Benign Prostatic Hypertrophy: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Benign Prostatic Hypertrophy?
A primary care doctor often starts the evaluation. A urologist, a doctor who treats the urinary tract and male sex organs, treats more severe cases. Tests may be done by a urologist to plan treatment. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is benign prostatic hypertrophy?
Benign prostatic hypertrophy is another name for benign prostatic hyperplasia, or BPH. In BPH the prostate gland grows larger than normal. The growth is not cancer. It does not raise your risk of prostate cancer.
The prostate is a gland. It makes some of the fluid that carries sperm. It surrounds the urethra, the tube that urine passes through. As it grows, it can squeeze the urethra. That makes urinating harder. Prostate enlargement happens to almost all men as they get older.
Symptoms
Less than half of all men with BPH have symptoms. Symptoms may include:
- Trouble starting a urine stream.
- A weak or slowed urine stream, or dribbling at the end of urinating.
- Needing to urinate 2 or more times per night.
- A strong and sudden urge to urinate.
- Incomplete emptying of the bladder.
- Inability to urinate (urinary retention).
- Pain with urination, or bloody urine.
Pain with urination or bloody urine may also point to an infection.
Causes and who gets it
The actual cause is unknown. Aging, changes in the cells of the testicles, and testosterone levels may play a part. The chance grows with age. Many men over 40 have a small amount of enlargement. More than 90% of men over 80 have the condition.
How doctors diagnose it
The doctor asks about your medical history. They do a digital rectal exam. That means feeling the prostate with a gloved finger. Other tests may include:
- Urine flow rate. And a test of how much urine is left in the bladder after you urinate.
- Urinalysis, a urine test. And a urine culture, to check for blood or infection.
- A PSA blood test. PSA stands for prostate-specific antigen. It screens for prostate cancer.
- Cystoscopy, which looks inside the urethra and bladder with a thin scope.
- BUN and creatinine blood tests, which check kidney function.
You may fill out a form. It rates how bad your symptoms are and how much they affect daily life.
Treatment
Treatment is based on your symptoms, how much they bother you, and your other medical problems. Options include watchful waiting, lifestyle changes, medicines, or surgery.
For mild symptoms, self-care helps. Avoid alcohol and caffeine, especially after dinner. Spread out fluids during the day. Exercise regularly. Cold and sinus medicines with decongestants or antihistamines can make symptoms worse. Try to avoid them.
Medicines include alpha-1 blockers. They relax the muscles of the bladder neck and prostate, so urine flows more easily. Finasteride and dutasteride shrink the gland and improve urine flow. The blockers often work within days. The shrinking medicines may take months.
Surgery may be recommended for incontinence, repeated blood in the urine, urinary retention, repeated urinary tract infections, bladder stones, decreasing kidney function, or symptoms that medicines do not help. TURP is the most common and most proven surgical treatment. Its full name is transurethral resection of the prostate. A scope removes the prostate piece by piece. Most men who have it improve in urine flow and symptoms.
When to see a doctor
Suddenly not being able to urinate is an emergency: call 911. Contact your doctor right away if you have less urine than usual, fever or chills, back, side, or belly pain, or blood or pus in your urine. Also get checked if your bladder never feels empty after you urinate. The same is true if self-care for 2 months has not helped. Tell the doctor about all medicines you take. Some make urinary problems worse. Do not stop or change them on your own.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Such a doctor can track your urinary symptoms over time. They can review the medicines you take that may affect urinating. They can also coordinate a visit with a urologist when treatment is needed.
Common questions
Is benign prostatic hypertrophy cancer?
No. It is a benign (not cancer) growth of the prostate. It does not raise your risk for prostate cancer.
Why does the prostate grow with age?
The exact cause is unknown. Factors linked to aging, changes in the cells of the testicles, and testosterone levels may have a role in the growth of the gland.
Which medicines help BPH?
Alpha-1 blockers relax the muscles of the bladder neck and prostate. That allows easier urination. Finasteride and dutasteride lower hormone levels made by the prostate. They reduce the size of the gland and improve urine flow.
When is surgery needed?
Surgery may be recommended for incontinence, repeated blood in the urine, urinary retention, repeated urinary tract infections, bladder stones, or decreasing kidney function. It is also an option for symptoms that do not respond to medicines.
Sources
- MedlinePlus - Enlarged prostate: MedlinePlus Medical Encyclopedia
- MedlinePlus - Enlarged Prostate (BPH)
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
