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may recommend treatment with medications called alpha blockers, which relax the prostate and lower blood pressure. Alpha blockers are effective in about 75 percent of men who have bladder outlet obstruction. These medications, such as tamsulosin and terazosin, work by relaxing the muscle of the prostate, allowing urine to flow more freely. However, alpha blockers can cause unpleasant side effects, including low blood pressure and dizziness on standing. Tamsulosin is less likely to cause these side effects, which usually lessen or disappear with continued use of either drug. Less frequently, a doctor may prescribe other medications to shrink the prostate. Because your symptoms usually will return when you stop any of these medications, you may need to take them indefinitely.

All of the surgical procedures for treating BPH involve eliminating excess prostate tissue. A prostatectomy is the removal of the overgrown portion of the prostate gland. A prostatectomy can be either closed or open. In a closed prostatectomy, the gland or the excess tissue is removed through a resectoscope (viewing tube) that is inserted up the urethra. In an open prostatectomy, the gland or the excess tissue is removed through an incision in the lower abdomen. Although closed prostatectomies have mostly replaced open prostatectomies, open procedures are still performed if the prostate gland is very large or if the surgeon plans to perform other procedures at the same time.

Transurethral resection of the prostate (TURP) is a closed procedure. TURP involves passing a resectoscope into the urethra and inserting a tiny wire loop or cutting edge through the scope to shave away excess prostate tissue from around the urethra. A major benefit of this procedure is the relief of many of the urinary symptoms associated with BPH. However, a relatively common effect of TURP is retrograde ejaculation, in which a man ejaculates backward into the bladder. Also, up to 1 percent of men who have this procedure experience subsequent problems with urinary incontinence. The procedure may need to be repeated if the tissue that was removed grows back.

Transurethral resection of the prostate

Transurethral resection of the prostate (TURP) is a closed surgical procedure in which the surgeon passes a viewing tube called a resectoscope through the urethra to the prostate gland. He or she then guides a tiny wire loop or scalpel through the resectoscope to shave away and remove excess prostate tissue from around the urethra.

Another closed procedure is called transurethral incision of the prostate (TUIP). In TUIP, the surgeon makes deep single or double cuts completely through the prostate to loosen its grip on the urethra. TUIP is a bit less effective than TURP but has a lower risk of causing retrograde ejaculation. Because it is less effective, TUIP is not appropriate for all men who have BPH. In some cases, the procedure may need to be repeated.

Other treatments for BPH include microwave thermotherapy, intraurethral stents, laser therapy, and transurethral needle ablation (TUNA). Microwave thermotherapy uses heat generated by microwaves to eliminate excess prostate tissue. Intraurethral stents are small tubelike devices inserted into the urethra to enlarge it and provide relief from urinary symptoms. Laser therapy uses a highly concentrated beam of light to vaporize excess prostate tissue. TUNA uses microwave technology to cut away obstructing tissue. Doctors are still evaluating the long-term effectiveness of these techniques. Discussing with your doctor the risks and benefits of any treatment you are considering can help you make an informed decision.

If you find that some foods and medications increase the intensity of your symptoms, try the following lifestyle tips and keep track of your symptoms to see if they improve:

• Eat a low-fat, low-cholesterol diet (see page 38). Men who follow such a diet have a lower risk of BPH.

• Eat more fruits and vegetables. Men who do so have a lower rate of BPH than those who do not.

• Ask your doctor if you should limit