Enlarged Prostate (BPH): Symptoms and Warning Signs

Enlarged prostate BPH symptoms diagnosis treatment and warning signs form “BPH care.” This guide explains BPH care in clear, plain language.

BPH is noncancerous prostate growth that becomes more common with age ^2,3. It can affect urine flow, sleep, and daily plans ^1,3.

Other prostate warning signs also need fast medical review ^2,3. Knowing the signs and choices can help you prepare for a medical visit.

Benign prostatic hyperplasia, or BPH, means noncancerous growth of prostate tissue ^2,4. It is also called an enlarged prostate ².

The prostate is a gland in the male reproductive system ³. It makes fluid that becomes part of semen ³.

The prostate sits below the bladder ^2,3. It surrounds part of the urethra, the tube that carries urine outward ^2,3.

Growing prostate tissue can press against the urethra ^2,3. This pressure can slow or block urine leaving the bladder ³.

The bladder muscle must work harder to push urine through the narrowed area ². Over time, that muscle may weaken ^2,3.

A weak bladder may not empty fully ^2,3. The urine left behind is called residual urine.

Prostate size does not reliably predict BPH symptoms ^1,2. A large prostate may cause few symptoms.

A slightly enlarged prostate may cause major urine problems. Some people with prostate growth have no symptoms.

BPH symptoms are rare before age 40 ^2,8. The chance of BPH rises as a person grows older ^2,3.

The following traits and health issues are linked with BPH:

These links do not prove that each condition causes prostate growth. Researchers still do not know the exact cause of BPH ^2,3.

The exact cause of an enlarged prostate remains unclear. The prostate has a growth phase during puberty ².

Changes in hormone levels may also play a role ^2,3. The prostate commonly continues to grow during adult life ^2,3.

BPH is not cancer and does not increase prostate cancer risk ^3,7. However, BPH and prostate cancer can occur together ⁷.

Both conditions may cause similar urine symptoms ^2,7. Infection and other bladder problems can cause similar symptoms too ^2,8.

Researchers have not found a proven way to prevent BPH ³. A medical review can help find the cause of new urinary changes.

BPH symptom scores group patients by severity into mild, moderate, and severe categories ⁴. Storage symptoms affect holding urine ⁴.

Voiding symptoms affect urine leaving the bladder ⁴. Some people have symptoms from both groups.

Storage symptoms affect when and how strongly urination is needed. Common examples include the following problems:

Nocturia means waking during the night to urinate. It can disturb sleep and make daily tasks harder.

A bladder diary can help assess nighttime urination ^4,5. It records when you urinate and how much urine passes.

Voiding symptoms appear as urine leaves the bladder. They may include the following changes:

Symptoms may slowly worsen, stay stable, or improve. Their severity does not always match the amount of prostate growth.

Urine symptoms can have causes other than BPH ^2,8. These include infection, bladder disease, prostate inflammation, stones, nerve problems, or cancer ^2,8.

Discuss new or changing urine symptoms with a health professional ^2,8. Even a slightly enlarged prostate may interfere with urination ^2,8.

These warning signs require emergency or prompt medical care:

Fever, chills, pain, and urgency can occur with a urinary infection. Read our UTI symptoms and treatment guide for more information.

Diagnosis starts with a health history and physical exam ^2,3. Tests may help identify BPH and other causes.

A primary care clinician may perform the first assessment. Some people are sent to a urologist, a urinary system specialist ^2,7.

Your clinician may ask when symptoms began ². They may ask how often the symptoms occur ².

The review may cover past urinary infections and major surgeries ². It may also cover prostate problems within your family ².

Fluid intake before bedtime may affect nighttime urination ². Tell the clinician about caffeine and alcohol use ².

Bring a list of all prescription and over-the-counter medicines. Several medicines can make urine problems worse ².

These products deserve special attention during the medicine review:

Ask your clinician to review these products before making changes. Your medical history may help guide the assessment ².

A symptom survey can rate the type and severity of urine problems ⁴. One version is the International Prostate Symptom Score ⁴.

Another symptom score is the American Urological Association symptom score ⁴. Clinicians can use the score to track changes after treatment ⁴.

A bladder diary records the time and amount of each urination ^4,5. It may be used as an optional part of a BPH evaluation ^4,5.

Large nighttime amounts may point toward high nighttime urine output. Urinary symptoms may suggest an overactive bladder ⁴.

The clinician may examine your abdomen for a full bladder or pain ^2,4. The groin and external genital area may also be checked ^2,4.

A digital rectal examination checks the prostate through the rectum. A gloved finger checks the gland’s size, shape, firmness, and surface ^4,7.

A smooth, enlarged prostate often fits BPH ⁴. A hard or uneven area may be detected during a prostate exam ^4,7.

Urinalysis is a laboratory check of a urine sample. It can find infection, blood, or another illness.

A blood test may be used when kidney problems are a concern. Test results can show whether kidney problems are present.

PSA means prostate-specific antigen, a protein made by the prostate. Prostate growth can raise the PSA level.

Illness, surgery, recent procedures, or prostate cancer can also raise PSA. Therefore, a high PSA result does not confirm cancer.

The benefits and limits of PSA testing deserve careful thought. Discuss those points with your clinician before choosing the test.

A urine-flow test measures the speed and amount of urine passed. Results can track whether urine flow changes over time.

A postvoid residual test checks urine left after urination. It may use ultrasound or a catheter placed into the bladder.

Ultrasound uses sound waves to create pictures. It can measure prostate size and examine the urinary tract ^3,5.

Complex cases may require one or more special tests. These tests can include the following options:

These tests are not part of every enlarged prostate diagnosis. The clinician selects them based on the earlier findings.

BPH treatment options depend on symptoms and their effect on daily life ^2,5. Prostate size, age, and overall health also guide the choice ^3,5.

Bladder or kidney problems can affect the treatment plan. Personal preferences also matter when several choices may help.

Mild symptoms may not need immediate treatment ^5,7. Watchful waiting means tracking symptoms before starting medicine or a procedure ^2,5.

Follow-up remains important during this approach. Some BPH symptoms can improve without treatment.

These practical steps may ease mild urine problems:

Do not change a prescription without speaking with its prescriber. Ask about safer choices if a medicine affects urine flow.

Medicines are often used for mild or moderate symptoms. Each medicine group works in a different way.

Alpha blockers relax muscle around the prostate and bladder neck. This action can make urination easier.

The time BPH medicines take to work can vary. Examples include tamsulosin, alfuzosin, doxazosin, silodosin, and terazosin.

Possible side effects include dizziness. Semen may also move backward into the bladder during ejaculation.

5-alpha reductase inhibitors block hormone changes that support prostate growth. These medicines can shrink an enlarged prostate.

Finasteride and dutasteride are examples. They may take up to six months to work well.

They can also cause sexual side effects. Ask how those effects may relate to your personal priorities.

Tadalafil often treats erectile dysfunction. It can also treat symptoms from an enlarged prostate.

Combination therapy uses two types of medicine together. One option combines an alpha blocker with a 5-alpha reductase inhibitor.

A clinician may suggest this approach when one medicine gives too little relief. Ask about side effects and possible medicine interactions.

A procedure may help when medicines provide too little relief ^3,5. It may also suit someone who prefers not to use medicine.

Procedures may be considered in the following situations:

Some less invasive procedures use a tool passed through the urethra ³. These procedures may widen the urethra ³.

Other options use heat to destroy part of the prostate ³. The goal is to improve urine flow through the narrowed area.

Transurethral resection of the prostate is shortened to TURP. A surgeon passes a scope through the urethra.

The surgeon then removes inner prostate tissue. TURP can improve symptoms and urine flow soon after treatment.

Transurethral incision of the prostate is shortened to TUIP. The surgeon makes small cuts in the prostate.

These cuts reduce pressure on the urethra. TUIP may suit a small or slightly enlarged prostate.

Possible procedure risks include bleeding, infection, and urine leakage. Erectile problems can also occur.

Ejaculation may change after some prostate procedures. Semen may move into the bladder instead of leaving through the penis.

Benefits and risks differ across procedures. Discuss expected recovery, sexual effects, and other choices before deciding.

Ongoing blockage can leave urine inside the bladder ². Retained urine may raise the chance of further problems ^2,8.

Possible BPH complications include the following conditions:

Follow-up can track symptoms, urine flow, and bladder emptying ^4,5. Contact your clinician if symptoms worsen or medicine causes unwanted effects.

Treatment should match the burden of your symptoms ^2,5. Prostate size, general health, and complications also matter ^3,5.

Sexual priorities and personal preferences deserve discussion. Before choosing care, consider asking these questions:

Understanding BPH care can help you compare your options. Mild symptoms may only need tracking and practical changes ^3,5.

Medicines can relax prostate muscles or reduce prostate size ^3,5. Procedures may help when symptoms remain severe or complications develop ^3,5.

Painful urgency with fever and chills also needs medical care right away ^2,3. Early treatment can help reduce BPH’s effects on quality of life ^2,8.