Treatment depends on how much the symptoms affect your quality of life.

Some men with mild symptoms may only need lifestyle changes. Men with more severe symptoms may need medications or surgery.

Lifestyle Changes

Small changes can help improve symptoms:

• Limit fluids a few hours before bedtime or before going out
• Avoid drinks that can worsen symptoms, such as caffeine and alcohol
• Stop smoking and avoid nicotine products

Medications

Two main types of medications are used to treat BPH:

1. Alpha blockers (such as tamsulosin). Alpha blockers relax the muscles in the prostate and bladder to help urine flow more easily.

   Common side effects include low blood pressure, dizziness (especially when standing), fatigue, weakness, and headache. Taking the medication at bedtime may help reduce these effects.

2. 5-alpha-reductase inhibitors (such as finasteride). 5-alpha-reductase inhibitors help stop the prostate from growing and may shrink it. 

   These medicines work best for men with larger prostates and are often used with alpha blockers. It may take up to 6 months to see improvement. These medicines can lower PSA levels by about half.

Using both types of medications together may work better over time. However, some men may have sexual side effects.

Herbal Medicines

Some people use saw palmetto to help with BPH symptoms. However, research has not shown clear benefits.

Tell your healthcare provider if you take any over-the-counter products or supplements. Some may interact with medications or cause harm.

Surgery

If symptoms do not improve with lifestyle changes or medications, surgery may be needed. Surgery removes or reduces part of the prostate to improve urine flow.

Your healthcare provider will help you choose the best option. Common procedures include:

• Transurethral resection of the prostate (TURP). Removes parts of the prostate through the urethra. This is a common and effective treatment, but some newer options may have fewer side effects.
• Prostatectomy. Surgery to remove the prostate gland

Possible complications include bleeding, sexual problems (such as difficulty with erections or ejaculation), and urinary incontinence (loss of bladder control).

Less Invasive Procedures

These may be used for men with smaller prostate enlargement:

• Transurethral incision of the prostate (TUIP). Widens the urethra
• Water vapor therapy. Uses steam to shrink the prostate
• Prostatic lift. Uses small implants to hold the urethra open
• Prostatic stent. A device placed to keep the urethra open (temporary or permanent)

These procedures often have fewer sexual side effects. They may be done with local anesthesia and usually do not require a hospital stay.

However, some treatments may need to be repeated if symptoms return.

Treatment depends on the cause, if it is known.

Medications

If prostatitis is caused by a bacterial infection, a healthcare provider will prescribe antibiotics.

Acute bacterial prostatitis can cause severe symptoms. Some people may need to be treated in the hospital with antibiotics given through a vein (IV).

• Antibiotics taken by mouth may be needed for up to 6 weeks to fully treat the infection.
• Antibiotics may also be used for long-term (chronic) prostatitis caused by bacteria. Some men may need treatment for several months or take low doses for a longer time.
• Alpha blockers may help with symptoms such as pain or trouble urinating. These medicines relax muscles in the prostate and bladder to help urine flow more easily.
• Anti-inflammatory medicines may help reduce pain and swelling. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen, and aspirin, should be used carefully in older adults. They can raise blood pressure, harm the kidneys, and increase bleeding risk. Ask your healthcare provider which pain medicine is best for you.

Herbal Medicines

Some herbal products are used for prostatitis, such as rye grass (cernilton), quercetin (found in green tea and onions), and saw palmetto. There is no strong evidence that these treatments work.

Tell your healthcare provider if you are taking any over-the-counter products or supplements. Some may contain multiple ingredients that could be harmful.

Other Treatments

Some people may get relief from:

• Acupuncture
• Physical therapy
• Sitz baths (soaking in warm water)

These may help symptoms in some men with long-term prostatitis.

Surgery

Surgery is rarely needed. It may be considered if prostatitis is caused by a problem in the bladder or urethra that does not improve with other treatments.

The treatment for prostate cancer depends on several factors. These include the stage and grade of the cancer, the person’s age and life expectancy, overall health, possible side effects, and personal preferences. The healthcare provider works with the person to choose the best treatment.

Active Surveillance

Not all prostate cancer needs treatment right away, and some may never need treatment:

• Early prostate cancer may not need treatment, especially in men who are expected to live less than 5 years. These cancers usually grow very slowly, and many men die from other causes.
• Treating early-stage prostate cancer does not always lower the risk of death compared to not treating it.
• Many men choose “active surveillance.” This means:
  • No treatment is given right away. The cancer is watched closely to see if it grows or spreads.
  • Monitoring may include regular prostate-specific antigen (PSA) blood tests, digital rectal exams, MRI scans, and repeat biopsies.
  • Active surveillance may also be used in some men with more advanced cancer if other health problems make treatment risky. The benefit is avoiding side effects. The risk is that the cancer may become harder to treat later.

If cancer spreads outside the prostate or to other parts of the body, treatment focuses on slowing its growth.

Radiation

Radiation therapy uses high-energy rays to kill cancer cells. Side effects may include problems with urination, bowel movements, and erections.

Brachytherapy

Brachytherapy is a type of radiation treatment. Small radioactive seeds are placed into the prostate for a period of time. This delivers radiation directly to the cancer. Side effects are similar to other types of radiation.

Hormone therapy

Hormone therapy lowers the body’s testosterone levels. Testosterone is a hormone that helps prostate cancer grow. This treatment can shrink the cancer and slow its growth.

Side effects may include hot flashes, bone loss (osteoporosis), and sexual problems. Hormone therapy is often used along with radiation.

Surgery

Surgery for prostate cancer usually involves removing the prostate gland (called a prostatectomy). Nearby tissue and lymph nodes that may contain cancer may also be removed.

This surgery can cause side effects, such as trouble controlling urine or problems with erections.

Monitoring

No matter the stage of prostate cancer, regular follow-up is important to see how well treatment is working. The most common test used is the PSA (prostate-specific antigen) blood test.

If the cancer has spread to other parts of the body, such as bones or organs, imaging tests like CT scans or PET scans may be used. These tests help show where the cancer is and guide treatment decisions.

You can also review Choosing Wisely recommendations about prostate cancer testing and treatment for more information.