If the enlarged prostate is not causing severe obstruction but is interfering with the patient’s quality of life, it may be reasonable to treat the symptoms with medication rather than proceeding directly to surgery.
The tissue surrounding the opening of the bladder as well as tissue within the prostate contains muscle cells. There are several medications specifically designed to relax these cells which has the effect of opening up the prostate channel and allowing the urine to flow through more freely. In many instances these medications are extremely effective and you can remain on these medications as long as they afford some symptom relief. If they are ineffective or should you not wish to take medications in the long term it is certainly reasonable to consider surgery earlier rather than later.
Some of these medications have an additional component that very slowly shrinks the prostate tissue. This can help men with very large prostates, or men who have recurrent episodes of bleeding from their prostate. This medication, however, has some specific side effects including erectile dysfunction.