During watchful waiting for BPH, which recommendation may help alleviate mild symptoms?</n>

• A. Take a mild decongestant at night to reduce nocturia.
• B. Increase fluids before bedtime to dilute acidic urine.
• C. Introduce acidic foods into the diet.
• D. Avoid sources of caffeine.

Answer: (D)

During watchful waiting for BPH, the aim is to reduce mild urinary symptoms with simple, non-pharmacologic tweaks. Avoiding caffeine helps because caffeine is a bladder irritant and a mild diuretic. It increases urine production and can trigger more frequent urination and nocturia, which worsens symptoms and disrupts sleep. By cutting back on caffeine-containing beverages, the bladder is less stimulated, and nighttime trips to the bathroom may decrease.

The other options don’t offer the same benefit and can even worsen symptoms. A nighttime decongestant can raise urinary retention risk by tightening the urinary outlet, making it harder to urinate. Increasing fluids before bed usually increases nighttime urine production. Introducing acidic foods has no proven effect on BPH symptoms. So avoiding caffeine is the most helpful recommendation in this scenario.