Can prostate size growth be slowed without surgery? When to start thinking about procedures like laser TURP

Medicine Made Simple Summary

Your prostate naturally grows a little as you age. In some men this leads to bothersome urinary symptoms and can progress to a condition called Benign Prostatic Hyperplasia (BPH). While you cannot completely stop prostate-growth, you can slow it down with lifestyle changes and medications. At some point, if symptoms are moderate to severe or complications set in, surgical procedures (including laser TURP) might become the logical next step. This blog explains how to slow prostate growth, when to act, and when to consider procedures.

What is prostate growth and BPH?

The prostate is a small gland located just below the bladder, surrounding the urethra (the tube through which urine exits). As men get older, the prostate tends to enlarge, especially in the transition zone around the urethra. This non-cancerous enlargement is called benign prostatic hyperplasia (BPH).

When the enlarged prostate begins to press on the urinary channel or affects how the bladder empties, you start noticing symptoms: frequent urination, urgency, weak stream, incomplete emptying, waking up at night to pee (nocturia). These are often called lower urinary tract symptoms (LUTS).

Because this process is gradual and age-related, many men may ignore early symptoms or assume they are “just part of ageing”. But early attention and action make a difference.

Can you slow prostate growth without surgery?

Short answer: yes—to a degree. You cannot completely arrest ageing-related prostate enlargement, but you can influence its pace and delay progression of symptoms.

Lifestyle changes make a significant difference:

• Regular physical activity: Men who exercise regularly have a lower risk of BPH progression.
• Healthy weight, good cardiovascular health, controlling diabetes and blood pressure: Because the prostate health is linked to metabolic and vascular health.
• Avoiding or reducing risk-factors: For example, excessive alcohol, heavy caffeine, smoking, and large late-night fluid loads can worsen symptoms.
• Diet: While no diet will guarantee stopping prostate growth, a diet rich in vegetables, moderate in red meat/fats, and with good micronutrients supports prostate health.

Medications can help slow progression of prostate enlargement and symptoms:

• 5-alpha reductase inhibitors (5-ARIs) such as finasteride or dutasteride: These act by reducing the androgen-driven growth of prostate tissue and are shown to shrink prostate size modestly over time.
• Alpha-blockers: These don’t shrink the prostate, but they relax the muscle around the prostate/urethra and reduce symptoms quickly. However they don’t significantly slow growth.
• Combination therapy: In some cases—especially when prostate size is larger or symptoms are moderate the combination of medication may be used to both treat symptoms and delay progression. P

So yes: if you catch early, adopt lifestyle measures and appropriate medications, you have a real chance of slowing symptom progression, delaying surgery, and improving quality of life.

When should you start thinking about procedures like laser TURP?

Procedures (including laser TURP) become relevant when conservative methods (lifestyle + medications) either don’t suffice, or when complications or risk-factors appear. According to the guideline recommendations from organisations like the American Urological Association (AUA) or the European Association of Urology (EAU), key triggers for procedural intervention include:

• Moderate to severe symptoms that are bothersome, and which affect quality of life (for example frequent nighttime urination, urgency, weak stream, incomplete emptying).
• Failure of medical therapy: when medications are not effective or cause intolerable side-effects.
• Complications of prostate enlargement/obstruction: such as urinary retention (inability to pass urine), bladder stones, recurrent urinary tract infections (UTIs), gross blood in urine (hematuria), or kidney damage/hydronephrosis.
• Prostate size & residual urine: A significantly enlarged prostate (volume >80-100 mL) or a high post-void residual volume (e.g., >200 mL) may suggest that conservative treatment alone will not be sufficient.

In simpler terms: You should start thinking about procedures when you are symptomatic enough, you’ve tried lifestyle + medical therapy, your prostate size or bladder residual is high, or you have complications.

What about laser TURP specifically?

Laser TURP (or laser-based prostate surgery) is one of the procedural options for BPH. It uses laser energy to remove or vaporise the obstructing prostate tissue via the urethra. When you’re considering a procedure, laser TURP might be discussed if:

• You have a larger prostate or bleeding risk (laser often means less bleeding).
• You want faster recovery or shorter hospital stay.
• You’ve been on medications for some time and still have bothersome symptoms.
• You are ready and willing to undergo surgical intervention and have discussed it thoroughly with your urologist.

Conversely, if your symptoms are mild, controlled with medications, or you have minimal risk, then conservative management may continue for longer.

How to monitor and decide when to act

Here’s a step-by-step way to think about it:

• Baseline assessment: When you first notice symptoms (frequency, urgency, weak stream, nocturia), see a urologist. They will typically check symptom scores (e.g., the International Prostate Symptom Score), measure prostate size (via ultrasound), check post-void residual urine, and rule out other causes (infection, cancer, etc).
• Adopt lifestyle + medications: Go for the lifestyle changes and medications. Monitor how you feel: are symptoms improving, stable, or worsening?
• Regular follow-up: Every 6-12 months (or as your urologist recommends) check symptom severity, prostate size/residual urine, bladder health. If you are stable and comfortable, you may continue medical/lifestyle approach.
• Red flags or progression: If you notice worsening symptoms (e.g., increasing nocturia, more daily trips, weak flow), complications (UTIs, retention), or your tests show high residual urine or prostate size, it’s time to ask about surgical options.
• Shared decision-making: Discuss with your doctor the pros and cons of continuing medications vs moving to procedure like laser TURP. Ask about your personal risk, expected benefits, recovery, cost, and side-effects.

Final thoughts

Yes—many men can slow prostate growth and delay needing surgery. The keys are: early recognition of symptoms, healthy lifestyle, medications when needed, and regular monitoring. However, surgery (including laser TURP) should not be seen as a last-resort only when things are dire—it may be appropriate before major complications arise, especially if you’re already on medication but still symptomatic or your prostate/bladder measurements suggest risk.

Conclusion

If you’re experiencing urinary symptoms (frequent night trips, urgency, weak stream, feeling like you haven’t emptied fully) don’t wait. Schedule a consultation with a urologist. Ask about your prostate size, bladder emptying, what lifestyle or medications you should start, and when you might need to consider a procedure like laser TURP. The sooner you act, the better the outcomes for your urinary health and quality of life.