Medical Management
Conservative Management

Lifestyle measures

  • Fluid management: It is essential to increase the water intake to 2 Litres per day to flush out all the chemicals excited in the urine. Otherwise, concentrated urine itself can irritate the bladder and cause lower urinary symptoms.
  • Avoiding bladder stimulants: Tea, Coffee, Fizzy drinks and alcohol act as bladder stimulants. In patients with an underlying bladder and prostate problems, these drinks could aggravate the symptoms and and best avoided.
  • Bladder Training: Gentle retraining of bladder to slowly increase the capacity and reduce the frequency is a good idea. However, this has to be done slowly and in small increments.

Medications:

  • Alpha blockers: These medicines cause stretching and relaxation of the muscles in the prostate area thereby improving the urinary flow and reducing the symptoms. Commonest medication used in this group is Tamsulocin which is taken 400 microgram capsules once daily. Relief of symptoms may appear within a few days and the tablets need to be continued for long term benefit. These tablets may cause giddiness on standing up from sitting position (postural hypotension) which usually improves after the first couple of days.
  • 5 Alpha Reductase Inhibitors (5ARI): These medications cause shrinking of prostate by inhibiting the effect of male sex hormone (Testosterone) on the prostate gland. Examples of this category of medications are Finasteride and Dutasteride. It may take upto 6 months for the effect of these medications to appear and for continued benefits, these medications will have to be taken indefinitely. Side effects of these medications include Erectile dysfunction due to the effect on Testosterone.
  • Combination Treatment: For patients with severe symptoms and large prostate, combination treatment with Alpha blockers and 5ARI is found to be beneficial. 

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