An enlarged prostate is an increase in the size of the prostate. It isn’t caused by cancer. The medical term for an enlarged prostate is benign prostatic enlargement (BPE).
- Benign – not cancer.
- Prostatic – to do with the prostate.
- Enlargement – an increase in size.
You might also hear it called benign prostatic hyperplasia (BPH). Hyperplasia means an increase in the number of cells. It is this increase in cells that makes the prostate grow bigger (see diagram). In our information, we use the words 'enlarged prostate' to describe both BPE and BPH.
An enlarged prostate is very common in men over the age of about 50. Not all men with an enlarged prostate get symptoms. But as the prostate grows, it can press on the outside of the urethra, causing the urethra to become narrow. This can slow down or sometimes even stop the flow of urine when you try to urinate.
About 1 in 3 men over the age of 50 have urinary symptoms. The most common cause of these symptoms is an enlarged prostate.
What causes an enlarged prostate?
We still don’t really know all the things that cause the prostate to grow. But we do know about two risk factors that can increase your risk of having an enlarged prostate.
Your risk of having an enlarged prostate increases as you get older. Many men aged 50 or over have an enlarged prostate, but they don’t all get symptoms. And some men have symptoms that don't bother them.
The balance of hormones (oestrogen and testosterone) in your body changes as you get older. This may cause your prostate to grow.
Some studies show that obese men and men who have diabetes may be more likely to develop an enlarged prostate. Regular exercise may help to reduce your risk of urinary symptoms. But we still need more studies into the causes of enlarged prostate to know for certain if, and how, we can prevent it.
There is also some research that suggests you may be more at risk of developing an enlarged prostate if your father or brother has one. Again, further studies are needed to confirm this.
What are the signs and symptoms of an enlarged prostate?
An enlarged prostate is the most common cause of urinary problems in men as they get older. Possible symptoms include:
- a weak flow when you urinate
- a feeling that your bladder hasn’t emptied properly
- difficulty starting to urinate
- dribbling urine after you finish urinating
- needing to urinate more often, especially at night
- a sudden urge to urinate – you may sometimes leak before you get to the toilet.
You may not get all of these symptoms, and some men with an enlarged prostate don’t get any symptoms at all. These symptoms can also be caused by other things, such as cold weather, anxiety, other health problems, lifestyle factors, and some medicines. Blood in your urine may be a symptom of an enlarged prostate. But this is rare and is usually caused by something else.
If you have any of the symptoms above, you should visit your GP to find out what may be causing them.
Am I more likely to get prostate cancer if I have an enlarged prostate?
No, having an enlarged prostate does not increase your risk of getting prostate cancer. The two problems usually begin in different parts of the prostate. But men can have an enlarged prostate and prostate cancer at the same time.
If you’re worried about prostate cancer, talk to your GP or call our Specialist Nurses.
How might an enlarged prostate affect my life?
Having an enlarged prostate affects men in different ways. Some men can manage mild symptoms and don’t need treatment. Other men find they need to stay near a toilet. This can make it difficult to work, drive, be outdoors and attend social events. If you need the toilet a lot during the night, this can affect your sleep and make you feel more tired during the day.
Some men with an enlarged prostate find their symptoms improve over time without treatment. But for most, the symptoms will stay the same or slowly start to cause more problems over time unless they have treatment.
What other problems might an enlarged prostate cause?
A small number of men may find it difficult to empty their bladder properly – this is called urine retention. If you’ve been diagnosed with an enlarged prostate, your doctor will look at your test results to see if you’re at risk of urine retention. You may be more likely to get urine retention if:
- you’re aged 70 or over
- your prostate is very large
- you have a raised prostate specific antigen (PSA) level
- you have severe urinary symptoms and a very slow flow.
Chronic urine retention
This is where you can’t empty your bladder fully, but can still urinate a little. It usually develops slowly over time. Chronic means long-lasting. The first signs often include a weak flow when you urinate, or leaking urine at night. You may feel that your abdomen (stomach area) is swollen, or that you’re not emptying your bladder fully.
Chronic urine retention is usually painless. But the pressure of the urine can slowly stretch your bladder muscle and make it weaker. This can cause urine to be left behind in the bladder when you urinate. If you don’t empty your bladder fully, you might get a urine infection, need to urinate more often, leak urine at night, or get painful bladder stones. You might also see some blood in your urine. Chronic urine retention can damage your bladder and kidneys if it isn’t treated.
There are treatments for chronic urine retention, including:
- passing a thin, flexible tube called a catheter to drain urine from your bladder
- surgery to widen the urethra.
Acute urine retention
This is when you suddenly and painfully can’t urinate at all. It needs treating straight away. If this happens, call your doctor or nurse, or go to your nearest accident and emergency (A&E) department. They may need to drain your bladder using a catheter. Before the catheter is removed, you may be offered a medicine called an alpha-blocker. This may help stop you getting acute retention again.
How is an enlarged prostate diagnosed?
Some tests for an enlarged prostate can be done at your GP surgery. Your GP might also arrange for you to see a doctor who specialises in urinary problems (a urologist) or a specialist nurse at the hospital.
Updated: December 2017 | Due for Review: December 2020
- Alcaraz A, Hammerer P, Tubaro A, Schröder FH, Castro R. Is There Evidence of a Relationship between Benign Prostatic Hyperplasia and Prostate Cancer? Findings of a Literature Review. Eur Urol. 2009;55(4):864–75.
- Egan KB. The Epidemiology of Benign Prostatic Hyperplasia Associated with Lower Urinary Tract Symptoms. Urol Clin North Am. 2016 Aug;43(3):289–97.
- Emberton M, Fitzpatrick JM, Garcia-Losa M, Qizilbash N, Djavan B. Progression of benign prostatic hyperplasia: systematic review of the placebo arms of clinical trials. BJU Int. 2008;102(8):981–6.
- Emberton M, Fitzpatrick JM, Rees J. Risk stratification for benign prostatic hyperplasia (BPH) treatment. BJU Int. 2011 Mar;107(6):876–80.
- Fisher E, Subramonian K, Omar MI. The role of alpha blockers prior to removal of urethral catheter for acute urinary retention in men. Cochrane Database Syst Rev. 2014;(6).
- Fitzpatrick JM, Desgrandchamps F, Adjali K, Guerra LG, Hong SJ, Khalid SE, et al. Management of acute urinary retention: a worldwide survey of 6074 men with benign prostatic hyperplasia. BJU Int. 2012 Jan;109(1):88–95.
- Gacci M, Corona G, Vignozzi L, Salvi M, Serni S, De Nunzio C, et al. Metabolic syndrome and benign prostatic enlargement: a systematic review and meta-analysis: Metabolic syndrome and BPE. BJU Int. 2015 Jan;115(1):24–31.
- Jarvis TR, Chughtai B, Kaplan SA. Bladder Outlet Obstruction and BPH. Curr Bladder Dysfunct Rep. 2014 Dec;9(4):372–8.
- Konwar R, Chattopadhyay N, Bid HK. Genetic polymorphism and pathogenesis of benign prostatic hyperplasia. BJU Int. 2008;102(5):536–44.
- Lee CH, Akin-Olugbade O, Kirschenbaum A. Overview of Prostate Anatomy, Histology, and Pathology. Endocrinol Metab Clin North Am. 2011 Sep;40(3):565–75.
- Ørsted DD, Nordestgaard BG, Jensen GB, Schnohr P, Bojesen SE. Prostate-Specific Antigen and Long-Term Prediction of Prostate Cancer Incidence and Mortality in the General Population. Eur Urol. 2012 May;61(5):865–74.
- Parsons JK, Kashefi C. Physical Activity, Benign Prostatic Hyperplasia, and Lower Urinary Tract Symptoms. Eur Urol. 2008;53(6):1228–35.
- Parsons JK. Benign Prostatic Hyperplasia and Male Lower Urinary Tract Symptoms: Epidemiology and Risk Factors. Curr Bladder Dysfunct Rep. 2010 Dec;5(4):212–8.
- Public Health England. Prostate cancer risk management programme (PCRMP): benefits and risks of PSA testing [Internet]. GOV.UK; 2016. Available from: https://www.gov.uk/government/publications/prostate-cancer-risk-management-programme-psa-test-benefits-and-risks/prostate-cancer-risk-management-programme-pcrmp-benefits-and-risks-of-psa-testing
- Raheem OA, Parsons JK. Associations of obesity, physical activity and diet with benign prostatic hyperplasia and lower urinary tract symptoms: Curr Opin Urol. 2014;24(1):10–4.
- Rees J, Bultitude M, Challacombe B. The management of lower urinary tract symptoms in men. BMJ. 2014 Jun 24;348(1):g3861–g3861.
- Roehrborn CG. BPH progression: concept and key learning from MTOPS, ALTESS, COMBAT, and ALF-ONE. BJU Int. 2008;101 Suppl 3:17–21.
- Russo GI, Castelli T, Urzì D, Privitera S, La Vignera S, Condorelli RA, et al. Emerging links between non-neurogenic lower urinary tract symptoms secondary to benign prostatic obstruction, metabolic syndrome and its components: A systematic review. Int J Urol. 2015 Nov;22(11):982–90.
- Sanda MG, Beaty TH, Stutzman RE, Childs B, Walsh PC. Genetic susceptibility of benign prostatic hyperplasia. J Urol. 1994;152(1):115–9.
- Schenk JM, Kristal AR, Arnold KB, Tangen CM, Neuhouser ML, Lin DW, et al. Association of Symptomatic Benign Prostatic Hyperplasia and Prostate Cancer: Results from the Prostate Cancer Prevention Trial. Am J Epidemiol. 2011;173(12):1419–28.
- Speakman M, Kirby R, Doyle S, Ioannou C. Burden of male lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH) - focus on the UK: Burden of male LUTS suggestive of BPH. BJU Int. 2015 Apr;115(4):508–19.
- Vignozzi L, Gacci M, Maggi M. Lower urinary tract symptoms, benign prostatic hyperplasia and metabolic syndrome. Nat Rev Urol. 2016 Jan 12;13(2):108–19.
- Vignozzi L, Rastrelli G, Corona G, Gacci M, Forti G, Maggi M. Benign prostatic hyperplasia: a new metabolic disease? J Endocrinol Invest. 2014 Apr;37(4):313–22.
- Vuichoud C, Loughlin KR. Lower urinary tract symptoms, benign prostatic hyperplasia and metabolic syndrome. Can J Urol. 2015;
- Wynder JL, Nicholson TM, DeFranco DB, Ricke WA. Estrogens and Male Lower Urinary Tract Dysfunction. Curr Urol Rep [Internet]. 2015 Sep [cited 2017 Apr 6];16(9). Available from: http://link.springer.com/10.1007/s11934-015-0534-6
- Young JM, Muscatello DJ, Ward JE. Are men with lower urinary tract symptoms at increased risk of prostate cancer? A systematic review and critique of the available evidence. BJU Int. 2000;85:1037–48.