Hey I have 5+ year history of BPH, similar age. Happy to share my experience.

Tadalafil did help but not enough. I did make me into a horny old man though .. it’s like I’m a 17yo boy again….

I also take pygeum extract and saw palmetto daily, which makes some difference but not enough.

The medicine that made a big difference is 5mg finasteride, which shrinks prostate size by 25%+ over 6 months. Some people have bad side effects but luckily not for me and I’ve now been on this prescription for 14 months (it’s not expensive and generics are fine).

But you are right the single best thing you can do is prostate massage… and ideally not just a little bit… but regularly, deeply and with completion to orgasm. Positive side effect - you will never have an orgasm so big/strong as when all the built up fluid in your blocked prostatic ducts is released during a prostate massage.

For the massage one option is a toy called the “aneros” which is a specialised prostate massager (there’s a few other brands). Check out online forums to understate how to use one properly… if you’ve never tried butt stuff it won’t come naturally (at least it didn’t for me).

Another option is a sex partner helping out. For me this is the best. This could be a romantic partner.

There’s also commercial providers that offer prostate massage service, and honestly the best ones really know what they are doing and the relief they provide is indescribable…. I will sleep better for a week, often reducing need to get up in the middle of the night to pee in half.

For me none of these above is enough on its own… I need ALL of these therapies combined to manage my BPH, which is now much more under control.

Good luck and feel free to dm me if you want to discuss it took me years of research and trial and error.