Most men with BPH symptoms will never need surgery

According to researchers' best estimates, about 3 out of every 10 men in Europe will handle their prostate symptoms without medication or surgery and perhaps only 1 in 10 will have surgery. The rest will use medications, including herbal medicines, if their symptoms become too troublesome.

In Germany and other European countries, drugs called alpha blockers have taken over as the most common treatment choice for benign prostatic hyperplasia. These drugs were originally developed to reduce high blood pressure, but prostate symptoms will also improve at least a little for 60% of the men who use them.

In analysing the research results for surgery, the Institute concluded that the original surgical procedures still have the best results. A few of the new surgical techniques appear to have good results - for example, possibly shortening the time needed in hospital. But more research is needed to confirm this. And most of the new techniques use equipment that has not yet been tested in enough trials.

Prostate surgery can be very effective, but the adverse effects are a major concern for many men. Some of the newer techniques might have fewer adverse effects, but they may be so much less effective that the symptoms return, as bad as ever, within a couple of years.