Benign Prostatic Hyperplasia (BPH)

Many men with benign prostatic hyperplasia (BPH) have no symptoms. When symptoms (known as lower urinary tract symptoms, or LUTS) occur, they may range from mild and barely noticeable to serious and disruptive. The amount of prostate enlargement is not always related to the severity of the symptoms. Some men with only slight enlargement have serious symptoms. And some men with a great deal of enlargement have few symptoms.

Your symptoms may become worse during cold weather or as a result of physical or emotional stress.

Some medicines can make your symptoms worse. These include over-the-counter cold medicines such as diphenhydramine (Benadryl, for example), pseudoephedrine (such as Sudafed), oxymetazoline spray (such as Afrin), and prescription medicines such as antidepressants, water pills (diuretics), testosterone (gels, implants, or injections), and pain medicines (narcotics).

The symptoms of BPH may involve problems emptying the bladder or problems with bladder storage.

Symptoms related to bladder emptying include:

• Difficulty starting a urine stream (hesitancy and straining).
• Decreased strength of the urine stream (weak flow).
• Dribbling after urination.
• Feeling that the bladder is not completely empty.
• An urge to urinate again soon after urinating.
• Pain during urination (dysuria).

Symptoms related to bladder storage include:

• Waking at night to urinate (nocturia).
• Frequent urination.
• A sudden, uncontrollable urge to urinate.

These symptoms are not always related to prostate enlargement and can be caused by other conditions. BPH symptoms are often balanced between the two types of symptoms. If symptoms come on rapidly, or if you have more of one type of symptom than the other type, you may have another condition. Other conditions that may cause similar symptoms include urinary tract infections, Reference prostatitis Opens New Window, prostate cancer, diabetes, Reference heart failure Opens New Window, and neurologic diseases.

You can use the Reference Interactive Tool: How Bad Are Your Urinary Symptoms From BPH? Reference to evaluate how bad your symptoms are and, later, to judge how well your treatment is working.

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