Benign prostatic hyperplasia (BPH) – Symptoms, causes, Diagnosis and Treatment


Benign prostatic hyperplasia (BPH) — also called prostate gland enlargement — is a common condition as men get older. An enlarged prostate gland can cause uncomfortable urinary symptoms, such as blocking the flow of urine out of the bladder. It can also cause bladder, urinary tract or kidney problems.

There are several effective treatments for prostate gland enlargement, including medications, minimally invasive therapies and surgery.


The severity of symptoms in people who have prostate gland enlargement varies, but symptoms tend to gradually worsen over time. Common signs and symptoms of BPH include:

  • Frequent or urgent need to urinate
  • Increased frequency of urination at night (nocturia)
  • Difficulty starting urination
  • Weak urine stream or a stream that stops and starts
  • Dribbling at the end of urination
  • Inability to completely empty the bladder

Less common signs and symptoms include:

  • Urinary tract infection
  • Inability to urinate
  • Blood in the urine


The prostate gland is located beneath your bladder. The tube that transports urine from the bladder out of your penis (urethra) passes through the center of the prostate. When the prostate enlarges, it begins to block urine flow.

Most men have continued prostate growth throughout life. In many men, this continued growth enlarges the prostate enough to cause urinary symptoms or to significantly block urine flow.

It isn't entirely clear what causes the prostate to enlarge. However, it might be due to changes in the balance of sex hormones as men grow older.


Complications of an enlarged prostate can include:

  • Sudden inability to urinate (urinary retention). 
  •  Urinary tract infections (UTIs). 
  •  Bladder stones. 
  •  Bladder damage. 
  •  Kidney damage. 


Your doctor will start by asking detailed questions about your symptoms and doing a physical exam. This initial exam is likely to include:

  • Digital rectal exam. 
  •  Urine test. 
  • Blood test. 
  •  Prostate-specific antigen (PSA) blood test. 

 After that, your doctor might recommend additional tests to help confirm an enlarged prostate and to rule out other conditions. These tests include:

  • Urinary flow test. 
  •  Postvoid residual volume test. 
  •  24-hour voiding diary. 

If your condition is more complex, your doctor may recommend:

  • Transrectal ultrasound. 
  •  Prostate biopsy. 
  •  Urodynamic and pressure flow studies. 
  •  Cystoscopy. 


A wide variety of treatments are available for enlarged prostate, including medication, minimally invasive therapies and surgery. The best treatment choice for you depends on several factors, including: The size of your prostate, Your age, Your overall health, the amount of discomfort or bother you are experiencing

  • Medication

Medication is the most common treatment for mild to moderate symptoms of prostate enlargement. The options include: Alpha blockers, 5-alpha reductase inhibitors, Combination drug therapy, Tadalafil (Cialis). 

  • Minimally invasive or surgical therapy
  • Transurethral resection of the prostate (TURP)
  • Transurethral incision of the prostate (TUIP)
  • Transurethral microwave thermotherapy (TUMT)
  • Laser therapy
  • Prostatic urethral lift (PUL)
  • Embolization
  • Open or robot-assisted prostatectomy

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