Medication is the most common treatment for mild to moderate symptoms of prostate enlargement. The options include:

Alpha blockers. These medications relax bladder neck muscles and smooth muscle fibers in the prostate, making urination easier. Alpha blockers — which include alfuzosin (Uroxatral), doxazosin (Cardura), tamsulosin (Flomax), and silodosin (Rapaflo). In general these medications usually work quickly in men with relatively small prostates and mild to moderate prostate. Side effects might include dizziness and a harmless condition in which the semen quantity diminishes (low ejaculate volume or anejaculation). These medications are not known to cause erectile dysfunction.

5-alpha reductase inhibitors. These medications progressively shrink the prostate by preventing hormonal changes that cause prostate growth. These medications which include finasteride (Proscar) and dutasteride (Avodart) typically take up to six months to be effective. Side effects include retrograde ejaculation or rarely breast enlargement.

Combination drug therapy. Your doctor might recommend taking an alpha blocker and a 5-alpha reductase inhibitor at the same time if either medication alone isn’t effective.

Tadalafil (Cialis). Recent studies have shown that Cialis 5 mg by mouth once a day, which is often used to treat erectile dysfunction, might help urinary symptoms associated with prostate enlargement. However, Cialis is not routinely used for BPH and is usually prescribed in men who also experience erectile dysfunction.
When Is Minimally invasive or surgical therapy Indicated?

Minimally invasive or surgical therapy might be recommended if your symptoms are moderate to severe or medication hasn’t relieved your symptoms. Other strong indications include severe urinary tract obstruction, bladder stones, gross blood in your urine or kidney problems. Other patients prefer surgical treatment instead of medications.

Any type of prostate procedure can cause side effects. Depending on the procedure you choose, complications might include:

Semen flowing backward into the bladder instead of out through the penis during ejaculation
Temporary difficulty with urination
Urinary tract infection
Bleeding
Erectile dysfunction
Very rarely, loss of bladder control (incontinence)
There are several types of minimally invasive or surgical therapy.
Transurethral resection of the prostate (TURP)
A lighted rigid scope is inserted into your urethra, and the surgeon removes the central part (transition zone) of the prostate. It is still possible to develop prostate cancer after a TURP. Therefore, the patients need continued monitoring using PSA and rectal examination. TURP generally relieves symptoms quickly, and most men have a stronger urine flow soon after the procedure. After TURP you might temporarily need a catheter to drain your bladder, and you’ll be able to do only light activity until you’ve healed. Usually erectile dysfunction is not noted after a TURP. Transurethral microwave thermotherapy (TUMT)

Your doctor inserts a special electrode through your urethra into your prostate area. Microwave energy from the electrode destroys the inner portion of the enlarged prostate gland, shrinking it and easing urine flow. This surgery is generally used only on small prostates in special circumstances because re-treatment might be necessary.

In this outpatient procedure, a scope is passed into your urethra, allowing your doctor to place needles into your prostate gland. Radio waves pass through the needles, heating and destroying excess prostate tissue that’s blocking urine flow.

This procedure might be a good choice if you bleed easily or have certain other health problems. However, like TUMT, TUNA might only partially relieve your symptoms and it might take some time before you notice results.

A high-energy laser destroys or removes overgrown prostate tissue. Laser therapy generally relieves symptoms right away and has a lower risk of side effects than does nonlaser surgery. Laser therapy might be used in men who shouldn’t have other prostate procedures because they take blood-thinning medications. There is no evidence that Laser prostate surgery is superior to TURP.

In this newly FDA approved transurethral procedure, special tags (like staples) are deployed through the urethra to compress the sides of the prostate to increase the flow of urine by retracting the lateral obstructing lobes of the prostate. Long-term data on the effectiveness of this procedure aren’t yet available.