Benign Prostatic Hyperplasia (BPH): What to Expect and What Works

Half of men over 60 show signs of an enlarged prostate. If you’re waking up at night, straining to pee, or feeling like your bladder never fully empties, BPH could be the reason. This page explains what BPH does, how doctors check for it, and real steps you can take to feel better.

What BPH feels like and how it’s diagnosed

BPH is a noncancerous growth of the prostate that presses on the urethra and slows urine flow. Common symptoms include weak stream, dribbling after peeing, urgency, frequent night trips to the bathroom, and incomplete emptying. Sudden inability to urinate, blood in urine, or fever with urinary problems need urgent care.

Doctors diagnose BPH with a few simple tools: a medical history and symptom check, a digital rectal exam (DRE), urine test to rule out infection, and often a PSA blood test. They may also measure how much urine is left after peeing (post-void residual) or use ultrasound. These tests show how big the prostate is and how much it’s affecting your bladder.

Practical treatments and everyday fixes

If symptoms are mild, watchful waiting is common: track symptoms, make lifestyle tweaks, and follow up. Try these simple changes first — they help many men. Cut back on caffeine and alcohol, especially in the evening. Avoid drinking large amounts before bed. Double voiding (pee, wait a minute, try again) can reduce that full-bladder feeling. Pelvic floor exercises and timed voiding often improve control.

When meds are needed, there are two main types. Alpha-blockers (tamsulosin, alfuzosin, doxazosin) relax the prostate and bladder neck to improve flow fast. Side effects can include dizziness or retrograde ejaculation. 5-alpha-reductase inhibitors (finasteride, dutasteride) shrink a larger prostate over months and lower long-term risk of needing surgery; they can affect libido and sometimes cause erectile changes. Doctors sometimes combine both for better results.

Minimally invasive procedures are options when meds don’t help. UroLift (tiny implants that lift the prostate), Rezum (steam therapy), and various laser treatments reduce obstruction with shorter recovery than older surgery. For severe blockage, transurethral resection of the prostate (TURP) or enucleation (HoLEP) remain reliable choices. Acute urinary retention is treated with a catheter right away.

Talk openly with your doctor about goals: relieve symptoms, avoid surgery, or preserve sexual function. Prostate size, symptom severity, and overall health guide the best plan. Regular follow-up matters — BPH can change over time.

If you have strong symptoms, sudden problems, or questions about medications and sexual side effects, see a urologist. Small changes and the right treatment make a big difference — you don’t have to just accept getting up all night to pee.