Enlarged prostate

Enlarged Prostate: Causes, Symptoms, Diagnosis, & Treatments | Prenuvo

The prostate is a small gland that is located just below the bladder in men and people assigned male at birth (AMAB). It produces fluid that mixes with sperm to make semen.

An enlarged prostate, also known as benign prostatic hyperplasia (BPH) or benign prostate enlargement, is a common condition affecting men over 50. Symptoms like difficulty urinating and frequent nighttime urination can impact daily life.

In this guide, you’ll learn:

How to identify the most common symptoms of BPH.
The most effective diagnostic tools, including MRI scans, such as Prenuvo’s Whole Body MRI.
Treatment options to manage and improve symptoms.

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What is an enlarged prostate?

Benign prostatic hyperplasia (BPH) is a condition that causes the prostate to enlarge. This can cause problems with urination, including pain or burning. BPH is the most common prostate problem in men and people assigned male at birth (AMAB). By age 70, most men will have some prostate enlargement.[1]

An enlarged prostate (BPH) is caused by an overgrowth of cells in the prostate. Some of the factors that can increase the risk for developing BPH are family history, age, obesity, lack of physical activity, erectile dysfunction, heart disease, and Type 2 diabetes.

Signs and symptoms usually start in people over 40. The enlarged prostate puts pressure on the urethra and bladder, which narrows or blocks the urethra, making it harder to urinate, and sometimes causing pain or discomfort.

How bad is an enlarged prostate? BPH is a non-cancerous condition which won’t spread to other parts of the body and is not usually life-threatening. BPH doesn't increase the risk of prostate cancer and it isn't considered a health problem unless it causes symptoms.

Learn more about prostate cancer.
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Signs and Symptoms of an Enlarged Prostate (BPH)

Men with BPH may not have any signs or symptoms. Enlarged prostate symptoms most often develop in men older than 50.

When the prostate enlarges, it may constrict the flow of urine. Nerves within the prostate and bladder may also play a role in causing the following common symptoms of an enlarged prostate, sometimes called lower urinary tract symptoms (LUTS):

Difficulty urinating, including weak or slow urine stream;
Increased frequency of urination, especially at night;
Strong or sudden urges to urinate;
Inability to empty the bladder completely, which can lead to urinary tract infections and bladder stones;
Difficulty controlling the bladder, which can cause urine to leak and dribble;
Blood in the urine.[1]

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Diagnosing an Enlarged Prostate

Healthcare professionals may diagnose an enlarged prostate based on your personal and family medical history, a physical exam, and/or diagnostic testing.

Personal and family medical history

Your healthcare provider may ask you about:

Symptoms you are experiencing, including onset and frequency;
History of recurrent urinary tract infections (UTIs);
Prescriptions and over-the-counter medications you take;
Amount of liquid consumed daily, including water, caffeine, and alcohol;
History of significant illnesses or surgeries;
Prostate problems among immediate family members.[1]

Physical exam

During a physical exam, your provider may perform an examination of your prostate through a digital rectal exam (DRE). When making an enlarged prostate diagnosis, they might also check for an enlarged bladder, urethral discharge, and/or enlarged or tender lymph nodes in your groin.

It is important to note that the DRE is not a completely accurate test, as your provider won’t be able to feel the whole prostate.[2]

Diagnostic tests

Your healthcare provider may refer you to a specialist, such as a urologist, for more rigorous diagnostic testing. Such testing may help diagnose lower urinary tract symptoms (LUTS) related to BPH and may help determine your treatment options.

Diagnostic testing may include:

Urinalysis;
Prostate tests, such as a prostate-specific antigen (PSA) blood test or prostate biopsy;
Urodynamic tests;
Cystoscopy;
MRI for BPH.[3]

Historically, MRI has been primarily used to diagnose and stage prostate cancer in patients at risk of having the disease (such as in those with elevated PSA).[4]

However, a recent study in the American Journal of Roentgenology (AJR) notes that emerging data supports the use of MRI for BPH to support preoperative interventions due to MRI’s ability to identify prostate volume and BPH types and to better predict outcomes.[4]

Prenuvo’s Whole Body MRI (WB-MRI) has been shown to improve measurement accuracy by 23.59%, compared with traditional volume estimates, aiding in the identification of patients with BPH. It has also had success in identifying early-stage (stage 1 / 2) cancers.[5]

Additionally, Prenuvo’s imaging of the prostate gland is equivalent to a dedicated MRI of the prostate, with the added benefit of no intravenous contrast or needles.

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Treatment Options for BPH

There are several treatment options for BPH, including watchful waiting, medications, minimally invasive procedures, and/or surgery. Your healthcare professional and you can discuss the severity of your symptoms and how they affect your quality of life when considering treatment options. Some patients might even forego treatment for BPH if their symptoms aren't bothersome.[7]

H3: Enlarged prostate treatment options include:

Watchful waiting, also known as active surveillance, which includes lifestyle changes such as:

Cutting back on liquids before bed;
Limiting or eliminating alcohol or caffeine consumption;
Increasing physical activity;
Emptying the bladder completely when urinating;
Avoiding or monitoring the use of medications that can make BPH symptoms worse;
Training the bladder to hold urine for longer stretches or practicing pelvic floor exercises.

Medications, including prescription drugs:

Alpha blockers to relax muscles in the bladder and prostate, making it easier to urinate;
5-alpha reductase inhibitors (5-ARIs) to help shrink or stop the enlargement of the prostate, improving your urine flow;
Phosphodiesterase-5 inhibitors to relax the muscles around the bladder, bladder neck, and prostate and relieve some symptoms of BPH

A study in the New England Journal of Medicine has shown that the combination of an alpha blocker and a 5-ARI may work better than one medicine alone.[6]

Note that some medications may have side effects.

Minimally invasive procedures to destroy enlarged prostate tissue or widen the urethra, including:

Aquablation, or transurethral water vapor therapy, which uses water vapor, or steam, to shrink an enlarged prostate;
Holmium laser enucleation of the prostate (HoLEP), which uses a laser to treat the enlarged prostate;
Prostatic urethral lift, which uses tiny implants to hold the prostate away from the urethra and improve urine flow.

Surgery to remove part or all of the prostate, including:

Transurethral resection surgery;
Laser surgery;
Electrovaporization;
Robotic surgery.

MRI is a highly effective tool for monitoring an enlarged prostate. It provides a very clear image of the prostate and surrounding area, showing you and your healthcare provider exactly how and where the prostate is enlarged,[7] and how it is responding to treatments.[8]

Prenuvo’s whole body MRIs are as useful as dedicated, contrast-enhanced prostate MRIs in the general population. Prenuvo’s MRI provides an accurate measurement of prostate size, aids in diagnosis of enlarged prostate (BPH), and can help you and your healthcare provider avoid the pitfalls of PSA interpretation. When repeated after one to two years, a subsequent Prenuvo MRI allows for longitudinal follow-up of gland size, suspicious lesions, and associated abnormalities (e.g. bladder outlet obstruction).[9]

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How the Prenuvo scan can impact care

BPH is a manageable condition with proper diagnosis and care. Whether you're experiencing symptoms or exploring treatment options, understanding your condition is the first step toward relief. Regular whole body MRI screening scans, like Prenuvo, can help you monitor your health proactively and identify hundreds of conditions, including enlarged prostate.

Schedule your Prenuvo MRI today for peace of mind

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Frequently Asked Questions

Is an enlarged prostate bad? Is an enlarged prostate dangerous?

Benign prostatic hyperplasia (BPH), commonly known as an enlarged prostate, is a widespread condition among aging men. While BPH is non-cancerous, it can lead to significant health issues. The enlarged prostate can compress the urethra, resulting in lower urinary tract symptoms (LUTS) such as increased urinary frequency, urgency, nocturia (nighttime urination), weak urinary stream, and incomplete bladder emptying. These symptoms can substantially affect quality of life, leading to sleep disturbances, reduced daily functioning, and decreased overall well-being.[10]

If left untreated, BPH can cause additional complications, including:

blood in the urine (hematuria)
urinary tract infections (UTIs)
kidney disease
bladder stones[3]

What is the cause of an enlarged prostate?

What is the best treatment for an enlarged prostate?

H3: How can I shrink my prostate naturally?

Making some of the following changes to your lifestyle might help with mild BPH symptoms:

Drinking less before bedtime or going out;
Avoiding or cutting back on beverages with caffeine and alcohol;
Bladder training and exercising the muscles that control urine flow;
Preventing or treating constipation.[11]

For mild to moderate BPH symptoms, some medications might help by:

Stopping the prostate from growing;
Shrinking the prostate;
Relaxing muscles to improve urine flow. [11]

How long does it take for an enlarged prostate to go away?

The amount of time it will take for enlarged prostate symptoms to lessen depends on the treatment.

Some men take alpha-1 blockers, which relax the muscles of the bladder neck and prostate to allow for easier urination. Many men who take alpha-1 blockers notice symptom improvement of BPH symptoms within 3 to 7 days after starting the medication treatment.[11]

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Sources

Benign prostatic hyperplasia (BPH). Cancer.ca. Accessed January 25, 2025. https://cancer.ca/en/cancer-information/cancer-types/prostate/what-is-prostate-cancer/benign-prostatic-hyperplasia
Digital rectal examination (DRE). ProstateCancerUK.org. Accessed January 25, 2025. https://prostatecanceruk.org/prostate-information-and-support/prostate-tests/digital-rectal-examination-dre
Enlarged Prostate (Benign Prostatic Hyperplasia). niddk.nih.gov. Accessed January 25, 2025. https://www.niddk.nih.gov/health-information/urologic-diseases/prostate-problems/enlarged-prostate-benign-prostatic-hyperplasia
Diaz TA, Benson B, Clinkenbeard A, et al. MRI Evaluation of Patients Before and After Interventions for Benign Prostatic Hyperplasia: An Update. AJR 2022: 218 (1). 88-100. doi.org/10.2214/AJR.21.26278
Deep Learning Strategy to Quantify Whole Prostate and Zonal Volumes, Trends with Aging and Detection of Benign Prostatic Hyperplasia. Prenuvo.com. Accessed January 25, 2025. https://prenuvo.com/research/deep-learning-strategy-to-quantify-whole-prostate-and-zonal-volumes-trends-with-aging-and-detection-of-benign-prostatic-hyperplasia
McConnell JD, Roehrborn CG, Bautista OM, et al. The long-term effect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia. NEJMedicine. 2003:349(25):2387–2398. doi:10.1056/NEJMoa030656
What is Benign Prostatic Hyperplasia (BPH)? UrologyHealth.org. Accessed January 25, 2025. https://www.urologyhealth.org/urology-a-z/b/benign-prostatic-hyperplasia-(bph)
Walker SM, Turkbey B. Role of mpMRI in Benign Prostatic Hyperplasia Assessment and Treatment. Curr Urol Rep. 2020:21(12):55. doi: 10.1007/s11934-020-01005-x
Ashley S, Muasher J, Chaffe E. Screening for Prostate Disease and Cancer: Prenuvo Webinar. YouTube. December 5, 2024. Accessed January 29, 2025. https://www.youtube.com/watch?v=psy_aIno87w
Platz EA, Kawachi I, Rimm EB, et al. Physical Activity and Benign Prostatic Hyperplasia. Arch Intern Med. 1998: 158(21): 2349–2356. DOI:10.1001/archinte.158.21.2349
Enlarged Prostate (BPH): Also called: benign prostatic hyperplasia. Medlineplus.gov. Accessed February 14, 2025. https://medlineplus.gov/enlargedprostatebph.html

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