Benign prostate enlargement (BPE), also known as benign prostatic hyperplasia (BPH), is a condition that affects older men.

It's particularly common in men over 50 years of age and isn't usually a serious threat to health.

Prostate gland

The prostate is a small gland found only in men, located in the pelvis, between the penis and bladder. It's involved in the production of semen.

The prostate produces a thick, white fluid that's made into a thinner liquid by a protein called prostate-specific antigen (PSA). The liquid is then mixed with sperm, produced by the testicles, to create semen.

If the prostate becomes enlarged, it can place pressure on the bladder and urethra (the tube through which urine passes). This can affect how you pass urine and may cause:

  • difficulty starting urination
  • a frequent need to urinate
  • difficulty fully emptying the bladder

In some men, the symptoms are mild and don't require treatment. In others, the symptoms can be very troublesome and have a major impact on a person's quality of life.

Read more about the symptoms of benign prostate enlargement.

Many men worry that having an enlarged prostate means they have an increased risk of developing prostate cancer. This isn't the case. The risk of prostate cancer is no greater for men with an enlarged prostate than it is for men without an enlarged prostate.

What causes benign prostate enlargement?

The cause of prostate enlargement is unknown, but most experts agree that it's linked to hormonal changes that occur as a man gets older.

Read more about the causes of benign prostate enlargement.

How is benign prostate enlargement diagnosed?

If your GP suspects that you have an enlarged prostate, you'll be asked to complete a questionnaire to assess your symptoms.

Each question has five possible answers that carry a score, and your overall score indicates the severity of your symptoms.

Your GP will also want to rule out other conditions that cause similar symptoms to prostate enlargement. 

You may have a number of standard tests, such as urine tests, plus some more specific tests, such as a blood test that measures PSA.

Read more about diagnosing benign prostate enlargement.

Treating benign prostate enlargement

Treatment for an enlarged prostate is determined by the severity of your symptoms.

If you have mild to moderate symptoms, you won't receive any immediate medical treatment, but you'll have regular check-ups to carefully monitor your prostate.

You'll probably also be advised to make lifestyle changes, such as limiting your caffeine and alcohol intake, and exercising regularly, to see if they improve your symptoms.

As well as lifestyle changes, medication is usually recommended to treat moderate to severe symptoms of benign prostate enlargement. Finasteride and dutasteride are medications that are commonly used. They block the effects of a hormone called dihydrotestosterone (DHT) on the prostate gland, which can reduce the size of the prostate and improve associated symptoms.

Alpha blockers may also be prescribed. They help to relax your bladder muscles, making it easier to pass urine. Tamsulosin and alfuzosin are two alpha blockers commonly used to treat benign prostate enlargement.

Surgery is usually only recommended for moderate to severe symptoms of benign prostate enlargement that have failed to respond to medication.

Read more about treating benign prostate enlargement.

Complications of benign prostate enlargement

Benign prostate enlargement can sometimes lead to complications such as a urinary tract infection (UTI) or acute urinary retention. Serious complications are rare.

Read more about the complications of benign prostate enlargement.

How common is benign prostate enlargement?

Benign prostate enlargement is a condition associated with ageing and is common in men over 50 years of age.

Around 4 out of 10 men (40%) over 50, and 3 out of 4 men (75%) in their 70s have urinary symptoms caused by an enlarged prostate.

Page last reviewed: 03/03/2015

Next review due: 03/03/2017