Constricting Your Urethra. The prostate is a walnut-shaped gland that forms part of the male reproductive system. It secretes fluid that helps transport sperm. The prostate is located below the bladder and surrounds the urethra, the tube that drains your bladder.

Often, the gland enlarges as you age. That narrows the urethra, making it difficult to urinate. This is known as benign prostatic hyperplasia (BPH). More than half of men over 50, and 80 percent of men in their 70's experience prostate enlargement. Symptoms and signs include getting up at night to urinate, a weak urinary stream, a frequent urge to urinate, and a feeling that your bladder never completely empties. You may also experience difficulty starting to urinate and dribbling at the end of urination. Although annoying, an enlarged prostate usually is not serious unless it becomes difficult for you to urinate or completely empty your bladder. This would increase your risk for having a bladder infection.

To Wait or Treat. Minor symptoms usually don't require treatment. Studies show untreated BPH will improve in 40 percent of cases, remain the same in 45 percent, and worsen in only 15 percent. Diet and lifestyle changes may help you (see Minimizing Prostate Symptioms.)

But when your symptoms are moderate or severe -- they interfere with your sleep or daily activities due to urine retention or bladder discomfort -- your doctor may advise treatment. Options include:

Drug Therapy - There are two types of medications for the treatment of BPH:alpha blockers and prostate-growth suppresors. Alpha blockers, such as terazosin (Hytrin), tamsulosin (Flomax), and doxazosin (Cardura), relax smooth muscle tissue in your prostate and outlet of the bladder, making the urethra less constricted and making if easier for you to urinate. Proscar is a medication that shrinks the size of the prostate and reduces its growth.

Surgery - Standard treatment is an operation called transurethral resection of the prostate (TURP). A urologist passes a tube (resectoscope) through the urethra into the center of the gland, then scrapes away prostate tissue with it.

Transurethral incision of the prostate (TUIP) is another treatment. A urologist makes one or two small incisions in the gland near the bladder outlet. The incisions relieve pressure on your urethra. Your doctor may recommend TUIP if your prostate is not particularly enlarged but still causes serious obstruction.

Removal of the prostate through an incision in the abdomen is usually necessary only when your prostate is excessively enlarged. This is called an open prostatectomy.

Alternative Treatments. Alternative therapies are available if you are reluctant/unable to take medications, or undergo surgery. They include:

Electrovaporization - This is a modification of TURP. An electrical current is applied through a device inserted into your urethra which vaporize prostatic tissue. This is associated with decreased bleeding at the time of the procedure.

Laser therapy - A urologist inserts a laser fiber into your urethra. The laser heats and destroys prostate tissue, which you eliminate over time. It may take several weeks to months to notice results.

Microwave therapy The prostate microwave machine is known as the Prostatron. It uses microwave energy to shrink prostate tissue. The Prostatron uses a microwave antenna inserted through a catheter to apply energy that heats and destroys cells deep within your prostate. This helps patients 50 percent of the time.

Experimental Treatments

Needle ablation therapy - This procedure uses high-frequency, high-intensity radio waves to destroy prostate tissue. It is performed much like laser and microwave therapy.

Minimizing Prostate Symptoms. To reduce frequency of urination at night:

• Stop drinking fluids 3 to 4 hours before bedtime.
• Try to empty your bladder completely each time you urinate.
• Cutdown on caffeinated drinks and chocolate, which can irritate your bladder.
• Go easy on salt and spices. Salt causes fluid retention and spices can increase symptoms.
• Limit alcoholic beverages. They increase urine production and make your bladder muscles weak.
• Avoid over-the-counter-decongestants (ie. Sudafed ®, Contac ®, Sinutab ®. They cause your urethra sphincter to tighten, making urination more difficult.