Enlarged prostate

Enlarged Prostate (BPH)

Enlarged Prostate (BPH)

An enlarged prostate causes a weak stream, urgency, and getting up at night. How it's evaluated, how to take the medications, and when procedures help.

Written and reviewed by Shervin Badkhshan, MD · Last reviewed

November 2026

Part of:

Enlarged prostate

Office & outpatient

Fellowship-Trained Reconstructive Urology

AT A GLANCE

From symptoms to treatment

1. SYMPTOMS

• Weak or slow stream • Getting up at night • Not emptying fully

2. TESTING

• IPSS symptom score • Urine test and PSA • Flow test and bladder scan

Test result guides →

3. TREATMENT

• Alpha-blockers, finasteride, dutasteride • UroLift or Rezūm in the office • TURP, Aquablation, or simple prostatectomy

Surgical options →

An enlarged prostate (benign prostatic hyperplasia, or BPH) is a non-cancerous growth of the prostate that squeezes the urethra. It's very common with age and is not cancer, and it doesn't raise your cancer risk.

What you might notice

  • A weak or slow stream, or stopping and starting

  • Getting up at night to urinate

  • Urgency and frequency

  • A feeling of not emptying, or dribbling afterward

How I evaluate it

A symptom score (the IPSS), a urine test, often a PSA, a flow test and bladder scan, and sometimes an ultrasound or cystoscopy to see the size and shape of the prostate. Those details decide which treatment fits.

Medications, and how to take them

  • Alpha-blockers (tamsulosin, alfuzosin, silodosin, doxazosin): relax the muscle in the prostate and usually help within days. Take them at the same time daily, often at bedtime. They can cause lightheadedness when standing, a stuffy nose, and less or no fluid with ejaculation. Tell your eye surgeon you take one before any cataract surgery.

  • 5-alpha reductase inhibitors (finasteride, dutasteride): slowly shrink the prostate over 6 to 12 months and work best for larger prostates. They lower PSA by about half, so tell whoever checks your PSA. Some men notice lower sex drive or erection and ejaculation changes.

  • Combination therapy: an alpha-blocker plus finasteride or dutasteride for larger prostates.

  • Daily tadalafil: helps urinary symptoms and erections at the same time.

  • Bladder medications: added when urgency and frequency remain after the blockage is treated.

Give a medication several weeks to work, and let me know about side effects. There's usually another option to try.

When medication isn't enough

Office options such as UroLift and Rezūm suit some men with smaller prostates. TURP and Aquablation treat most sizes, and robotic simple prostatectomy is for very large prostates. Treatment is also recommended for retention, bladder stones, repeated infections, or kidney changes.

Related

Enlarged prostate treatments · TURP and Aquablation · UroLift and Rezūm · PSA explained · Urinary symptom self-check (IPSS)

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Your results and questions

Your actual test results, visit notes, and messages with your care team are in your patient portal, the same one you use to book visits. Send questions through the portal or call the office at (516) 535-1900. For anything urgent, call the office or go to the nearest emergency room.