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The symptoms of BPH usually involve problems with emptying the bladder or storing urine in the bladder. However, the severity of the symptoms can vary widely, from mild and barely noticeable to serious and disruptive. Interestingly, the size of the prostate enlargement is often not related to the intensity of the symptoms; slight enlargements may produce serious symptoms, or significant enlargements may result in few symptoms.


  • Pushing or straining to begin urination
  • A weak urinary stream
  • Dribbling after urination
  • A frequent need to urinate, sometimes every 2 hours or less
  • A recurrent, sudden, or uncontrollable urge to urinate
  • Feeling the bladder has not completely emptied after urination
  • Pain during urination
  • Waking at night to urinate

In extreme cases, a man may be completely unable to urinate. In such situations, emergency medical attention is required.

An enlarged prostate does not directly affect sexual function. However, many men experience sexual dysfunction and BPH symptoms at the same time. This is due to aging and the common medical conditions older men often encounter, including vascular disease and diabetes. Since all these conditions take place with aging, sexual dysfunction tends to be more pronounced in men with BPH.

While the symptoms above may indicate an enlarged prostate, sometimes they point to a different problem. For instance, they may be caused by a urinary tract infection involving the bladder, ureters, or the kidney; a chronic infection of the prostate; or a medication.

To assess BPH symptoms, the American Urological Association (AUA) has created a list of questions called a Symptom Score Index. It can help you evaluate your symptoms—from mild to severe—and, later, help you measure the success of your treatment. To fill out the AUA Symptom Score Index, click the button below:



When your symptoms suggest BPH, your doctor may send you to a urologist. To confirm an enlarged prostate, your urologist will begin with a physical examination, study your medical history, and evaluate your symptoms. Then, a series of tests will be performed. These tests may vary from patient to patient, but can include the following:

Tests Often Performed

  • Digital rectal exam (DRE)—checks the size and firmness of the prostate. The size of the prostate does not always determine the severity of the symptoms; a man with a small amount of prostate enlargement may have more severe symptoms than a man with a more significant enlargement.
  • Urinalysis and urine culture—check for a urinary tract infection that might be the cause of the symptoms.
  • Prostate-specific antigen (PSA) test—a blood test that helps check for prostate cancer, which can cause symptoms similar to those of an enlarged prostate.

Other Tests That May Be Performed

  • Post-void residual urine test (PVR)—measures the amount of urine left in the bladder after urination.
  • Pressure flow study—measures pressure in the bladder during urination.
  • Cystometrogram—measures bladder pressure and the storage capacity of your bladder.
  • Uroflowmetry test—measures how fast the urine flows out of the bladder.



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