Mild Enlarged Prostate: Do You Need Contiflo (Tamsulosin) for Life?

First: Is a 35–39 g Prostate a Serious Enlargement?

No. Those measurements represent a mild to modest enlargement, not a dangerously large prostate.

More importantly, modern BPH treatment is not based on prostate size alone. Current European guidance recommends watchful waiting for men with mild or moderate urinary symptoms who are minimally bothered.

Treatment should consider:

• how bothersome the urinary symptoms are;
• urinary flow;
• post-void residual urine;
• prostate size and anatomy;
• history of urinary retention or infection;
• kidney/bladder complications; and
• the patient’s preferences and medication side effects.

Do the Changes From 35 g to 31 g to 39 g Mean the Prostate Is Progressing?

Not necessarily.

Ultrasound prostate-volume measurements can vary between examinations because of:

• measurement technique;
• operator differences;
• bladder filling;
• the imaging approach; and
• the fact that the prostate is not a perfect geometric shape.

A change from 31 g to 39 g on separate scans does not automatically prove clinically important growth.

It is also important to understand that tamsulosin would not be expected to reduce the prostate size. Therefore, the temporary 31 g measurement should not be interpreted as the medicine shrinking the gland.

What Exactly Is Contiflo Icon 0.4?

Current Indian product information from Sun Pharmaceutical Industries lists Contiflo Icon 0.4 mg as tamsulosin 0.4 mg.

Tamsulosin is a selective alpha-1 blocker.

It reduces prostate and bladder-neck smooth-muscle tone, which may improve:

• weak stream;
• hesitancy;
• straining;
• incomplete-emptying symptoms; and
• some frequency/urgency symptoms.

Current EAU guidance recommends alpha blockers particularly for men with moderate-to-severe bothersome LUTS.

Does Tamsulosin Shrink the Prostate?

No.

This is one of the most important facts for this page.

Alpha blockers such as tamsulosin improve symptoms but:

• do not substantially reduce prostate size;
• do not meaningfully change PSA;
• do not prevent future acute urinary retention; and
• do not prevent the eventual need for BPH surgery in men whose disease progresses.

If the goal is actually to reduce prostate volume and progression risk, a different drug class—5-alpha-reductase inhibitors such as finasteride or dutasteride—is used in appropriately selected men with larger prostates and greater progression risk.

See our BPH medication guide.

Is a 39 g Prostate Large Enough for Finasteride or Dutasteride?

Possibly, but prostate size alone is not enough to decide.

The EAU gives prostate volume above approximately 40 mL as an example of increased progression risk where a 5-alpha-reductase inhibitor may be useful in a man with moderate-to-severe symptoms.

A prostate reported at about 39 g sits near that practical range, but your very low PSA and normal uroflowmetry make it especially important to consider whether you actually have significant bothersome obstruction before adding long-term medication.

If symptoms are minimal, watchful waiting may be more appropriate than escalating treatment.

Does PSA Around 0.4 ng/mL Tell Us Anything?

Your PSA values appear consistently low.

Tamsulosin does not significantly suppress PSA, so a PSA around 0.4 ng/mL is not being artificially lowered by Contiflo.

However, PSA should not be used alone to determine whether you need BPH treatment. PSA is primarily interpreted in the context of prostate-cancer risk and can also correlate loosely with prostate volume.

Whether continued PSA screening is appropriate depends on your current age, health, family history and previous results.

See our PSA guide.

Do You Need Contiflo for Life?

Not automatically.

Tamsulosin controls symptoms while you take it. It does not cure BPH or permanently change the prostate.

If you stop treatment, one of three things may happen:

1. your urinary symptoms remain mild and you do well without medication;
2. symptoms gradually return and you decide the medicine was helping; or
3. objective measures such as flow or residual urine worsen enough that treatment should be restarted or changed.

A 2019 systematic review found that stopping alpha-blocker monotherapy tended to worsen symptoms and urinary flow over the following months compared with continuing treatment, although a proportion of patients remained off therapy successfully.

More recent deprescribing research also supports the idea that some long-term users receive little ongoing benefit and can be identified through supervised trials off medication.

Can You Take Tamsulosin Intermittently?

The standard Contiflo/tamsulosin regimen is 0.4 mg once daily.

However, intermittent treatment has been studied.

A clinical trial found that in men who initially responded to daily tamsulosin, taking 0.4 mg every other day maintained similar symptom, flow and residual-urine results over six months compared with daily therapy. Other small studies have used intermittent dosing to reduce tamsulosin-related ejaculatory problems.

A 2023 study of men with tamsulosin-related ejaculatory dysfunction also found that every-other-day treatment improved ejaculation in many participants while maintaining acceptable urinary symptom control.

But these are relatively small studies.

What Are the Important Side Effects of Tamsulosin?

The side-effect list in the original article was misleading. Fever, lower-back pain and cough should not be presented as the main clinically relevant adverse effects.

The effects patients most need to understand are:

What About Baidyanath Prostaid?

Current manufacturer information describes Baidyanath Prostaid as a traditional Ayurvedic formulation intended to support urinary function and prostate wellness.

The manufacturer’s current product page lists ingredients including:

• Kababchini;
• Khus;
• Safed Chandan;
• Swarna Makhika Bhasma;
• Sudh Prawal Bhasma; and
• Sudh Shilajeet.

This is different from some older ingredient lists that have circulated online, so if you consider using the product, check the exact current package.

Is Prostaid Proven to Work Like Tamsulosin?

No.

The manufacturer advertises Prostaid for urinary-flow, bladder-control and prostate-support benefits. Those marketing claims should not be treated as equivalent to evidence from major international BPH guidelines.

I have not found guideline-level evidence showing that Baidyanath Prostaid reliably:

• improves urinary flow to the same degree as an alpha blocker;
• shrinks the prostate;
• prevents acute urinary retention;
• reduces the need for BPH surgery; or
• can safely replace tamsulosin in a man who depends on tamsulosin for symptom control.

Would I Recommend Trying Prostaid?

I would not recommend it as the first strategy in your situation.

You already have a much more useful clinical clue: your uroflowmetry was normal.

If your current symptoms are also minimal and your bladder empties normally, I would first ask your clinician whether you are a candidate for watchful waiting or a supervised trial without tamsulosin.

If symptoms return and are bothersome, then you know that tamsulosin was providing meaningful benefit.

Do You Need Treatment Just to Stop the Prostate From Getting Bigger?

Tamsulosin cannot accomplish that goal.

If prevention of BPH progression is clinically important because the prostate is clearly enlarged and you have meaningful symptoms or other risk factors, finasteride or dutasteride may be discussed instead.

But those medicines also have side effects and are intended for selected men—not simply for everyone whose scan reports a prostate in the 30–40 g range.

A Practical Plan to Discuss With Your Doctor

1. Record your current urinary symptoms using an IPSS questionnaire.
2. Confirm whether you have a meaningful post-void residual.
3. Review your current urine-flow result and whether symptoms remain bothersome.
4. Confirm your current prostate volume if the result would change management.
5. If symptoms are mild and bladder emptying is satisfactory, ask about a supervised trial off tamsulosin.
6. If stopping causes bothersome symptoms to return, discuss restarting daily therapy or whether an individualized intermittent schedule is appropriate.
7. Do not substitute Prostaid automatically; decide first whether you need active BPH medication at all.

When Should You Not Simply Stop Treatment?

You need medical review rather than casual medication withdrawal if you have:

• recurrent urinary retention;
• a persistently high post-void residual;
• recurrent urinary infections;
• bladder stones;
• kidney effects from obstruction;
• very weak urinary flow; or
• moderate-to-severe symptoms that substantially affect quality of life.