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Frequent urination
Urine urgency
Peeing problems
It is difficult to pee
I feel urine remained after urination
Difficult to urinate
I am peeing again within in 2 hours
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What is Benign Prostatic Hyperplasia?
Non-cancerous enlargement of the prostate. Age-related changes in male hormone levels are thought to be the cause. Incidence increases with age with an estimated 80% of men over the age of 70 with BPH. Symptoms may include a weak urinary stream, leakage of urine after voiding and urinating frequently at night (nocturia).
Typical Symptoms of Benign Prostatic Hyperplasia
- Having difficulty urinating or producing less urine
- Often need to urinate again within 2 hours after last going
- Pain at the start of passing urine
- Urine stream is weaker than it used to be
- Urine flow stops and starts
- Burning or painful urination with reduced urine volume
- Need to strain or bear down to pass urine, in the past month
- History of diabetes requiring medications
Diagnostic Questions for Benign Prostatic Hyperplasia
Your doctor may ask these questions to check for this disease:
- Have you been experiencing difficulty urinating or producing less urine?
- Do you often need to urinate again within 2 hours after last going?
- Do you feel pain when you start peeing?
- Is your urine stream weaker than it used to be?
- Does your urine flow stop and start?
Treatment of Benign Prostatic Hyperplasia
Mild cases do not require treatment. However, your primary care provider or a specialist may recommend treatment if the condition is causing significant symptoms. Treatment options include medications to shrink the prostate over time or procedures and surgery to remove all or part of the prostate.
Reviewed By:
Kenji Taylor, MD, MSc (Family Medicine, Primary Care)
Dr. Taylor is a Japanese-African American physician who grew up and was educated in the United States but spent a considerable amount of time in Japan as a college student, working professional and now father of three. After graduating from Brown, he worked in finance first before attending medical school at Penn. He then completed a fellowship with the Centers for Disease Control before going on to specialize in Family and Community Medicine at the University of California, San Francisco (UCSF) where he was also a chief resident. After a faculty position at Stanford, he moved with his family to Japan where he continues to see families on a military base outside of Tokyo, teach Japanese residents and serve remotely as a medical director for Roots Community Health Center. He also enjoys editing and writing podcast summaries for Hippo Education.
Nao Saito, MD (Urology)
After graduating from Tokyo Women's Medical University School of Medicine, Dr. Saito worked at Tokyo Women's Medical University Hospital, Toda Chuo General Hospital, Tokyo Women's Medical University Yachiyo Medical Center, and Ako Chuo Hospital before becoming Deputy Director (current position) at Takasaki Tower Clinic Department of Ophthalmology and Urology in April 2020.
Content updated on Feb 19, 2025
Following the Medical Content Editorial Policy
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People with similar symptoms also use Ubie's symptom checker to find possible causes
- Decreased urine output
- Not peeing enough
- Pain at the beginning of urination
- Drinking lots of water but not urinating much
- Weak urine stream
- No urine output in 12 hours
- Incomplete bladder emptying
- Urinating less than normal
- Pain when I start peeing
- Very difficult to urinate
- Reduction in urine volume
- Unable to empty bladder completely
- It hurts when I pee
- Frequent urination at night
- Frequent urination at night
See full list
Symptoms Related to Benign Prostatic Hyperplasia
Diseases Related to Benign Prostatic Hyperplasia
FAQs
Q.
Weak Stream? Why Flomax is Prescribed & Medically Approved Next Steps
A.
A weak urine stream is most often due to BPH; Flomax tamsulosin is a first-line, FDA-approved alpha-1 blocker that relaxes prostate and bladder neck muscles to quickly improve flow, but it does not shrink the prostate or cure BPH. There are several factors to consider, including getting evaluated to confirm the cause, watching for urgent red flags like inability to urinate, blood, or fever, and weighing side effects such as dizziness or retrograde ejaculation alongside options like lifestyle changes, add-on medicines, or procedures if symptoms persist. See the complete guidance below to choose the safest next step for your care.
References:
* Chou, R., Selph, S., Blazina, I., & Zakher, B. (2018). Pharmacologic Treatments for Benign Prostatic Hyperplasia: A Systematic Review. *Annals of Internal Medicine*, *169*(12), 856–865.
* McVary, K. T., Elterman, D., Kaplan, S. A., Roehrborn, C. G., & Al-Qadiri, H. A. (2021). The 2021 AUA Guidelines for the Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: What's New? *Current Urology Reports*, *22*(8), 1–7.
* Gravas, S., & Oelke, M. (2021). Alpha-blockers for benign prostatic hyperplasia: evidence and insights. *Therapeutic Advances in Urology*, *13*, 17562872211019672.
* Laniado, M. E., & McVary, K. T. (2020). Diagnosis and initial evaluation of benign prostatic hyperplasia. *Urologic Clinics of North America*, *47*(3), 305–311.
* Oelke, M., Oelke, M., Gravas, S., & Bachmann, A. (2020). Medical treatment of benign prostatic hyperplasia. *European Urology Focus*, *6*(6), 1085–1094.
Q.
Frequent Urination? Why Your Prostate Is Enlarging & Medical Next Steps
A.
Frequent bathroom trips, especially at night, are most often from an enlarged prostate called benign prostatic hyperplasia, a common non-cancerous cause as men age, though infections, prostatitis, bladder problems, and prostate cancer can present similarly. Next steps include seeing a clinician for a history, exam with a brief digital rectal exam, urinalysis, and a PSA blood test, seeking urgent care for inability to urinate, blood in urine, fever with painful urination, or severe lower abdominal pain, and considering treatments from lifestyle changes to alpha blockers, 5-alpha reductase inhibitors, and procedures when needed; there are several factors to consider, and complete details are below.
References:
* Lerner LB, McVary KT, Barry MJ, Bixler BR, Dahm P, Das AK, Elliott S, Foster HE Jr, Gavazzi A, Kibel AS, Koziol S, Lopez-Leon MM, Mitchell C, Plowe J, Roehrborn CG, Te AE, Wilt TJ. Management of Benign Prostatic Hyperplasia. N Engl J Med. 2020 Feb 20;382(8):745-756. doi: 10.1056/NEJMcp1816150. PMID: 32075791.
* Lee CL, Cheng YC, Liu CC. Etiology and Pathophysiology of Benign Prostatic Hyperplasia: What Does the Future Hold? Urol Clin North Am. 2021 Jul;48(3):263-271. doi: 10.1016/j.ucl.2021.04.001. PMID: 34092490.
* Fung D, Chou R, Badani KK, Sanda MG. Lower Urinary Tract Symptoms in Men with Benign Prostatic Hyperplasia. Urol Clin North Am. 2021 Jul;48(3):273-281. doi: 10.1016/j.ucl.2021.04.002. PMID: 34092491.
* Lerner LB, McVary KT, Barry MJ, Bixler BR, Dahm P, Das AK, Elliott S Jr, Foster HE Jr, Gavazzi A, Kibel AS, Koziol S, Lopez-Leon MM, Mitchell C, Plowe J, Roehrborn CG, Te AE, Wilt TJ. Management of Benign Prostatic Hyperplasia (2018). J Urol. 2018 Oct;200(4):783-798. doi: 10.1016/j.juro.2018.04.072. Epub 2018 Apr 23. PMID: 29778248.
* Chou R, Fung D, Sanda MG. Medical Management of Benign Prostatic Hyperplasia. Urol Clin North Am. 2021 Jul;48(3):319-332. doi: 10.1016/j.ucl.2021.04.006. PMID: 34092495.
Q.
Can benign prostatic hyperplasia (BPH) cause erectile dysfunction (ED)?
A.
BPH may contribute to erectile dysfunction because many of the same underlying factors that cause urinary problems can also affect sexual function.
References:
Bruskewitz RC. Quality of life and sexual function in patients with benign prostatic hyperplasia. Rev Urol. 2003 Spring;5(2):72-80. PMID: 16985624; PMCID: PMC1473005.
Glina S, Glina FP. Pathogenic mechanisms linking benign prostatic hyperplasia, lower urinary tract symptoms and erectile dysfunction. Ther Adv Urol. 2013 Aug;5(4):211-8. doi: 10.1177/1756287213488236. PMID: 23904860; PMCID: PMC3721438.
Q.
Does alpha blockers work for benign prostatic hyperplasia (bph) ?
A.
Yes, alpha blockers are an effective treatment for BPH because they help relax the muscles in the prostate and bladder neck, which eases urinary symptoms.
References:
Edwards JL. Diagnosis and management of benign prostatic hyperplasia. _Am Fam Physician_. 2008;77(10):1403-1410.
Miernik A, Gratzke C. Current Treatment for Benign Prostatic Hyperplasia. Dtsch Arztebl Int. 2020 Dec 4;117(49):843-854. doi: 10.3238/arztebl.2020.0843. PMID: 33593479; PMCID: PMC8021971.
Q.
Does benign prostatic hyperplasia (BPH) lead to cancer?
A.
No, benign prostatic hyperplasia (BPH) is a non-cancerous enlargement of the prostate and does not cause cancer, though both conditions can sometimes occur in the same age group.
References:
Miah S, Catto J. BPH and prostate cancer risk. Indian J Urol. 2014 Apr;30(2):214-8. doi: 10.4103/0970-1591.126909. PMID: 24744523; PMCID: PMC3989826.
Dai X, Fang X, Ma Y, Xianyu J. Benign Prostatic Hyperplasia and the Risk of Prostate Cancer and Bladder Cancer: A Meta-Analysis of Observational Studies. Medicine (Baltimore). 2016 May;95(18):e3493. doi: 10.1097/MD.0000000000003493. PMID: 27149447; PMCID: PMC4863764.
Q.
Does prostate massage help with benign prostatic hyperplasia (BPH)?
A.
Some research suggests that prostate massage might provide some relief from urinary symptoms in BPH, but it is not a proven cure and should be used with caution.
References:
Hennenfent BR, Lazarte AR, Feliciano AE Jr. Repetitive prostatic massage and drug therapy as an alternative to transurethral resection of the prostate. MedGenMed. 2006 Oct 25;8(4):19. PMID: 17415302; PMCID: PMC1868377.
http://dx.doi.org/10.2174/1874303X01002010020
Q.
How do I differentiate benign prostatic hyperplasia (BPH) vs prostate cancer?
A.
Doctors differentiate between BPH and prostate cancer using a mix of tests like PSA blood tests, digital rectal exams, imaging, and sometimes biopsy, since both may cause similar symptoms but have different causes and outcomes.
References:
Lilja H, Ulmert D, Vickers AJ. Prostate-specific antigen and prostate cancer: prediction, detection and monitoring. Nat Rev Cancer. 2008 Apr;8(4):268-78. doi: 10.1038/nrc2351. Erratum in: Nat Rev Cancer. 2008 May;8(5):403. PMID: 18337732.
McNally CJ, Ruddock MW, Moore T, McKenna DJ. Biomarkers That Differentiate Benign Prostatic Hyperplasia from Prostate Cancer: A Literature Review. Cancer Manag Res. 2020 Jul 1;12:5225-5241. doi: 10.2147/CMAR.S250829. PMID: 32669872; PMCID: PMC7335899.
Gravestock P, Shaw M, Veeratterapillay R, et al. Prostate Cancer Diagnosis: Biopsy Approaches. In: Barber N, Ali A, editors. Urologic Cancers [Internet]. Brisbane (AU): Exon Publications; 2022 Sep 12. Chapter 12.
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Chughtai B, Forde JC, Thomas DD, Laor L, Hossack T, Woo HH, Te AE, Kaplan SA (2016). Benign prostatic hyperplasia. Nature reviews. Disease primers.
https://pubmed.ncbi.nlm.nih.gov/27147135/Mobley D, Feibus A, Baum N (2015). Benign prostatic hyperplasia and urinary symptoms: Evaluation and treatment. Postgraduate medicine.
https://pubmed.ncbi.nlm.nih.gov/25823641/Bushman W (2000). Etiology, epidemiology, and natural history of benign prostatic hyperplasia. The Urologic clinics of North America.
https://pubmed.ncbi.nlm.nih.gov/19942041/