Do I Need Treatment?
If there is evidence of kidney damage, or if you are totally unable to empty your bladder, then surgical treatment will be required. Otherwise, treatment will depend upon how troublesome your symptoms are. If they bother you a lot then you will benefit from treatment, but if your symptoms are minimal, you may wish to defer treatment. Your doctor will continue to monitor your symptoms and check for any evidence of complications. This is called “watchful waiting”.
Symptoms do not necessarily worsen and may stay the same or even improve. A urologist should be able to predict (based on your age, the size of your prostate, and your PSA level) your personal risk for future deterioration of symptoms, having an episode of acute urinary retention, or eventually requiring surgery.
Your urologist will discuss with you the advantages and disadvantages of treatment versus watchful waiting, but the decision regarding treatment will be yours. You should also discuss your risk of developing prostate cancer and what you can do to prevent it. Treatment of BPH may affect your risk of developing prostate cancer, but your urologist can advise you on that risk, and what measures might help prevent it.
Treatment Options For BPH
In addition to watchful waiting , there are a number of treatment options available including drug therapy, surgical approach and minimally invasive procedures. Some of these are considered standard treatment because they are effective and the benefit is lasting. Some newer treatments continue to be evaluated and may not be generally available. You should discuss these options with your doctor prior to deciding which treatment is best for you.
Which Option Should I Choose?
Many patients with mild to moderate symptoms of BPH do not require treatment and will be managed by “watchful waiting”. The decision regarding treatment will depend upon a variety of factors such as severity and rate of progression of your symptoms, age, general health, prostate size, PSA and current availability of some of these treatment options, as well as your own preferences. The advantages and disadvantages and availability of these options should be discussed with your doctor.