What Is BPH?

Benign prostatic hyperplasia (BPH) is a common condition in which the prostate gland grows larger and presses against the urethra — the tube that carries urine out of the body. As the prostate squeezes the urethra, it can slow or block the flow of urine and irritate the bladder, leading to the urinary symptoms many men notice as they get older.

BPH becomes more common with age. It is a normal part of aging for many men, and while the symptoms can be frustrating, the condition itself is not dangerous in most cases.

BPH Is Not Prostate Cancer

The word "benign" means non-cancerous. BPH does not turn into cancer and does not raise your risk of prostate cancer. However, BPH and prostate cancer can cause similar urinary symptoms, so your urologist may still check your prostate and review your PSA to be thorough.

Common Symptoms

BPH symptoms generally fall into two categories — those caused by the blockage of urine flow (obstructive) and those caused by an irritated, overactive bladder (irritative).

Obstructive Symptoms

  • Weak or slow urinary stream
  • Trouble starting urination
  • Straining to urinate
  • Dribbling at the end of urination
  • Feeling like the bladder isn't completely empty

Irritative Symptoms

  • Urinary urgency (a sudden, strong need to go)
  • Frequent urination, especially at night (nocturia)
  • Urge incontinence (leakage before reaching the bathroom)

Symptoms vary widely from man to man and do not always match the size of the prostate — some men with very large prostates have few symptoms, while others with mild enlargement are quite bothered.

Who's at Risk?

Several factors can make BPH more likely. You may be more likely to develop BPH if you:

  • Are older — risk increases steadily with age, and BPH is very common after 50
  • Have a sedentary lifestyle — limited physical activity is associated with more symptoms
  • Have high blood pressure or diabetes — these and other metabolic conditions are linked to BPH
  • Have a family history of an enlarged prostate

How Is BPH Diagnosed?

Diagnosing BPH starts with a conversation about your symptoms and how much they bother you, followed by a few simple tests to confirm the cause and rule out other conditions.

Symptom Assessment

  • IPSS questionnaire — the International Prostate Symptom Score rates how severe and bothersome your symptoms are, and helps track them over time
  • Digital rectal exam (DRE) — a quick exam to estimate the size and feel of the prostate

Tests & Imaging

  • Urinalysis — to rule out a urinary tract infection or blood in the urine
  • Ultrasound — may be used to measure prostate size and check how well the bladder empties
  • PSA test — a blood test that helps check prostate health; it is not required in every case

Treatment Options

BPH treatment follows a "ladder" — most men start with the simplest measures and step up only if symptoms persist or worsen. The right choice depends on how bothersome your symptoms are, your prostate size, and your overall health and goals.

1. Lifestyle Changes

  • Limit caffeine and alcohol, which can irritate the bladder
  • Avoid drinking fluids late in the evening to reduce nighttime trips
  • Try pelvic floor (Kegel) exercises to improve bladder control

2. Medications

  • Alpha blockers — relax the muscle in the prostate and bladder neck for faster symptom relief
  • 5-alpha reductase inhibitors (5-ARIs) — shrink the prostate over time; the difference in symptoms is usually noticed about a year after starting, and they can have sexual side effects
  • PDE5 inhibitors — relax the smooth muscle in the bladder and prostate, with no sexual side effects (and a benefit for erectile function)
  • Combination therapy — pairing two medication types may work better for some men

For a closer look at each drug class, see our BPH medications & lifestyle guide.

3. Procedures & Surgery

Considered when symptoms don't improve with medication, or when complications develop. Modern urology offers several minimally invasive options in addition to traditional surgery:

  • TURP (transurethral resection of the prostate) — the traditional, time-tested surgery that removes obstructing prostate tissue
  • Aquablation — a robotically guided water-jet procedure that removes prostate tissue
  • UroLift — tiny implants that hold the prostate tissue open without cutting
  • ThuLEP — laser enucleation that removes obstructing tissue, well suited to larger prostates
  • Prostate artery embolization (PAE) — an interventional radiology procedure that shrinks the prostate by reducing its blood supply
  • Robotic simple prostatectomy — minimally invasive removal of the inner prostate, often chosen for very large glands

Not sure which is right for you? Our side-by-side comparison of BPH procedures walks through the trade-offs.

What About Natural Treatments?

Many supplements are marketed for prostate health. The evidence is mixed — here is what the research currently shows:

Possibly Helpful

  • Pygeum africanum
  • Beta-sitosterol

Not Effective

  • Saw palmetto — high-quality studies have shown it does not help BPH symptoms

Always tell your urologist about any supplements you take, since some can interact with medications or affect your PSA results.

Complications to Watch For

For most men BPH is a quality-of-life issue, but if it is left untreated and the bladder cannot empty properly, it can lead to more serious problems:

  • Urinary retention — a sudden inability to urinate at all, which is a medical emergency
  • Bladder infections — from urine that sits in an incompletely emptied bladder
  • Bladder stones — which can form from retained urine
  • Long-term bladder damage — the bladder muscle can weaken over time
  • Long-term kidney damage — from back-pressure when the bladder stays full

Regular follow-ups are important to track your progress and adjust treatment as needed. If you suddenly cannot urinate, have a fever with urinary symptoms, or see blood in your urine, contact us promptly.

Frequently Asked Questions

Does BPH mean I have or will get prostate cancer?

No. BPH is benign (non-cancerous) and does not turn into or cause prostate cancer. Because the two can cause similar urinary symptoms, your urologist may still examine your prostate and review your PSA to be thorough.

Do I have to treat BPH?

Not always. If your symptoms are mild and not bothersome, careful monitoring ("watchful waiting") with lifestyle adjustments may be all you need. Treatment is recommended when symptoms affect your quality of life or complications develop.

Will I need surgery?

Most men are managed successfully with lifestyle changes and medication. Procedures are reserved for men whose symptoms don't improve with medication, who can't tolerate the medications, or who develop complications. Many of today's procedures are minimally invasive with quick recovery.

Will BPH treatment affect my sex life?

It depends on the treatment. Some medications (5-ARIs) can affect sexual function, while others (PDE5 inhibitors) may improve it. Most minimally invasive procedures aim to preserve sexual function. We'll discuss the trade-offs of each option with you before deciding.

Relief From Bothersome Urinary Symptoms Is Within Reach

If a weak stream, frequent trips to the bathroom, or waking up at night are affecting your life, you have more options than ever. Our team will evaluate your symptoms, explain the full treatment ladder, and tailor a plan to your goals — from simple lifestyle steps to advanced minimally invasive procedures.

  • ✅ Thorough evaluation, including IPSS, exam, and appropriate testing
  • ✅ Full range of medications and minimally invasive procedures
  • ✅ Treatment matched to your prostate size, symptoms, and goals
  • ✅ Experienced team with ongoing follow-up
Schedule Your Consultation

Call 678-344-8900 to speak with our team