Not every man with an enlarged prostate needs tablets or a procedure. For mild to moderate symptoms, simple changes to daily habits often make a real difference. NICE guidance on urinary symptoms in men recommends trying these first, and they also support any treatment you have later.
Drink the right amount
It is tempting to drink less to avoid trips to the toilet, but this can make things worse. Concentrated urine can irritate the bladder and increase urgency.
Aim for about 1.5 to 2 litres of fluid a day, unless your doctor has advised otherwise. Spread it through the day, and drink less in the two hours before bed. A bladder diary can show whether you are drinking too much, too little or at the wrong times.
Cut down on caffeine
Caffeine increases urine production and can irritate the bladder. It is found in:
- coffee and tea
- cola and energy drinks
- some soft drinks
- chocolate, in smaller amounts
Switching gradually to decaffeinated drinks over a couple of weeks avoids withdrawal headaches. Many men notice less urgency within days. Fizzy drinks and artificial sweeteners can also irritate the bladder in some people, so it may be worth noticing whether they make a difference for you.
Watch your alcohol intake
Alcohol increases urine output and can make the bladder more sensitive. Drinking in the evening often leads to more trips at night. Keeping within recommended limits and avoiding alcohol close to bedtime can help.
Bladder training
If urgency is a problem, bladder training can help the bladder hold more urine over time:
- When you feel the urge, try to wait a few minutes before going.
- Gradually increase the time between visits over several weeks.
- Use distraction or slow breathing to help the urge pass.
Pelvic floor exercises can also improve control and reduce leaks. Bladder and Bowel UK has practical guidance.
Double voiding
If you feel the bladder has not emptied fully, try double voiding. After passing urine, wait a minute or two, then try again. Leaning forward slightly can help.
Reduce dribbling
To reduce dribbling after passing urine, gently press with your fingers behind the scrotum and move forward along the underside. This helps clear urine left in the urethra.
Review your medicines
Some medicines can affect the bladder, including:
- water tablets, which are best taken in the morning
- some cold and allergy remedies containing decongestants or antihistamines
- some antidepressants
Never stop a prescribed medicine without advice, but ask your GP or pharmacist whether any could be affecting your symptoms.
Keep active and manage your weight
Regular activity and a healthy weight support bladder health and general wellbeing. Constipation can press on the bladder and worsen symptoms, so a diet with plenty of fibre and fluid helps too. Give any change at least two to four weeks before judging whether it has helped, as the bladder takes time to adjust.
Plan ahead
Small practical steps can reduce worry:
- going before long journeys or meetings
- knowing where toilets are when out
- wearing clothes that are easy to undo quickly
When lifestyle changes are not enough
If your symptoms still bother you after a few weeks of changes, it is worth discussing treatment. Options include tablets and minimally invasive procedures such as iTind and prostate artery embolisation. Our guide to what an enlarged prostate is explains why symptoms can progress. Our page on benign prostatic enlargement explains the treatments.
Seek prompt advice if you cannot pass urine, see blood in your urine or develop a fever. Professor Prokar Dasgupta can review your symptoms and the options at The London Clinic. Please contact the clinic to arrange a consultation.