Patient information from BMJ

Enlarged prostate: what is it?

Last published:Mar 11, 2025

The prostate gland is part of the male reproductive system. The prostate can get larger as men get older. This is called benign prostatic hyperplasia, or BPH for short. An enlarged prostate can cause problems, such as having to get up at night to urinate.

But an enlarged prostate isn't usually a serious health problem and doesn’t always need treatment.

What is the prostate?

The prostate is a small, solid gland about the size of a walnut. Men have this gland to help produce the fluid in semen.

The prostate is located at the base of your bladder. It is wrapped around your urethra, the tube that carries urine and semen out of your body.

If the size or shape of your prostate changes, it can make the urethra more narrow. This can make it difficult for urine to pass out.

Many men's prostate glands get larger as they get older. Doctors may call it having an enlarged prostate or benign prostatic hyperplasia (BPH).

BPH is not cancer and it isn't usually a serious health problem. But the symptoms of BPH can be difficult to live with.

Many men find it difficult to talk to their doctor about prostate problems. But there's no need to be embarrassed. Your doctor will have seen many men with your symptoms.

What are the symptoms of benign prostatic hyperplasia (BPH)?

You might notice some of the symptoms of BPH as you get older. It's important to get these symptoms checked by a doctor, because some BPH symptoms are similar to those of more serious conditions such as prostate cancer.

Your doctor might also be able to give you some simple advice that can help your symptoms without any treatment. Symptoms of an enlarged prostate include:

• having to wait before you can start urinating

• stopping and starting when urinating

• having to push or strain to urinate

• having a weak stream of urine

• feeling like your bladder's never quite empty

• having to urinate more often than you used to

• finding it difficult to put off urinating

• needing to get up at night to urinate

• dribbling after you pass urine

• often feeling desperate to urinate (this is called urgency).

You may hear doctors describe these problems as lower urinary tract symptoms (LUTS).

Having an enlarged prostate can also affect you in other ways. For example, you might:

• feel tired because you never sleep through the night,

• feel anxious during the day if you're not close to a toilet, or

• find that it disrupts your daily life, for example, by not going out as much.

Your doctor can check your prostate during a physical examination. If you have a digital rectal examination, your doctor or nurse uses a finger to check inside your bottom. They will be able to feel your prostate through the wall of your rectum.

Do I need treatment?

Only you can decide whether your symptoms are bothering you so much that you’d like some treatment. If you don’t find your symptoms too troublesome your doctor may suggest watchful waiting. This means not starting treatment but seeing your doctor regularly to monitor your symptoms.

Your doctor might suggest some things that may help with your symptoms, such as avoiding drinking large amounts of liquid at any one time. Cutting back on caffeine and alcohol might also be helpful, as caffeine and alcohol can stimulate your bladder. While they might not help everyone, some people find these tips useful. For more, see our patient information: Enlarged prostate: what are the treatment options?

When you go for check-ups your doctor will ask whether your symptoms have got any worse and if you think you would like any treatment.

Your doctor might suggest that you have treatment if they think that there is a danger that your symptoms could lead to worse problems.

What happens next?

No one can tell you for certain whether your symptoms will get worse over time. But BPH doesn't usually get worse quickly, so you don't have to rush into having treatment.

Many men find that their symptoms gradually get worse as they get older. But this is not always the case.

• Some men find that their symptoms change slowly.

• Others find that their symptoms don't change at all.

• Some men even find that their symptoms get better on their own.

Although it's usually not serious, BPH can sometimes cause complications.

For example, it can make you unable to urinate at all. This is called acute urinary retention. It affects less than 3 out of every 100 men with BPH.[1]​ But if it happens, it needs to be treated urgently, usually with surgery. 

Getting treatment for BPH can reduce your chance of getting complications. Still, doctors often advise men to wait and see what happens before they start treatment. This is because symptoms don’t usually change very quickly. Some treatments for BPH may also cause side effects themselves.

If your symptoms do change quickly, you should see your doctor right away.

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