Free Advice on Living with BPH

Under the SilGro home page for Alan Silverstein and Cathie Grow
Email me at
Last update: January 29, 2023

Here is free advice I'll offer in addition to three other webpages: tricks to deal with AUR (acute urinary retention), how to self-catheterize, and how to live with a Foley catheter. Also here is some background information about this webpage.

Standard disclaimer: I am not a doctor. This is not medical advice. I offer this just in case it helps you with useful ideas. Personal discretion is advised.

"Public Service Announcement" (PSA, not to be confused with the prostate-specific-antigen blood test, grin):

If you suffer from BPH (benign prostatic hyperplasia) (or know someone who does, usually an aging male) and have any close calls with extreme difficulty starting or finishing voiding your bladder, even if it seems rare and eventually clears up (within a few hours), do not repeat my mistake and fall into denial or complacency. Instead, see a competent urologist ASAP to get it checked out. Even if they have you pass a voiding test and then want to send you on your way, that's great, but again, don't get complacent. Be proactive and insist on "active monitoring" of your condition, meaning revisiting every 6-12 months. Also pay casual attention to whether your symptoms are getting worse (slowly, over time).

Also perhaps ask for TRUS (transrectal ultrasound), which was fairly quick and painless for me (when I finally got it done), to measure the size and examine the anatomy of your prostate, and repeat to watch its growth. Consider getting on single or double dose tamsulosin or equivalent (alpha-blockers) to relax your bladder neck, and possibly finasteride or equivalent (5-alpha-reductase inhibitors) to (slowly) shrink your prostate (a little, but it could be enough), despite the risks to your libido, erectile function, etc.

Don't attempt CIC (clean intermittent catherization, self-cath) without training. For 11 years I carried a basic catheter (not self-lubing; obtained by request from urologist) "just in case". But I see now in hindsight, after attempting self-cath the first time Oct 21, 2022, even with a better model catheter, and doing some reading and viewing videos, that at least with my friable mucosa (easy bleeding), it was nearly impossible to succeed without some proper (guided) practice first. It's a damn good thing I never had to do it while camped alone in a tent overnight in freezing conditions far from a hospital!

If you're skirting the cliff of AUR, trust me, you do not want to fall over it. Even if an ER is nearby and can help you quickly, you will enter an extended period of unbelievable misery, plus risk a horrible death within hours/days if you can't get catheterized STAT.

Also, study everything you can find on the web; there are a lot of clinical/technical articles available, especially under the NIH, also some prostate health support groups on Facebook (that I finally found and joined Dec 13, 2022):

But don't take any of it as gospel... Figure out what applies to your own situation and anatomy. And remember not to confuse probability with plausibility, or be scared by "anecdotal outliers" of particularly bad experiences.

This PSA is the nudge that in 20/20 hindsight I wish someone (like a healthcare professional?) had given me years ago, when perhaps I could still have prevented further prostate growth through "chemical pruning" (finasteride or equivalent, despite all related risks and side-effects) before requiring "mechanical pruning".