Benign prostatic hyperplasia (BPH) is a condition in which the prostate gland grows larger than normal, but the growth is not caused by cancer.
The prostate has two main growth phases. The first growth phase happens early in puberty, when the prostate doubles in size. The second growth phase starts around age 25 and continues throughout life. 1 BPH often occurs late in the second growth phase.
View full-sized image Your prostate sits below your bladder and surrounds the urethra at the neck of the bladder.
Benign prostatic hyperplasia is also called enlarged prostate, benign prostatic hypertrophy, or benign prostatic obstruction.
Experts estimate that BPH affects 5% to 6% of men ages 40 to 64 and 29% to 33% of those ages 65 and older. 2 BPH is the most common prostate problem in men older than age 50. 1 BPH rarely causes symptoms in men younger than age 40. 1
You are more likely to develop BPH if you
An enlarged prostate can cause problems with emptying your bladder. As the prostate grows, it squeezes the urethra. The bladder muscles have to work harder to push urine through the narrowed urethra, which might make your urinary symptoms worse. Eventually, the bladder muscles may weaken and be unable to empty completely, leaving some urine in the bladder. This condition is called urinary retention.
Other complications can include
If you have BPH, you may have
Some medicines can make BPH symptoms worse. Tell a health care professional if you are taking
BPH symptoms or difficulty urinating may not be directly related to the size of your prostate. Sometimes, a large prostate may not affect urinating and cause few symptoms. Other times, a slightly enlarged prostate may interfere with urinating and cause more symptoms.
You should discuss any urinary symptoms with a health care professional. Some of these symptoms could be caused by other urinary problems, such as
Tell a health care professional right away if you
Scientists aren’t sure why BPH occurs. They think that factors related to aging may cause BPH because BPH becomes more common with age. Changes in hormone levels as you age may also cause BPH.
A health care provider diagnoses benign prostatic hyperplasia based on
A health care professional may ask
During a physical exam, a health care professional may perform a digital rectal exam to feel your prostate. A health care professional may also check for
You may be referred to a urologist for medical tests. The tests will help diagnose lower urinary tract problems related to BPH. Test results also help health care professionals determine your treatment options. Tests may include
BPH can be treated with watchful waiting, medicines, or surgery. A health care professional will consider how severe your symptoms are and how they affect your quality of life before discussing treatment options with you.
If your prostate is slightly enlarged and your symptoms don’t affect your quality of life, a health care professional may recommend watchful waiting, also known as active surveillance. You may still have yearly checkups. Lifestyle changes may also help reduce your symptoms. For example, try to
A health care professional may recommend medicines to treat your BPH such as
Research shows that a combination of an alpha blocker and a 5-ARI may work better than one medicine alone. 3
Some medicines may have minor to serious side effects. Tell a health care professional about any side effects you have while taking medicines to treat BPH.
Your health care professional may recommend a medical procedure or device to relieve your BPH symptoms. These minimally invasive surgical therapies (MIST) remove enlarged prostate tissue or widen the urethra so urine flows more easily. Examples of MIST procedures and devices include
You may need surgery to remove part or all of your prostate if
Removing some or all of your prostate can relieve symptoms but may not cure BPH. Surgeons may use different methods to remove part or all of your prostate, including transurethral resection surgery, laser surgery, electrovaporization, or robotic surgery.
After surgery, the prostate, urethra, and surrounding areas may be irritated and swollen. You may have trouble urinating. To prevent problems caused by urine staying in the bladder, you may need to use a Foley catheter for several days after surgery. A Foley catheter drains urine from your bladder, through your urethra, and into a pouch attached to your leg.
View full-sized image Foley catheter
After surgery, you may have painful muscle spasms that squeeze urine out of your bladder. These spasms will eventually stop. Your health care professional may prescribe medicines to relax your bladder muscles and prevent spasms.
You may experience complications after BPH surgery, such as
Talk with a health care professional about what to expect after surgery.
You may need more treatment if your prostate problems, including BPH, return. In some cases, these problems may return if not enough of the prostate is removed. About 10% of people who had surgery may need more surgery within 20 years. 1
A health care professional may recommend a digital rectal exam once a year or more often to check your prostate.
Researchers have not found a way to prevent BPH, but being physically active may help reduce your risk. If you have risk factors for BPH, talk with a health care professional about any lower urinary tract symptoms you have and how often you may need a prostate exam. Early treatment can help reduce the effects of BPH on your quality of life.
Researchers have not found eating, diet, or nutrition to cause or prevent BPH. However, changes in eating, diet, and nutrition could help treat or lessen some of your symptoms.
You can reduce how often you need to urinate when out in public or while sleeping by limiting how much you drink before outings and bedtime. You can also decrease the number of times you need to urinate by avoiding or reducing alcohol and caffeine intake.
NIDDK conducts and supports clinical trials in many diseases and conditions, including urologic diseases. The trials look to find new ways to prevent, detect, or treat disease and improve quality of life.
Clinical trials—and other types of clinical studies—are part of medical research and involve people like you. When you volunteer to take part in a clinical study, you help doctors and researchers learn more about disease and improve health care for people in the future.
Researchers are studying many aspects of BPH, such as what causes the prostate to grow larger and how to improve BPH medicines and surgeries.
Watch a video of NIDDK Director Dr. Griffin P. Rodgers explaining the importance of participating in clinical trials.
You can view a filtered list of clinical studies on BPH that are federally funded, open, and recruiting at www.ClinicalTrials.gov. You can expand or narrow the list to include clinical studies from industry, universities, and individuals; however, the National Institutes of Health does not review these studies and cannot ensure they are safe for you. Always talk with your health care provider before you participate in a clinical study.
[1] Langan RC. Benign prostatic hyperplasia. Primary Care. 2019;46(2):223–232. doi:10.1016/j.pop.2019.2.003
[2] National Institute of Diabetes and Digestive and Kidney Diseases. Benign Prostatic Hyperplasia and Associated Lower Urinary Tract Symptoms. In: 2024 Urologic Diseases in America: Annual Data Report. National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health; 2024. Updated April 26, 2024. Accessed June 4, 2024. www.niddk.nih.gov/about-niddk/strategic-plans-reports/urologic-diseases-in-america
[3] McConnell JD, Roehrborn CG, Bautista OM, et al. The long-term effect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia. The New England Journal of Medicine. 2003;349(25):2387–2398. doi:10.1056/NEJMoa030656
Last Reviewed June 2024 Share this page Print Facebook X Email More Options WhatsApp LinkedIn Reddit Pinterest Copy LinkThis content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by NIDDK is carefully reviewed by NIDDK scientists and other experts.
NIDDK would like to thank:
Kevin McVary, M.D., Loyola University Medical College
