Medically reviewed by Andrew Vartanian, MD
September is Prostate Health Month. It’s a fitting time to talk about something most men will deal with eventually and few see coming: benign prostatic hyperplasia, or BPH– an enlarged prostate.
By age 50, about half of men have some degree of BPH. By 70, it’s more than 80%.¹ And yet most men who have it don’t know they have it– not until a doctor points it out, or the symptoms get bad enough to force the issue. That gap is the problem. Signs of an enlarged prostate build for years before most men act on them.
BPH is not prostate cancer, and having an enlarged prostate does not mean you have cancer. However, some urinary symptoms can overlap with other prostate and urinary conditions, which is why persistent or worsening symptoms should be evaluated by a healthcare provider.
The most common signs of an enlarged prostate include frequent urination, waking at night to urinate, a weak urine stream, difficulty starting urination, stopping and starting during urination, urinary urgency, straining, incomplete bladder emptying, and dribbling after urination. Doctors often refer to these problems collectively as lower urinary tract symptoms (LUTS), and BPH is one of the common causes of LUTS in men as they age.
Here are 10 signs of an enlarged prostate to watch for if you’re over 50– and what to do if a few of them sound familiar.
1. You’re up two or three times a night
Occasionally waking during the night to use the bathroom isn’t unusual. But regularly waking two, three, or more times can be a sign that something has changed. It’s usually the first thing patients mention when we ask about signs of an enlarged prostate. As the prostate grows, it presses against the urethra and irritates the bladder wall, so it holds less urine before signaling “go.”
Frequent nighttime urination is called nocturia, and it is a common complaint among men with BPH. If bathroom trips are consistently interrupting your sleep, they’re worth mentioning to your doctor.
2. Your stream has gotten weaker
Ask a man with BPH when it started and most can’t tell you– it’s a slow fade, not a sudden change. A spouse or a doctor often notices before he does. The cause is mechanical: prostate tissue narrowing the channel urine has to pass through.
3. Starting takes longer than it used to
Standing there for a few extra seconds before anything happens. The bladder has to generate more pressure to push urine past a narrower opening, and that takes a bit longer than it should.
This difficulty getting the urine stream started is known as urinary hesitancy, another common lower urinary tract symptom associated with BPH.
4. You never quite feel done
Walk away from the bathroom and still feel like there’s more in there. That’s not in your head- an enlarged prostate can physically block the bladder from emptying completely, leaving urine behind every time.
This is known as incomplete bladder emptying and is another symptom worth discussing with your healthcare provider if it becomes persistent.
5. The stream stops and restarts
Instead of one steady flow, it cuts out, then starts again– sometimes more than once. The bladder is contracting against resistance and losing momentum partway through.
6. Sudden urges that don’t wait
A bladder that’s been working overtime against a blockage tends to get twitchy. The result is urgency that shows up with little warning, sometimes in the middle of a meeting or a drive, and doesn’t leave much room to plan around it.
7. You have to push
Bearing down to get the stream going, rather than it happening on its own, is the bladder compensating for a narrowed urethra. Over months or years, that extra strain can affect the bladder muscle itself.
8. More bathroom trips, period
Not just at night. If you’re finding excuses to know where the nearest bathroom is; on a road trip, at a ballgame, in a meeting, that’s daytime frequency creeping up, and it tends to arrive quietly enough that most men adjust their routines around it before ever naming it as a symptom.
9. Dribbling after you’ve finished
A small amount of urine may leak out after you think you’re done. Post-urination dribbling can occur when urine remains in the urethra or the bladder doesn’t empty completely. It can be associated with BPH as well as other urinary conditions.
10. Blood in the urine, or new pain
Less common, and not something to sit on. Blood in the urine or new burning/pain during urination can happen with BPH, but it can also point to an infection or, less often, prostate cancer. This one gets a same-week call to your doctor, not a “monitor and see.”
If you are unable to urinate at all, seek prompt medical attention.
When Should You See a Doctor for Enlarged Prostate Symptoms?
Talk with your healthcare provider if urinary symptoms are persistent, worsening, or beginning to interfere with your sleep or everyday life.
Seek prompt medical attention if you are unable to urinate, see blood in your urine, develop fever or chills along with urinary symptoms, or experience significant urinary pain.
Even when symptoms are relatively mild, getting evaluated earlier can help determine what’s causing them and what treatment options may be appropriate.
Is it BPH, or something else?
These are things your doctor will look at to make a diagnosis:
- How it started. BPH builds over months or years. An infection or injury usually has a clear onset — you can point to when it began.
- What it looks like. BPH symptoms center on urination itself — flow, frequency, urgency. Fever or sharp, sudden pain points toward infection, which needs prompt attention, not a wait-and-see approach.
- Who’s at risk. Age is the dominant factor; risk rises steadily after 50.¹ Family history, obesity, and metabolic conditions like diabetes also increase the odds.²
No single item on this list means much alone. Two or three together, sticking around for weeks, is the pattern that’s worth a urologist’s opinion.
Is an Enlarged Prostate the Same as Prostate Cancer?
No. Benign prostatic hyperplasia is not prostate cancer. BPH is a noncancerous enlargement of prostate tissue, while prostate cancer occurs when abnormal cells grow within the prostate.
The two conditions can cause some overlapping urinary symptoms, however, and it’s possible for a man to have both. That’s one reason persistent changes in urination shouldn’t simply be written off as a normal part of aging. Your healthcare provider can recommend appropriate testing based on your symptoms, age, medical history, and individual risk factors.
Why early matters more than most men think
BPH symptoms can progress over time, and urinary symptoms may become more bothersome as the prostate enlarges. In some men, significant or untreated obstruction can eventually contribute to urinary retention or, less commonly, bladder and kidney complications3.The men who come in early have more choices. The ones who wait usually have fewer.
For a long time, those choices were limited to three: watch and wait, take daily medication indefinitely, or have surgery. There’s a fourth option now that didn’t exist a generation ago: a non-surgical BPH treatment that treats the cause without the recovery time or risk profile of an operating room.
What is Prostate Artery Embolization (PAE) for BPH?
Prostate artery embolization (PAE) is a minimally invasive, non-surgical treatment for BPH that reduces blood flow to enlarged prostate tissue, allowing the prostate to gradually shrink and helping relieve pressure on the urethra.
It’s done under local anesthesia and most patients go home the same day. There’s no catheter left in place overnight in the majority of cases, and most men are back to normal activity within a few days rather than the weeks associated with surgical options.
It’s not the right fit for every case — prostate size, anatomy, and overall health all factor in — but for the right candidate, it offers real symptom relief while avoiding the risk of sexual side effects more commonly seen with surgical BPH treatment.
Who Is a Candidate for Prostate Artery Embolization?
PAE may be worth considering for men with bothersome signs of an enlarged prostate caused by BPH who want to explore alternatives to traditional prostate surgery.
It may be especially worth discussing if:
- BPH symptoms are interfering with your sleep or daily life
- Medication isn’t providing enough relief
- You’re experiencing unwanted medication side effects
- You want to explore a minimally invasive, non-surgical treatment
- You’re concerned about the recovery time or sexual side effects associated with certain surgical BPH treatments
PAE isn’t right for everyone. Your symptoms, prostate size, vascular anatomy, medical history, and previous treatments all help determine whether you’re a good candidate.
Frequently Asked Questions About Enlarged Prostate Symptoms
Can an enlarged prostate cause frequent urination?
Yes. Frequent urination is one of the common symptoms associated with BPH. An enlarged prostate can restrict urine flow and affect bladder function, which may cause you to feel the need to urinate more frequently during the day or night.
Does an enlarged prostate cause you to wake up at night to pee?
It can. Frequent nighttime urination, known as nocturia, is commonly reported by men with BPH. However, nocturia can have several causes, so regularly waking multiple times each night should be discussed with your healthcare provider.
Is an enlarged prostate cancer?
No. BPH is a benign, or noncancerous, enlargement of the prostate. It does not mean you have prostate cancer. Because some signs of an enlarged prostate can overlap with other prostate conditions, persistent urinary symptoms should still be evaluated.
Can BPH be treated without surgery?
Yes. BPH treatment depends on the severity of your symptoms and your individual situation. Options can include monitoring, medications, minimally invasive procedures, and surgery. Prostate artery embolization (PAE) is a minimally invasive, non-surgical treatment that may be appropriate for some men with symptomatic BPH.
Don’t let this be next year’s problem
If three or four of these signs of an enlarged prostate sound like you, Prostate Health Month is as good a reason as any to stop waiting. The earlier BPH gets addressed, the more non-surgical options stay on the table.
Urinary symptoms don’t have to become something you simply accept as part of getting older. If you’re experiencing signs of an enlarged prostate and want to explore a minimally invasive alternative to traditional BPH surgery, PrecisionIR can help determine whether PAE may be an option for you.
Call PrecisionIR at (947) 228-5500 to schedule a consultation and find out whether prostate artery embolization is right for you.
Sources
- Yale Medicine. “Enlarged Prostate (Benign Prostatic Hyperplasia).” Reviewed by Daniel Kellner, MD. yalemedicine.org
- National Library of Medicine, PMC. “Risk factors for benign prostatic hyperplasia: a comprehensive review.” 2025. pmc.ncbi.nlm.nih.gov
- Keck Medicine of USC. “How Dangerous Is Having an Enlarged Prostate?” June 2025. keckmedicine.org
