BPH (benign prostatic hyperplasia) is a non-cancerous enlargement of the prostate gland that happens naturally as men age. As the prostate grows, it can squeeze the urethra — the tube that carries urine — making it harder to pass urine. It is extremely common and is not linked to prostate cancer.
BPH affects about 5–6% of men aged 40–64, rising to 29–33% of men 65 and older (NIDDK). By age 60, roughly half of men have BPH symptoms, and by 85 that reaches about 90% (NIDDK / Cleveland Clinic).
Causes & risk factors
- Aging — the primary driver; BPH is rare before age 40
- Family history of BPH
- Obesity and a sedentary lifestyle
- Heart or vascular disease and type 2 diabetes
- Hormonal shifts in testosterone/DHT balance with age
Symptoms to watch for
- Weak or interrupted urine stream
- Frequent urination, especially at night (nocturia)
- Urgency and difficulty starting urination
- A feeling of incomplete bladder emptying
- Complete inability to urinate, blood in urine, or fever/chills with urinary symptoms — needs immediate care
How it's diagnosed
- Digital rectal exam (DRE)
- PSA blood test, to help rule out prostate cancer
- Urinalysis
- Uroflow test (measures urine stream speed) and post-void residual measurement
- Cystoscopy in select cases
Treatment options
- Watchful waiting: with lifestyle changes, appropriate for mild symptoms.
- Alpha-blockers: (e.g. tamsulosin) relax prostate and bladder-neck muscles for quick symptom relief.
- 5-alpha reductase inhibitors: (e.g. finasteride) shrink the prostate over months — best for larger glands.
- Minimally invasive procedures: such as UroLift or Rezum, done in-office with minimal downtime.
- HoLEP (Holmium Laser Enucleation): a laser removes the enlarged prostate tissue through the urethra with no incision, minimal bleeding, and effectiveness even in very large prostates.
- TURP (Transurethral Resection): the traditional surgical approach, removing obstructing tissue through the urethra for fast relief.
Outlook & prevention
BPH is very manageable — most men get significant relief from medication or a single procedure. There's no proven way to prevent it, but regular exercise and managing weight and blood pressure may lower risk. Around 10% of patients may need a repeat procedure within 20 years of surgery.
- Sudden inability to urinate
- Blood in urine or painful urination together with fever
- Urinary symptoms significantly affecting daily life or sleep