Because the natural progression of BPH in a specific patient, isn't predictable. Occasionally the symptoms of BPH can resolve without treatment. In fact, the course of BPH is not predictable in an individual patient. Sometimes the symptoms will flare and then revert back to normal. In other cases, the symptoms of urination will get worse and then reach a plateau and stay that way for many years. In other patients, the symptoms progressively, slowly get worse with time. On an individual basis, this is difficult to predict. If treatment is required, it usually starts with medications. There are two broad classes of medications. The first is called 5 alpha reductase inhibitors. The common name is Proscar. And the goal of that is to shrink the prostate over time. It may take three to six months to have an effect. The other class of agents is called alpha blockers. It's almost like a muscle relaxer. Now the prostate is not a muscle, but it does have some muscle tone to it. And there are some microscopic muscle fibers in it. These agents, the most common one is called Flomax or tamsulosin, relaxes the tone of the prostate, opening up the prostate channel to make it easier to urinate.
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