Enlarged prostate (BPH): symptoms, causes and treatment

The prostate is a small gland below the bladder that makes semen and controls the flow of pee from the bladder to the penis. If it gets bigger it can put pressure on the urethra, the tube that carries pee from the bladder, causing problems with peeing. The NHS says the symptoms usually develop slowly and may gradually get worse as you get older.

• Difficulty starting to pee, or having to push or strain to pee.

• A weak flow of pee, stopping and starting, and taking longer than usual to empty your bladder.

• Feeling like you cannot fully empty your bladder.

• Dribbling pee after you finish peeing.

• Needing to pee more often or urgently, including getting up to pee during the night.

The NHS says an enlarged prostate does not always need treatment, and that it depends on your symptoms and how they affect you. If symptoms are not causing many problems doctors will usually recommend trying lifestyle changes first. If they get worse you may need medicines or surgery.

The NHS suggests the following things that may help with symptoms.

• Cut down on alcohol and caffeine, as they can make you pee more.

• Reduce how much you drink before bed or before going out, but drink enough during the rest of the day.

• Eat enough fibre to help prevent constipation, which can put pressure on your bladder.

• Keep to a healthy weight, as being overweight can make symptoms worse.

• Wait a few moments after you pee and then try again to help empty your bladder.

• Do not strain or push when peeing; try to relax.

• Do not cut down too much on fluids, as this can cause problems such as urinary tract infections.

• Ask a doctor or pharmacist whether any medicines you take for other conditions could be making symptoms worse.

The NHS says an enlarged prostate is thought to be caused by changes in hormone levels as you get older. It is very common, and you may be more likely to get it if you are over 50 or if others in your family have one.

Prostate Cancer UK says the balance of oestrogen and testosterone changes with age, which may cause the prostate to grow, and that some studies show obese men and men with diabetes may be more likely to develop it. Regular exercise may help reduce your risk of urinary symptoms, though more research is needed.

A GP will ask about your symptoms, such as how often you pee, may examine your tummy and penis, and may do a rectal examination to check the size of your prostate. You will usually be asked to keep a record for at least 3 days of how much you drink and how often and how much you pee.

The GP may test a sample of your pee and do a blood test called a PSA test. You may be referred to a specialist for a urine flow test, an ultrasound scan of the bladder or a cystoscopy, which looks inside the bladder with a camera.

The symptoms can sometimes be caused by other conditions, including prostate cancer, so the NHS says it is important to get them checked by a GP, because finding cancer early may make it easier to treat.

Prostate Cancer UK says having an enlarged prostate does not increase your risk of prostate cancer, because the two problems usually begin in different parts of the prostate, but it is possible to have both at the same time. If you are worried, talk to your GP.

See a GP if you have difficulty peeing or need to pee more frequently, and try not to be embarrassed, as the GP will be used to talking about these symptoms.

The NHS says to ask for an urgent GP appointment or get help from NHS 111 if you have blood in your pee (it may look pink, red or brown), pain when peeing, or you cannot pee at all. Prostate Cancer UK describes urine retention, where you cannot fully empty your bladder or empty it at all, as something that may need a catheter, medicines or surgery.

A GP can start assessment and treatment on the NHS and refer you to a urology service for flow tests, scans or surgery. The NHS also points to a decision support tool for choosing between options. Private urologists offer the same tests and operations, often with shorter waits; ask what is included, and keep your GP informed so medicines are monitored.