated or anesthetized so you won’t feel any pain during the procedure, and may stay overnight in the hospital or may go home the same day. You and your doctor will decide which of these is the best procedure for you:  TURP, or transurethral resection of the prostate: parts of the prostate are removed to improve flow; this may cause sexual side effects like trouble ejaculating. Prostate ablation: parts of the prostate are burned away with heat or light; this is better for men with medical issues, as it causes less bleeding than the TURP. Some minimally invasive procedures have fewer side effects and can be done in a day, though urinary trouble may recur afterwards: widening of the urethra with an incision in the prostate, radiofrequency ablation, microwave thermotherapy, or a prostatic lift. If you are generally healthy and your prostate is very large, over 100g, or causes very severe urinary symptoms that affect your quality of life, you can have your prostate removed with surgery. You may need surgery if you have frequent blood in your urine, recurring urinary tract infections, bladder stones, kidney problems, or the inability to urinate.

Summary:
Visit your doctor for a prostate exam after age 50. Adjust your bathroom habits. Take saw palmetto extract. Take prescription medications for mild symptoms. Have surgery for moderate to severe symptoms. Have your prostate surgically removed.