What is the prostate?
The prostate is a gland in the male reproductive system. It lies just below the bladder. It makes fluid that is part of semen.
What is an enlarged prostate (BPH)?
An enlarged prostate is when your prostate gland becomes larger than normal. It's also called benign prostatic hyperplasia or BPH for short. Benign means not cancer. And hyperplasia means too much cell growth. BPH isn't cancer and it doesn't increase your risk of getting prostate cancer.
Usually, the prostate gland continues to grow during adult life. That's why BPH is the most common prostate condition in people over age 50. As the prostate gets bigger, it may press against the bladder and pinch the urethra. This can slow or block the flow of urine out of your bladder.
Over time, the bladder muscle may become weak from trying to pass urine through a narrow urethra. When this happens, your bladder may not empty completely when you urinate. A narrowed urethra and weak bladder cause many of the urinary problems you may have with BPH.
What causes an enlarged prostate (BPH)?
Researchers aren't sure why the prostate keeps growing. Some researchers think changes in hormones with aging may cause the prostate to get bigger.
Who is more likely to develop BPH?
You're more likely to develop BPH if you:
- Are age 40 or older. The chance of getting BPH increases as you get older.
- Have family members who have had BPH.
- Have certain health conditions such as:
- Don't get enough physical activity.
What are the symptoms of BPH?
Symptoms of BPH include:
- Having a frequent or urgent need to urinate
- Waking up many times to urinate
- Having problems with urine flow, such as:
- Trouble starting to urinate
- A stream that's weak, slow, or stops and starts
- Dribbling after urination
- Urinary incontinence
- Feeling that you can't completely empty your bladder
- Pain after ejaculation or during urination
- Urine with an unusual color or smell
It's important to see your health care provider if you have any of these symptoms because they could be from a more serious health problem.
You should get medical help right away if you:
- Can't urinate at all
- Have fever and chills with urination that's painful, frequent, and urgent
- Have blood in your urine
- Have pain in your lower abdomen (belly) and urinary tract
What other problems can BPH cause?
For most people, BPH doesn't cause other problems. But BPH increases your chance of developing serious conditions, including:
- Acute urinary retention. With this condition, you suddenly can't urinate at all. This a medical emergency. Acute urinary retention is common in older males and the chance of having it increases with age. It may be triggered by:
- Urinary tract infections (UTIs)
- Bladder damage and bladder stones
- Kidney damage
How is BPH diagnosed?
To find out if you have BPH, your provider will:
- Ask about your medical history. Be sure to tell your provider about all the medicines you take, because certain medicines can make BPH symptoms worse.
- Ask about your family health history.
- Examine you. The exam may include a digital rectal exam (DRE) of your prostate. In a DRE, your provider inserts a gloved finger into your rectum to check if your prostate is large, tender, or irregular in any other way.
- Order medical tests, if needed, such as:
What are the treatments for BPH?
Not everyone needs treatment for BPH. Treatment options depend on how much your symptoms bother you, your health, age, and the size of your prostate:
Lifestyle changes may improve mild symptoms. They include:
- Drinking less before bedtime or going out
- Avoiding or cutting back on beverages with caffeine and alcohol
- Bladder training and exercising the muscles that control urine flow
- Preventing or treating constipation
Medicines can help mild to moderate symptoms by:
- Stopping the prostate from growing
- Shrinking the prostate
- Relaxing muscles to improve urine flow
Sometimes combining 2 types of medicine helps more than taking just one type of medicine.
Medical procedures can help improve moderate to severe BPH symptoms when medicines don't help enough. There are several different types of procedures. They all use an instrument inserted into the urethra to either:
- Widen the urethra
- Destroy part of the prostate with heat
Surgery may be helpful when symptoms are severe, other treatments haven't helped, or you have another problem, such as bladder damage. Different types of surgery are used to:
- Remove part or all of the prostate
- Make cuts in the prostate to take pressure off the urethra
Most BPH surgery is done with tools inserted into the urethra.
Your provider can explain the possible benefits and side effects of your treatment options so you can decide what's best for you.
Can BPH be prevented?
Researchers haven't found ways to prevent BPH. You can take care of your prostate health by:
- Talking with your provider about your risk for developing an enlarged prostate
- Getting regular checkups
- Paying attention to your symptoms so you can get treatment early if you see signs of BPH
NIH: National Institute of Diabetes and Digestive and Kidney Diseases
- Benign Prostatic Hyperplasia (BPH) (American Academy of Family Physicians) Also in Spanish
- Prostate Enlargement: Benign Prostatic Hyperplasia (BPH) (National Institute of Diabetes and Digestive and Kidney Diseases)
Diagnosis and Tests
- Blood in Urine (National Library of Medicine) Also in Spanish
- Prostate MRI (Magnetic Resonance Imaging) (American College of Radiology; Radiological Society of North America) Also in Spanish
- Prostate Tests (National Institute of Diabetes and Digestive and Kidney Diseases)
- Prostate-Specific Antigen (PSA) Test (National Cancer Institute) Also in Spanish
- Ultrasound - Prostate (American College of Radiology; Radiological Society of North America) Also in Spanish
- Urinary Retention (National Institute of Diabetes and Digestive and Kidney Diseases) Also in Spanish
Treatments and Therapies
- Saw Palmetto (National Center for Complementary and Integrative Health)
- ClinicalTrials.gov: Prostatic Hyperplasia (National Institutes of Health)
Journal Articles References and abstracts from MEDLINE/PubMed (National Library of Medicine)
- Article: Serum organic acid metabolites can be used as potential biomarkers to...
- Article: Sinomenine Hydrochloride Can Ameliorate Benign Prostatic Hyperplasia by Lowering the 5α-Reductase...
- Article: Correlation Between Benign Prostatic Hyperplasia/Lower Urinary Tract Symptoms and Renal Function...
- Enlarged Prostate (BPH) -- see more articles
- Digital rectal exam (Medical Encyclopedia) Also in Spanish
- Enlarged prostate (Medical Encyclopedia) Also in Spanish
- Enlarged prostate - after care (Medical Encyclopedia) Also in Spanish
- Prostate removal (Medical Encyclopedia) Also in Spanish
- Prostate resection - minimally invasive (Medical Encyclopedia) Also in Spanish
- Urinary Retention (National Institute of Diabetes and Digestive and Kidney Diseases)