The management of benign prostatic hyperplasia: Behavioral Modifications
Certain lifestyle changes can help relieve symptoms and are particularly important for patients who choose to avoid surgery or drug therapy. It is important for patients with benign prostatic hyperplasia (BPH) to urinate on a regular basis and not just in response to an urge to void. Avoiding exposure to extreme cold reduces the urge to urinate. Immobility can be detrimental to voiding, and thus men should try to sit in aisle seats in planes and theaters and avoid prolonged stretches in cars or other means of transportation. Regular exercising may be useful to relieve stress.
Avoiding alcohol, coffee, and other fluids after the evening meal is recommended. Drinking green tea, which contains flavonoids, may be of benefit. Gensini, a chemical found in soy, has been associated with a reduction in prostate tissue. Indeed, there is speculation that zinc supplementation may be helpful in treating males with BPH whose prostate is zinc deficient.
Men with benign prostatic hyperplasia should avoid prolonged use of decongestants and anticholinergics. Oral decongestants that may exacerbate benign prostatic hyperplasia include ephedrine, phenylephrine, and pseudoephedrine. Anticholinergic agents that may exacerbate BPH include first generation antihistamines (chlorpheniramine and brompheniramine), tricyclic antidepressants, and typical antipsychotics. These agents may reduce urine flow or increase prostate size in patients with benign prostatic hyperplasia. It should be noted that patients on diuretics may need to reduce their dosage or switch to another agent.
Kegel, or pelvic floor muscle, exercises may be useful in helping to prevent urine leakage. They strengthen the muscles of the pelvic floor that both support the bladder and close the sphincter. The exercises consist of repeatedly tightening and releasing the pelvic muscle. Since the muscle is difficult to isolate, patients should best perform this exercise while urinating, contracting and then relaxing the muscle to stop and then release the flow of urine. Kegel exercises should be performed three to five times a day.