Enlarged prostate (BPH): symptoms, tests, treatment and which doctor to see
What an enlarged prostate is, the urinary symptoms it causes, the tests that rule out other problems, the treatment options and when to get help fast.
Also known as: BPH; Benign Prostatic Hypertrophy; Benign prostatic hyperplasia
What an enlarged prostate is
The prostate is a walnut-sized gland below the bladder in men, wrapped around the urethra, the tube that carries urine out of the body. It commonly grows larger with age. This non-cancerous growth is called benign prostatic hyperplasia (BPH). As the gland enlarges, it can squeeze the urethra and make the bladder work harder.
BPH is not cancer and does not turn into cancer, although both can occur in the same man and cause similar symptoms. The size of the prostate does not always match the symptoms: some men with a large gland have few problems, and others with a small one have many.
Symptoms
- Weak urine stream, or a stream that stops and starts
- Difficulty starting urination, or straining
- Frequent urination during the day
- Urgency — a sudden need to go that is hard to hold
- Passing urine at night, waking once or more
- Dribbling at the end of urination
- Feeling the bladder has not emptied fully
Many men put these down to age and do not mention them, but they can be treated and they deserve a check, because other conditions — infection, stones, diabetes, bladder problems and prostate cancer — can cause similar symptoms.
Who is at risk
BPH becomes more common from middle age and is very common in older men. Risk is higher with a family history, obesity, type 2 diabetes, heart disease and physical inactivity. Some medicines, including certain cold and allergy remedies (antihistamines and decongestants), can worsen symptoms or trigger sudden inability to pass urine.
How it is diagnosed
Your doctor will ask about your symptoms, often using a short questionnaire, and may suggest a few days of a bladder diary. Tests include:
- Digital rectal examination — a gloved finger in the back passage to feel the size and texture of the prostate
- Urine test — for infection, blood and sugar
- PSA (prostate-specific antigen) — a blood test that can be raised by BPH, infection or cancer; your doctor will discuss whether it is useful for you
- Uroflowmetry — you pass urine into a machine that measures the strength of the flow
- Ultrasound — of the kidneys, bladder and prostate, often with a post-void residual measurement of how much urine stays in the bladder after you go
- Kidney function blood tests
Some men need cystoscopy, a camera test of the urethra and bladder, or more detailed pressure tests, especially before surgery.
Keeping a bladder diary for three days — noting when you pass urine, roughly how much, what you drink and when you leak or feel urgency — is one of the most useful things you can bring to the appointment. It often shows patterns, such as large amounts of fluid in the evening or heavy tea drinking, that simple changes can fix.
Which doctor to see
A general physician can assess mild symptoms and start treatment. A urologist should be seen for troublesome symptoms, blood in the urine, a raised PSA, an abnormal examination, retention of urine, repeated infections or stones, or when surgery is being considered.
You can find urologists in Bengaluru on The Doctor Index, each with a registration you can check.
Treatment
Lifestyle changes
For mild symptoms, lifestyle changes may be enough: drinking less in the evening, cutting down on tea, coffee and alcohol, emptying the bladder before bed and before travel, double voiding (waiting and trying again), avoiding constipation, and reviewing medicines that worsen symptoms.
Medicines
- Alpha blockers, such as tamsulosin, relax the muscle of the prostate and bladder neck and improve flow within days or weeks. They can cause dizziness on standing and affect ejaculation.
- 5-alpha reductase inhibitors, such as finasteride and dutasteride, slowly shrink the prostate over months. They lower PSA, so tell any doctor checking your PSA that you take one.
- Combinations of the two, and other medicines for urgency or for men who also have erection problems.
Procedures and surgery
Surgery is considered when symptoms remain troublesome, or for complications such as retention, repeated infections, bladder stones or kidney damage. TURP (transurethral resection of the prostate) removes the inner part of the gland through the urethra. Laser prostate surgery, such as HoLEP, is another option. Newer minimally invasive procedures suit some men. Your urologist will explain the effects on ejaculation and continence.
Do not stop prescribed prostate medicines on your own, and be wary of herbal products advertised for prostate health — evidence for them is weak.
Left untreated for a long time, a badly obstructed bladder can stretch and weaken, urine can back up to the kidneys and harm them, and stones and infections become more likely. That is one more reason not to ignore worsening symptoms, even if you have learned to live with them.
Living with it: follow-up
- A review a few weeks after starting medicine, then yearly
- Reporting new blood in the urine, pain or fever
- Checking with your doctor or pharmacist before taking cold, allergy or other new medicines
- Kidney and residual urine checks if your bladder does not empty well
When it is an emergency
Call 112 or 108, or go to the nearest emergency department, for:
- Being unable to pass urine at all, with a painful, swollen lower abdomen — acute urinary retention needs a catheter urgently
- Fever, chills and back pain with urinary symptoms
- Heavy blood in the urine, or passing clots
Questions to ask at your appointment
- Are my symptoms caused by BPH or something else?
- Do I need a PSA test, and what would the result mean?
- What are the side effects of the medicine you suggest?
- How long will it take to work?
- When would surgery be advisable, and what are the options?
- Which medicines should I avoid?
Common questions
Questions people ask
- Does an enlarged prostate mean I have cancer?
- No. BPH is a non-cancerous enlargement and does not turn into cancer. However, prostate cancer can cause similar symptoms and can occur alongside BPH, so your doctor may examine your prostate and discuss a PSA test.
- Do I have to have surgery for an enlarged prostate?
- Most men do not. Mild symptoms often improve with lifestyle changes, and medicines help many more. Surgery is considered when symptoms stay troublesome despite medicine, or for complications such as retention, stones or repeated infections.
- Will prostate surgery affect my sex life?
- Erections are not usually affected by surgery for BPH, but many men afterwards ejaculate backwards into the bladder (dry orgasm). Some newer procedures aim to preserve ejaculation. Discuss your priorities with your urologist before deciding.
- Why must I avoid some cold medicines?
- Antihistamines and decongestants found in many cold and allergy remedies can tighten the bladder outlet or weaken the bladder, and in men with BPH can trigger sudden inability to pass urine. Check with a pharmacist or doctor first.
This condition is usually assessed by a urologist. Every profile shows the doctor’s registration and what has been checked.
Urologists in Bangalore
A few urologists listed on The Doctor Index. They are shown because of their speciality, not a stated interest in Enlarged Prostate (BPH); ask the clinic whether the doctor sees it.
Related conditions
Practical reading
All postsSources
- MedlinePlus, US National Library of Medicine — Enlarged Prostate (BPH)
- NIDDK, US National Institutes of Health — Prostate Enlargement (Benign Prostatic Hyperplasia)
- MedlinePlus, National Library of Medicine — Enlarged Prostate (BPH) — Public-domain health-topic summary
Enlarged prostate (BPH): symptoms, tests, treatment and which doctor to see is original text by The Doctor Index; the compiled source draft was used for research. Source: MedlinePlus, National Library of Medicine. Orphadata Science: Free access data from Orphanet. © INSERM 1999; July 2026 data, CC BY 4.0. This product uses the Human Phenotype Ontology (hp/releases/2026-09-01). Only sources listed for this article apply. Source material has been selected and arranged; HPO definitions are reproduced without alteration. No source organisation endorses this compilation. Köhler S et al. The Human Phenotype Ontology project: linking molecular biology and disease through phenotype data. Nucleic Acids Research 2014;42(D1):D966–D974. doi:10.1093/nar/gkt1026.
General information, not advice about your situation. Errors can be reported through the corrections process. Reference TDI-C-0831.