Benign prostatic hyperplasia (enlarged prostate)

What is benign prostatic hyperplasia?

Benign prostatic hyperplasia (BPH) is an enlargement of the prostate that makes it harder to fully empty your bladder. This may mean getting up several times a night or having a weak urine stream. This common condition affects many people over 50 who are assigned male at birth. It happens when the prostate gland, which helps make fluid for semen, grows larger than normal. Because the prostate surrounds the tube that carries urine out of the body, growth of the gland can squeeze that tube and make it hard to empty your bladder. BPH is benign, meaning it’s not cancer, and it doesn’t increase your risk of developing prostate cancer.

BPH is typically treated by urologists and interventional radiologists. At Penn Medicine, our interventional radiology and urology specialists work together to recommend the least invasive and most effective treatment option for you. Many people are treated without surgery, but when procedures are needed, our experts offer advanced minimally invasive, robotic, and microsurgical techniques. We were the first in the region to offer prostate artery embolization, an innovative, nonsurgical approach that shrinks the prostate and relieves symptoms. These options support smaller incisions, faster recovery, and strong outcomes.

Urinary changes that may signal an enlarged prostate

While many people with an enlarged prostate have no symptoms at all, others find that the condition interferes with their sleep and daily activities. You might notice that your bathroom habits have changed over time.

Common symptoms include:

  • A weak or slow urine stream
  • Trouble starting urination
  • Feeling like your bladder doesn’t fully empty
  • Dribbling or leaking at the end of your stream
  • Needing to urinate two or more times during the night
  • A sudden, strong urge to go right away

What causes prostate enlargement?

The exact reason the prostate begins to grow isn’t fully known. It’s believed that shifts in hormone levels, like testosterone and estrogen, play a role. BPH is also closely linked to getting older. Most people assigned male at birth will have some prostate growth if they live long enough. It rarely causes issues before age 40, but most people over age 80 have some level of enlargement.

Certain health conditions can also play a part. You may be more likely to experience symptoms if you have a family history of BPH or live with conditions like obesity, diabetes, or heart disease. Sometimes, even common medications like decongestants can make your symptoms feel worse.

Diagnostic tests for benign prostatic hyperplasia

Diagnosis starts with a conversation about your symptoms and how they affect your life. Your provider may perform a physical exam, including a digital rectal exam to feel the size and shape of the gland. Urine and blood tests check for infection, kidney problems, or other causes of urinary issues. These tests can also measure your urine flow rate. A quick image scan can see if any urine stays in the bladder after you go.

Treatment options for BPH 

Treatment depends on how severe your symptoms are and how much they affect your quality of life. Some people find relief with lifestyle changes or medication. If symptoms continue or worsen, minimally invasive or surgical treatments may be recommended.

Related specialties

Schedule an appointment

We can help you schedule an appointment or you can search our directory of specialists.