Launching January 2027

BPH/Enlarged Prostate

BPH At A Glance

  • Benign prostatic hyperplasia (BPH) is a noncancerous enlargement of the prostate gland that becomes increasingly common with age.
  • As the prostate enlarges, it can press on the urethra and interfere with the normal flow of urine from the bladder.
  • Common symptoms include frequent or urgent urination, waking at night to urinate, difficulty starting urination, a weak or interrupted stream, and feeling that the bladder has not completely emptied.
  • BPH is not prostate cancer and does not appear to increase prostate-cancer risk, although both conditions can occur at the same time and cause similar symptoms.
  • Mild BPH may be managed with monitoring and lifestyle changes, while medications can relax the prostate and bladder outlet or gradually shrink an enlarged prostate.
  • Minimally invasive procedures or surgery may be recommended when symptoms are severe, medications do not provide enough relief, or complications such as urinary retention develop.

Table of Contents

Table of Contents

What Is BPH?

Benign prostatic hyperplasia (BPH) is noncancerous growth of the prostate gland. It is also called an enlarged prostate, benign prostatic hypertrophy, or benign prostatic obstruction. The prostate sits below the bladder and surrounds part of the urethra, the tube that carries urine out of the body.

As the prostate grows, it can press on the urethra and make the bladder work harder. This may cause a weak stream, urgency, frequent urination, nighttime urination, or trouble emptying the bladder. BPH is not prostate cancer and does not appear to increase prostate-cancer risk, but the two conditions can occur at the same time and may cause similar symptoms.

Learn More

Enlarged Prostate (Benign Prostatic Hyperplasia) – NIDDK
https://www.niddk.nih.gov/health-information/urologic-diseases/prostate-problems/enlarged-prostate-benign-prostatic-hyperplasia

Provides comprehensive patient information about BPH symptoms, diagnosis, treatment, complications, and self-care.

Understanding Prostate Changes – National Cancer Institute
https://www.cancer.gov/types/prostate/understanding-prostate-changes

Explains age-related prostate changes, BPH, prostatitis, prostate cancer, testing, and questions to ask.

How Common Is BPH?

BPH becomes more common with age and is the most common prostate problem in people older than 50. NIDDK estimates that it affects about 5% to 6% of men ages 40 to 64 and about 29% to 33% of those age 65 and older.

An enlarged prostate does not always cause symptoms. Prostate size and symptom severity do not always match; a mildly enlarged gland can cause major symptoms, while a larger gland may cause little trouble.

Learn More

Enlarged Prostate (Benign Prostatic Hyperplasia) – NIDDK
https://www.niddk.nih.gov/health-information/urologic-diseases/prostate-problems/enlarged-prostate-benign-prostatic-hyperplasia

Provides comprehensive patient information about BPH symptoms, diagnosis, treatment, complications, and self-care.

What Symptoms Might You Notice?

BPH can cause lower urinary tract symptoms, including:

  • Frequent urination during the day
  • A sudden, difficult-to-delay urge to urinate
  • Waking at night to urinate (nocturia)
  • Difficulty starting the urine stream (hesitancy)
  • A weak, slow, interrupted, or spraying stream
  • Straining or pushing to urinate
  • Dribbling at the end of urination
  • Feeling that the bladder did not empty completely
  • Needing to urinate again soon after finishing
  • Urine leakage related to urgency or an overfull bladder

Burning, fever, visible blood, new pelvic pain, or sudden inability to urinate is not something to assume is routine BPH. These symptoms need prompt evaluation for infection, stones, retention, cancer, or another cause.

How Is BPH Diagnosed?

Your provider will ask about the pattern, severity, and effect of your urinary symptoms. They may use a questionnaire such as the International Prostate Symptom Score, review a bladder diary, and ask about medicines, fluid intake, infections, neurologic symptoms, sexual function, and family history.

The examination may include the abdomen, genitals, and a digital rectal exam to estimate prostate size and feel for unusual areas. Because BPH symptoms overlap with infection, overactive bladder, urethral narrowing, bladder disease, neurologic conditions, and prostate cancer, testing is used to rule out other causes.

Learn More

Enlarged Prostate (Benign Prostatic Hyperplasia) – NIDDK
https://www.niddk.nih.gov/health-information/urologic-diseases/prostate-problems/enlarged-prostate-benign-prostatic-hyperplasia

Provides comprehensive patient information about BPH symptoms, diagnosis, treatment, complications, and self-care.

Understanding Prostate Changes – National Cancer Institute
https://www.cancer.gov/types/prostate/understanding-prostate-changes

Explains age-related prostate changes, BPH, prostatitis, prostate cancer, testing, and questions to ask.

BPH/Enlarged Prostate infographic – click to enlarge

What Causes BPH?

The exact cause is not fully understood. BPH develops as prostate cells increase in number during aging, and lifelong changes in hormones—especially testosterone and dihydrotestosterone—likely contribute.

Factors linked with a greater chance of BPH or urinary symptoms include:

  • Age 40 or older
  • A family history of BPH
  • Obesity or low physical activity
  • Type 2 diabetes
  • Heart and blood-vessel disease
  • Chronic kidney disease
  • Erectile dysfunction

BPH is not caused by sexual activity, masturbation, a sexually transmitted infection, or poor hygiene.

Learn More

Enlarged Prostate (Benign Prostatic Hyperplasia) – NIDDK
https://www.niddk.nih.gov/health-information/urologic-diseases/prostate-problems/enlarged-prostate-benign-prostatic-hyperplasia

Provides comprehensive patient information about BPH symptoms, diagnosis, treatment, complications, and self-care.

What Can Make BPH Worse?

Symptoms may worsen when the bladder is very full, urine production increases, or a medicine tightens the bladder outlet or weakens bladder contraction.

  • Drinking large amounts of fluid at one time
  • Alcohol or caffeine, especially later in the day
  • Constipation
  • Cold medicines containing decongestants such as pseudoephedrine or phenylephrine
  • Some antihistamines, sleep medicines, bladder medicines, and other drugs
  • Diuretics (water pills), which increase urine production
  • Holding urine for long periods
  • Urinary infection, prostatitis, or poorly controlled diabetes
  • Inactivity and weight gain

Do not stop a prescribed medicine on your own. Ask a pharmacist or provider to review all prescription drugs, over-the-counter products, and supplements for effects on urination.

Learn More

Enlarged Prostate (Benign Prostatic Hyperplasia) – NIDDK
https://www.niddk.nih.gov/health-information/urologic-diseases/prostate-problems/enlarged-prostate-benign-prostatic-hyperplasia

Provides comprehensive patient information about BPH symptoms, diagnosis, treatment, complications, and self-care.

Prevention

BPH cannot always be prevented because prostate growth is strongly linked with aging. Healthy habits may reduce symptom burden or lower risks associated with obesity, diabetes, and inactivity.

  • Stay physically active and work toward a healthy weight.
  • Manage diabetes, heart disease, blood pressure, and sleep apnea.
  • Avoid smoking.
  • Use caffeine and alcohol in moderation if they worsen symptoms.
  • Prevent constipation.
  • Review medicines that may impair urination.
  • Seek evaluation early for persistent urinary changes rather than waiting for retention.
  • Keep recommended follow-up and prostate-cancer screening discussions.

Lifestyle habits do not guarantee that the prostate will stay small, but they can improve overall urinary and general health.

Learn More

Enlarged Prostate (Benign Prostatic Hyperplasia) – NIDDK
https://www.niddk.nih.gov/health-information/urologic-diseases/prostate-problems/enlarged-prostate-benign-prostatic-hyperplasia

Provides comprehensive patient information about BPH symptoms, diagnosis, treatment, complications, and self-care.

Labs

Laboratory tests help check for other causes and complications. Testing may include:

  • Urinalysis: Looks for blood, infection, glucose, protein, and other abnormalities.
  • Urine Culture: Identifies bacteria when a urinary infection is suspected.
  • Prostate-Specific Antigen (PSA): May help assess prostate-cancer risk and can also be elevated by BPH, prostatitis, recent procedures, or other factors.
  • Kidney Function Tests: Creatinine and estimated filtration rate may be checked when retention or kidney problems are possible.
  • Blood Glucose or A1C: May be considered when diabetes could be contributing to frequent urination.

A PSA result does not diagnose or exclude cancer by itself. Discuss the possible benefits, limitations, timing, and next steps before testing.

Learn More

Urinalysis – NIH MedlinePlus
https://medlineplus.gov/lab-tests/urinalysis/

Explains how urine testing is performed and what abnormal results may mean.

Prostate-Specific Antigen (PSA) Test – National Cancer Institute
https://www.cancer.gov/types/prostate/psa-fact-sheet

Explains what PSA testing can and cannot show and how results may be interpreted.

Diagnostics

Not everyone needs every test. Your provider may use:

  • Post-Void Residual: Ultrasound or a catheter measures urine left in the bladder after urination.
  • Uroflowmetry: Measures the strength and amount of urine flow.
  • Bladder Diary: Records fluid intake, urination times, amounts, urgency, and leakage.
  • Ultrasound: Evaluates the prostate, bladder, kidneys, stones, or urinary retention.
  • Cystoscopy: A small flexible scope looks inside the urethra and bladder after numbing medicine is used.
  • Urodynamic Testing: Measures bladder pressure and function when the diagnosis is unclear or before selected procedures.
  • Prostate Imaging or Biopsy: Used when prostate size must be measured or cancer evaluation is needed, not to diagnose routine BPH in every patient.

Ask what each test is expected to clarify and whether results will change treatment.

Learn More

Enlarged Prostate (Benign Prostatic Hyperplasia) – NIDDK
https://www.niddk.nih.gov/health-information/urologic-diseases/prostate-problems/enlarged-prostate-benign-prostatic-hyperplasia

Provides comprehensive patient information about BPH symptoms, diagnosis, treatment, complications, and self-care.

Cystoscopy – NIH MedlinePlus
https://medlineplus.gov/ency/article/003903.htm

Explains why cystoscopy is performed, preparation, what to expect, and possible risks.

Treatment & Management

Treatment Options

Treatment depends on how much symptoms bother you, prostate size, urine retention, complications, other health conditions, sexual priorities, and personal preferences.

  • Watchful Waiting: Regular monitoring and lifestyle changes for mild symptoms without complications.
  • Medication: Relaxes the prostate and bladder outlet, shrinks the prostate over time, or improves related symptoms.
  • Minimally Invasive Therapy: Uses implants, steam, heat, water pressure, or other techniques to open the urine channel.
  • Surgery: Removes or destroys blocking prostate tissue when symptoms are severe, complications occur, or other treatments do not help.
  • Catheter Drainage: Temporarily empties the bladder during acute urinary retention or when the bladder cannot empty safely.

Untreated mild BPH does not always progress quickly. However, repeated retention, infections, bladder stones, blood in the urine, or kidney effects may make a procedure more appropriate.

Learn More

Enlarged Prostate (Benign Prostatic Hyperplasia) – NIDDK
https://www.niddk.nih.gov/health-information/urologic-diseases/prostate-problems/enlarged-prostate-benign-prostatic-hyperplasia

Provides comprehensive patient information about BPH symptoms, diagnosis, treatment, complications, and self-care.

Enlarged Prostate – NIH MedlinePlus
https://medlineplus.gov/enlargedprostatebph.html

Offers plain-language information and reliable links about BPH, urinary symptoms, medicines, and procedures.

Lifestyle Changes

Daily habits may reduce symptoms, especially when BPH is mild.

  • Spread fluids through the day instead of drinking a large amount at once.
  • Reduce fluids for several hours before bedtime or long travel while staying adequately hydrated overall.
  • Limit caffeine and alcohol if they worsen urgency or nighttime urination.
  • Urinate when you first feel the need and take time to empty without straining.
  • Try double voiding: wait briefly after urinating, relax, and try again.
  • Prevent constipation with fiber, activity, and appropriate fluid intake.
  • Exercise regularly and work toward a healthy weight.
  • Keep a bladder diary to identify patterns and triggers.
  • Use night-lights and clear the path to the bathroom to reduce fall risk.

Avoid severe fluid restriction. Concentrated urine can irritate the bladder, and dehydration can cause other health problems.

Learn More

Enlarged Prostate (Benign Prostatic Hyperplasia) – NIDDK
https://www.niddk.nih.gov/health-information/urologic-diseases/prostate-problems/enlarged-prostate-benign-prostatic-hyperplasia

Provides comprehensive patient information about BPH symptoms, diagnosis, treatment, complications, and self-care.

Medications

BPH medicines work in different ways. Benefits and side effects should be reviewed against your symptoms, blood pressure, prostate size, sexual goals, and other medicines.

  • Alpha Blockers: Tamsulosin, alfuzosin, silodosin, doxazosin, and terazosin relax the prostate and bladder outlet and often work within days; dizziness, low blood pressure, and ejaculation changes can occur.
  • 5-Alpha-Reductase Inhibitors: Finasteride and dutasteride gradually shrink an enlarged prostate and reduce retention risk; benefit may take months, and sexual side effects can occur.
  • Tadalafil: A daily PDE-5 inhibitor can improve BPH symptoms and erectile dysfunction in selected patients; it must not be combined with nitrates.
  • Combination Therapy: An alpha blocker plus a 5-alpha-reductase inhibitor may help people with larger prostates and higher progression risk.
  • Other Bladder Medicines: Antimuscarinic or beta-3 agonist medicines may be added for urgency and frequency after checking bladder emptying.

Tell an eye surgeon if you take or previously took tamsulosin or another alpha blocker because it can affect cataract surgery. Ask before using herbal products; saw palmetto and other supplements have inconsistent evidence and can interact with medicines.

Learn More

Enlarged Prostate (Benign Prostatic Hyperplasia) – NIDDK
https://www.niddk.nih.gov/health-information/urologic-diseases/prostate-problems/enlarged-prostate-benign-prostatic-hyperplasia

Provides comprehensive patient information about BPH symptoms, diagnosis, treatment, complications, and self-care.

Finding and Learning About Side Effects – FDA
https://www.fda.gov/consumers/consumer-updates/finding-and-learning-about-side-effects-adverse-reactions

Helps patients find reliable medicine safety information and report possible side effects.

Procedures

A urologist may recommend a procedure when medicines do not help enough, side effects are unacceptable, or complications develop.

  • Prostatic Urethral Lift (UroLift): Small implants hold prostate tissue away from the urethra; recovery is often quick and ejaculation may be preserved in many patients.
  • Water Vapor Thermal Therapy (Rezum): Steam treats prostate tissue, which shrinks over time; temporary catheter use and urinary irritation may occur.
  • Transurethral Resection of the Prostate (TURP): An instrument passed through the penis removes blocking tissue; it is effective but can affect ejaculation and cause bleeding or other risks.
  • Laser Procedures, Including HoLEP: Laser energy removes or vaporizes tissue and can treat a wide range of prostate sizes.
  • Robotic Waterjet Treatment: Image-guided high-pressure water removes selected prostate tissue.
  • Prostate Artery Embolization: An interventional radiologist reduces prostate blood flow; availability, candidacy, and long-term results should be discussed.
  • Simple Prostatectomy: Removes the inner blocking portion of a very large prostate through open, laparoscopic, or robotic surgery.

Options differ in symptom relief, durability, catheter time, anesthesia, recovery, bleeding risk, retreatment rates, and effects on erection, ejaculation, fertility, and continence. Ask the urologist to compare the choices that fit your anatomy and goals.

Learn More

Enlarged Prostate (Benign Prostatic Hyperplasia) – NIDDK
https://www.niddk.nih.gov/health-information/urologic-diseases/prostate-problems/enlarged-prostate-benign-prostatic-hyperplasia

Provides comprehensive patient information about BPH symptoms, diagnosis, treatment, complications, and self-care.

What Should You Expect Long-Term?

BPH often changes slowly. Mild symptoms may remain stable, improve, or worsen over time. Medicines may control symptoms for years, but some must be continued to maintain benefit.

Possible complications include acute or chronic urinary retention, repeated urinary infections, bladder stones, blood in the urine, bladder damage, and kidney problems. Regular follow-up helps track symptoms, bladder emptying, medicine effects, and whether treatment should change.

Learn More

Enlarged Prostate (Benign Prostatic Hyperplasia) – NIDDK
https://www.niddk.nih.gov/health-information/urologic-diseases/prostate-problems/enlarged-prostate-benign-prostatic-hyperplasia

Provides comprehensive patient information about BPH symptoms, diagnosis, treatment, complications, and self-care.

What Can You Do At Home?

Helpful home steps include:

  • Track urination, urgency, leakage, nighttime trips, and fluid intake for several days.
  • Take medicines at the same time each day as directed.
  • Stand up slowly if an alpha blocker causes dizziness.
  • Plan bathroom access during travel or events.
  • Use double voiding without forceful straining.
  • Reduce evening caffeine, alcohol, and large fluid loads.
  • Treat constipation and stay physically active.
  • Ask before taking cold, allergy, sleep, or bladder medicines.
  • Contact your provider if symptoms worsen, side effects appear, or urine becomes bloody.

Do not attempt to insert a catheter or other object unless a clinician has trained you and provided the correct supplies.

Learn More

Enlarged Prostate (Benign Prostatic Hyperplasia) – NIDDK
https://www.niddk.nih.gov/health-information/urologic-diseases/prostate-problems/enlarged-prostate-benign-prostatic-hyperplasia

Provides comprehensive patient information about BPH symptoms, diagnosis, treatment, complications, and self-care.

Frequently Asked Questions

Is BPH prostate cancer?

No. BPH is noncancerous growth. It does not appear to cause prostate cancer, but both can occur at the same time and may cause similar symptoms.

Does a larger prostate always cause worse symptoms?

No. Symptoms depend on where the prostate presses, bladder function, and other factors—not size alone.

Can BPH affect erections or ejaculation?

BPH, aging, other health conditions, medicines, and procedures can affect sexual function. Ask about these effects before choosing treatment.

Why do I urinate more at night?

BPH may contribute, but evening fluids, sleep apnea, leg swelling, diabetes, heart conditions, and certain medicines can also cause nocturia.

Can I take cold medicine with BPH?

Some decongestants and antihistamines can make urination harder. Check with a pharmacist or provider before using them.

Does saw palmetto shrink the prostate?

Research has not shown consistent meaningful benefit. Supplements can cause side effects or interactions, so discuss them before use.

Will I need surgery?

Many people do not. Surgery or a minimally invasive procedure is considered when symptoms remain bothersome, complications occur, or medicines are not appropriate.

Questions To Ask Your Provider

Consider asking:

  • Are my symptoms most likely caused by BPH or another condition?
  • How severe are my symptoms, and am I emptying my bladder safely?
  • Do I need a urinalysis, PSA discussion, kidney tests, or imaging?
  • Would watchful waiting be safe for me?
  • Which medicine best fits my blood pressure, prostate size, and sexual goals?
  • Could any of my current medicines worsen urination?
  • How long should I try medication before deciding whether it works?
  • Which procedure options fit the size and shape of my prostate?
  • How might treatment affect erections, ejaculation, fertility, or bladder control?
  • What symptoms mean I should seek urgent care?
  • How often should I return for follow-up?

Specialist Referrals

A primary care provider may diagnose and manage uncomplicated BPH. Referral may be made to:

  • Urologist: Evaluates persistent or severe symptoms, retention, blood in the urine, stones, repeated infections, abnormal testing, or procedure options.
  • Interventional Radiologist: Evaluates selected patients for prostate artery embolization.
  • Nephrologist: Helps manage kidney damage or chronic kidney disease when present.
  • Pelvic Floor Physical Therapist: May help selected patients with urgency, leakage, pelvic-floor coordination, or recovery after a procedure.

Seek earlier urology evaluation if you cannot empty the bladder, have recurrent retention, or develop complications.

Learn More

Enlarged Prostate (Benign Prostatic Hyperplasia) – NIDDK
https://www.niddk.nih.gov/health-information/urologic-diseases/prostate-problems/enlarged-prostate-benign-prostatic-hyperplasia

Provides comprehensive patient information about BPH symptoms, diagnosis, treatment, complications, and self-care.

Is BPH Curable?

BPH is a chronic age-related condition, so medicines control it rather than permanently cure it. Symptoms may improve greatly with lifestyle changes and medication, but the prostate can continue to grow.

Procedures and surgery can provide long-lasting relief by opening the urine channel or removing blocking tissue. Some patients later need repeat treatment, and urinary symptoms may persist if the bladder or another condition also contributes.

Learn More

Enlarged Prostate (Benign Prostatic Hyperplasia) – NIDDK
https://www.niddk.nih.gov/health-information/urologic-diseases/prostate-problems/enlarged-prostate-benign-prostatic-hyperplasia

Provides comprehensive patient information about BPH symptoms, diagnosis, treatment, complications, and self-care.

Emergency Symptoms / When To Seek Immediate Help

Seek emergency or same-day care for:

  • Complete inability to urinate, especially with painful lower-abdominal swelling
  • Fever or chills with painful, frequent, or difficult urination
  • Visible blood in the urine, blood clots, or heavy bleeding
  • Severe lower abdominal, pelvic, back, or flank pain
  • Vomiting, confusion, weakness, or signs of serious illness with urinary symptoms
  • Very little urine along with swelling, shortness of breath, or known kidney disease
  • Fainting or severe dizziness after starting a BPH medicine

Acute urinary retention is an emergency because the bladder and kidneys can be harmed. A clinician may need to place a catheter to drain the bladder promptly.

Learn More

Enlarged Prostate (Benign Prostatic Hyperplasia) – NIDDK
https://www.niddk.nih.gov/health-information/urologic-diseases/prostate-problems/enlarged-prostate-benign-prostatic-hyperplasia

Provides comprehensive patient information about BPH symptoms, diagnosis, treatment, complications, and self-care.

CALL 911

APNS does not provide emergency medical services. If you believe you are experiencing a medical emergency, including (but not limited to) chest pain, difficulty breathing, stroke symptoms, severe allergic reactions, anaphylaxis, uncontrolled bleeding, seizures, loss of consciousness, or any other potentially life-threatening condition, you are instructed to call 911 immediately or go immediately to the nearest emergency department.

Official Resources / External Links

Enlarged Prostate (Benign Prostatic Hyperplasia) – NIDDK
https://www.niddk.nih.gov/health-information/urologic-diseases/prostate-problems/enlarged-prostate-benign-prostatic-hyperplasia

Provides comprehensive patient information about BPH symptoms, diagnosis, treatment, complications, and self-care.

Enlarged Prostate – NIH MedlinePlus
https://medlineplus.gov/enlargedprostatebph.html

Offers plain-language information and reliable links about BPH, urinary symptoms, medicines, and procedures.

Understanding Prostate Changes – National Cancer Institute
https://www.cancer.gov/types/prostate/understanding-prostate-changes

Explains age-related prostate changes, BPH, prostatitis, prostate cancer, testing, and questions to ask.

Prostate-Specific Antigen (PSA) Test – National Cancer Institute
https://www.cancer.gov/types/prostate/psa-fact-sheet

Explains what PSA testing can and cannot show and how results may be interpreted.

This guide is intended for educational purposes only and should not replace medical advice, diagnosis, or treatment from your healthcare provider or urologist. Urinary symptoms may be caused by BPH, infection, medication effects, bladder or neurologic conditions, prostate cancer, or other problems. Seek urgent care if you cannot urinate, have fever with urinary symptoms, pass significant blood or clots, develop severe pain, or experience signs of kidney problems or a serious medication reaction.

Get personalized care for BPH

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