Overview
What is benign prostatic hyperplasia?
Benign prostatic hyperplasia, known as BPH, is an enlargement of the prostate gland. You might hear BPH
called prostate gland enlargement or bladder outlet obstruction.
BPH is not cancer. It does not cause cancer. It is not a life-threatening condition. But BPH commonly
causes symptoms that can affect quality of life. And, while rare, it can cause serious health issues in later
stages of the disease.
The prostate
The prostate is a walnut-sized gland at the base of the bladder. See Figure 1. It makes fluid that helps carry sperm
during ejaculation. The tube that carries urine from the bladder is called the urethra. It passes through the center of
the prostate.
With BPH, the prostate becomes enlarged. This makes it harder for urine to pass through the prostate. See Figure 2.
An enlarged prostate gland can cause uncomfortable urinary symptoms such as:
• An increase in the urge to urinate.
• A slow urine stream.
• Straining to urinate.
• A feeling of urine still in the bladder.
• Taking a long time to empty your bladder.
• Getting up multiple times a night to urinate.
An enlarged prostate also can cause bladder, urinary tract and kidney problems.
Facts about benign prostatic hyperplasia
As men grow older, BPH is a common condition. In the U.S. it affects more than 26 million men each year. By
age 60, half of all men have an enlarged prostate. By age 80, most men have an enlarged prostate. Of those with
an enlarged prostate, about half have symptoms of BPH.
It isn’t entirely clear what causes the prostate to enlarge. Nor is it clear why some men have symptoms and
others don’t. As men grow older, changes in the balance of sex hormones may play a role in BPH.
Risk factors for BPH include:
• Aging. An enlarged prostate gland rarely causes signs and symptoms in men younger than age 40. But by
age 60, about one-third of men experience moderate to severe symptoms. And by age 80 about half do.
• Family history. A blood relative, such as a father or a brother, with prostate problems means you’re more
likely to have problems.
• Diabetes and heart disease. Studies show that diabetes as well as heart disease and use of beta blockers
might increase the risk of BPH.
• Lifestyle. Obesity increases the risk of BPH. Exercise can lower your risk.
A number of treatments are available for enlarged prostate. Treatment options include medications, minimally invasive
therapies and surgery. To decide the best treatment option for you, you and your health care provider will consider
your symptoms, the size of your prostate, other health conditions you might have and your treatment goals.
This information explains the symptoms of BPH. It explains how BPH is diagnosed and treated. If you have questions
about this information or about your BPH diagnosis and treatment, be sure to reach out to your health care team. They
are here to help.
What are the symptoms of benign prostatic hyperplasia?
Common signs and symptoms of BPH, called lower urinary tract symptoms or LUTS, include:
• Frequent or urgent need to urinate.
• Increased need to urinate at night. This is called nocturia.
• Difficulty starting urination.
• Weak urine stream or a stream that stops and starts.
• Not being able to completely empty the bladder.
The severity of symptoms in people who have BPH differs from person to person. But, over time, symptoms
tend to get worse slowly.
The size of your prostate doesn’t always determine how severe your symptoms may be. Some men with only
slightly enlarged prostates have symptoms that bother them. Others with very enlarged prostates have only
minor symptoms.
Emptying and storage symptoms
The symptoms of BPH are often separated into two categories:
Emptying symptoms, also called voiding symptoms. These symptoms are caused by an obstruction in
the lower urinary tract that makes it more difficult to pass urine. Symptoms include slow urine stream,
splitting or spraying, straining to urinate, and a urine stream that starts and stops.
Symptoms also include trouble starting to urinate, which is called hesitancy. Dribbling urine as you are
finishing up is called terminal dribble. But this condition is not always caused by BPH.
Storage symptoms. These symptoms are caused by changes in how you are able to store urine. Symptoms
include changes in bladder sensations. They also include an increase in how often you pass urine during
the day and at night. You might hear increased nighttime urination called nocturia. Symptoms also
include leaking urine and an urgency to urinate.
Complications of benign prostatic hyperplasia
Most men with an enlarged prostate don’t develop complications. However, complications of an enlarged
prostate can include:
• Sudden inability to urinate, also called acute urinary retention. This is often painful. You may need
to have a thin tube, called a catheter, inserted into your bladder to drain the urine. Some men with an
enlarged prostate need surgery to treat acute urinary retention.
• Urinary tract infections. These infections are often called UTIs. Not fully emptying your bladder can
increase the risk of infection in your urinary tract. If you often have UTIs, you might need surgery to
remove part of the prostate.
• Bladder stones. These are usually caused when you are not able to completely empty the bladder. Bladder
stones can cause infection, bladder irritation and blood in the urine. They can also obstruct how urine flows.
• Bladder damage. A bladder that has not emptied completely can stretch and become weak over time.
Then the muscular wall of the bladder no longer contracts properly. This makes it harder to fully empty
the bladder.
• Kidney damage. Pressure in the bladder from urinary retention can cause damage to the kidneys. And it can
allow bladder infections to reach the kidneys.
• Hematuria. This is also called benign prostatic bleeding. This means you pass blood in the urine. This is
caused by an increase in the number of blood vessels that cover the surface of an enlarged prostate.
All these complications must be treated. Acute urinary retention and kidney damage can be serious
health issues.