Enlarged prostate

An enlarged prostate is a long-term condition that’s not usually serious, but symptoms can be troublesome and may sometimes lead to complications.

It’s also known as benign prostatic enlargement (BPE) or benign prostatic hyperplasia (BPH).

By Wallace Health I Medically reviewed by Adrian Roberts.
Page last reviewed: October 2018 I Next review due: October 2021

What is an enlarged prostate?

The prostate is a small, walnut-sized gland that sits at the base of the bladder in men. As you age, it often gets bigger, pressing on your bladder and urethra – the tube that carries urine to your penis and out of your body. This is common in men over the age of 50, and can cause symptoms that affect your urine flow.

It’s not serious in itself but it can raise your risk of a urinary tract infection or a condition called acute urinary retention, when you can’t empty your bladder even though it’s full - this is a medical emergency.

An enlarged prostate doesn’t increase your risk of prostate cancer, but you can have both at the same time.

How to tell if you have an enlarged prostate

Typical symptoms include:

  • Difficulty starting to pass urine
  • A weak flow of urine that stops and starts
  • Needing to strain to pass urine
  • Frequent urination, especially at night
  • Getting sudden urges to pass urine
  • Feeling that you haven’t emptied your bladder properly
  • If there's blood in your urine
  • Pain when urinating
  • Urinary incontinence 

Talk to your doctor if you’re concerned about symptoms

You can book an appointment with a Spire private GP today.

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Diagnosis and tests for enlarged prostate

Some of the symptoms of an enlarged prostate are similar to those caused by prostate cancer, so it’s important to get them checked by your GP. Tests to spot the signs may include:

  • A physical examination of your back passage, stomach and genitals
  • Urine tests to check for an infection or diabetes
  • Blood tests to check your kidney function or your level of a protein called prostate-specific antigen (PSA) – raised levels may be a sign of cancer

Your GP may refer you to a urologist, a doctor who specialises in urinary problems.

Causes of enlarged prostate

The exact causes are unknown but it’s thought to be down to hormonal changes that happen as men get older. Certain things that may increase your risk include:

  • Being middle aged or older
  • Being overweight
  • Having diabetes
  • Having close relatives with an enlarged prostate

Common treatments for enlarged prostate

You may be able to manage your symptoms through lifestyle changes:

  • Reducing fizzy drinks, alcohol and caffeine
  • Wearing pads or a sheath to deal with leaks
  • Losing weight
  • Strengthening your pelvic floor muscles

You can also try changing your urinary habits:

  • Practising urethral massage – a technique to help you empty your urethra
  • Trying a bladder-training programme to help reduce trips to the loo
  • Emptying your bladder twice in quick succession – known as ‘double voiding’

If lifestyle changes aren’t enough, your GP may recommend medications which can shrink your prostate, help you pass urine or prevent urination at night.

If symptoms persist, there are many surgical and non-surgical methods available. Your doctor will recommend what’s best for you.

Surgical procedures

  • Transurethral resection of the prostate (TURP) – removal of part of the prostate gland using a heated metal loop
  • Laser prostate surgery – removal of prostate tissue using heat generated from a laser
  • Water ablation – water or steam under pressure is used to destroy prostate tissue
  • Prostatic urethral lift implants to push the prostate away from your urethra

Non-surgical procedures

  • Injections of botulinum toxin (Botox) – relaxes your bladder wall muscles so they don’t contract too early
  • Implanted sacral nerve stimulation – a small electrical device implanted under the skin of your buttocks sends signals to the nerves that control your bladder


A catheter is a soft tube that can help drain your bladder. It may be an option if lifestyle changes and medication haven’t worked, you aren’t suitable for surgery and you have problems totally emptying your bladder.

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