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Symptoms of Benign Prostatic Hyperplasia (BPH)

What is benign prostatic hyperplasia?

male reproductive system

Most men experience prostate gland enlargement as they age. This is a condition called benign prostatic hyperplasia (BPH).

The prostate gland is underneath the bladder. When it gets bigger, it can block the flow of urine through the urethra, which is the tube that carries urine from the bladder out through the penis. This can cause problems with urination. Mayo Clinic experts theorize that the prostate gland grows as men age as a result of changes in hormonal balance. If you don’t get treatment for it, BPH can cause bladder, urinary tract, or kidney problems.

The complications of BPH can be serious, but BPH isn’t prostate cancer. Having BPH doesn’t mean you have an increased risk of prostate cancer. The prostate tissue growth associated with BPH begins around the inner prostate, which is a ring of tissue around the urethra, and continues growing inward. Prostate cancer begins growing on the outer part of the prostate and grows outward. 

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A frequent or urgent need to urinate

A frequent or urgent need to urinate

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Many men with BPH will feel the need to urinate frequently, especially at night. This is a condition called nocturia. Frequent urination is defined by the National Institutes of Health as having to urinate eight or more times per day. Sometimes, this need to urinate may be urgent. An enlarged prostate gland puts increased pressure on the urethra and bladder, which results in an inability to hold in your urine.

Difficulty urinating

Difficulty urinating

Difficulty urinating

BPH can make the act of urinating difficult. Increased pressure on the urethra can block the flow of urine from the bladder out through the penis. This can make it hard to start a urine stream, and it can cause a weak or interrupted urine stream, especially at the end of urination. This is sometimes referred to as urine dribbling.

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Pain during urination or ejaculation

Pain during urination or ejaculation

Pain during urination or ejaculation

The pressure on your reproductive system and urinary tract from BPH can result in pain during urination or ejaculation. Some men feel the need to push urine out during urination, which can also cause pain. Pain during urination or ejaculation may also occur due to infection, which is a relatively common complication of BPH.

Urine with blood or an unusual color or smell

Urine with blood or an unusual color or smell

Urine with blood or an unusual color or smell

Urinary retention can cause urine to take on a darker color and unusual smell. Foul-smelling urine is typically a sign of a urinary tract infection (UTI). Blood in the urine, or hematuria, can occur as a result of the dilated veins on the surface of an enlarged prostate gland. Visible blood in the urine is called gross hematuria. If you see blood in your urine, see your doctor right away.

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Urinary retention

Urinary retention

Urinary retention

If you cannot pass any urine, it’s important to seek immediate medical care. Your doctor will have to insert a tube known as a catheter into your bladder to drain the urine. Depending on the severity of your BPH, your doctor may recommend surgery to remove some of your enlarged prostate tissue or to make cuts in your prostate to widen the urethra. 

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Urinary tract infections

Urinary tract infections

Urinary tract infections

The inability to fully empty urine out of the bladder can cause bacteria to grow in the bladder. This can lead to UTIs. These infections may cause the urine to darken or result in foul-smelling or bloody urine. Your doctor may recommend surgery to remove part of the prostate if you have frequent UTIs

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Bladder stones

Bladder stones

Bladder stones

Bladder stones, like UTIs, usually occur due to an inability to empty the bladder completely, which is one of the main symptoms of BPH. Bladder stones are hard lumps of minerals in the bladder that form when urine in the bladder becomes highly concentrated. This causes the minerals in urine to crystallize. These stones can cause:

  • severe infections
  • blood in the urine
  • bladder irritation
  • a blockage of urine flow

Bladder and kidney damage

Bladder and kidney damage

Bladder and kidney damage

The bladder may stretch and weaken if it cannot empty completely. This can cause the muscular wall of the bladder to lose its ability to contract normally, making it more difficult to empty the bladder completely. Urinary retention due to BPH can also put pressure on the bladder, damaging the kidneys. Additionally, infections that start in the bladder may spread to your kidneys, causing damage.

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Outlook for men with BPH

Outlook for men with BPH

Outlook for men with BPH

If you’re experiencing any of the symptoms or complications of BPH, check in with your doctor right away. They may recommend you directly to a doctor who specializes in urinary problems called a “urologist.” Before your appointment, make a list of your symptoms and medical information, such as existing medical conditions and medications you’re taking, keep track of your urinary habits, and write down any questions you have for your doctor.

Most men find that common treatments for BPH, such as surgery, medication, and home remedies, help alleviate their symptoms. BPH can be uncomfortable and may lead to complications, but you can avoid or minimize the symptoms and damage to your bladder and kidneys if you get treatment early.

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