Benign prostatic enlargement

What is the prostate?

The prostate is a gland located in the lower urinary tract, under the bladder and around the urethra (Fig. 1). Only men have a prostate. It produces the fluid which carries semen. The prostate has smooth muscles which help to push out the semen during ejaculation.

A healthy prostate is about the size of a large walnut and has a volume of 15-25 millilitres (ml). The prostate slowly grows as men grow older.

Fig. 1: A healthy prostate in the lower urinary tract.
Fig. 1: A healthy prostate in the lower urinary tract.

Benign prostatic enlargement

Prostate diseases are usually associated with older age. They can cause bothersome symptoms in the lower urinary tract in men over the age of 50. These symptoms may be caused by an enlargement of the prostate, a condition which is known as benign prostatic enlargement (BPE) (Fig. 2). Other conditions can also cause these symptoms and your doctor will take this into account.

Benign prostatic enlargement is a common condition. It is related to hormonal changes which happen as men grow older. Prostate diseases can be very worrying but it is important to know that BPE is not prostate cancer. BPE does not become prostate cancer, even if it is left untreated. However, both benign prostatic enlargement and prostate cancer may develop with age. Some people may have both diseases. You should consult your doctor to discuss any of your concerns.

What are BPH, BPE, and BPO?

Benign prostatic hyperplasia (BPH) is a common benign (non-cancerous) condition which happens to some extent in all men. This condition is related to hormonal changes which happen as men grow older. In about half of these men, BPH may result in benign prostatic enlargement (BPE). In turn, this enlargement may obstruct the flow of urine, a condition which is called benign prostatic obstruction (BPO). BPO happens in about half of men with a benign prostatic enlargement. Your doctor may be referring to your condition by using either of the three terms.

Fig. 2: An enlarged prostate compressing the urethra and bladder.
Fig. 2: An enlarged prostate compressing the urethra and bladder.

This information was updated by the EAU Patient Information Working Group, March 2018.

The content is in line with the EAU Guidelines on the Management of Non-Neurogenic Male Lower Urinary Tract Symptoms 2017.

This information was produced by the European Association of Urology (EAU).

Series contributors:

  • Prof. Thorsten Bach – Hamburg, Germany
  • Prof. Alexander Bachmann – Basel, Switzerland
  • Prof. Louis Denis – Antwerp, Belgium
  • Dr. Günter Feick – Gehrden, Germany
  • Prof. Stavros Gravas – Larissa, Greece
  • Dr. Hashim Hashim – Bristol, United Kingdom
  • Prof. Rolf Muschter – Rotenburg, Germany
  • Dr. Cosimo De Nunzio – Rome, Italy
  • Mr. Hans Ransdorp – Bussem, The Netherlands
  • Prof. Jens Rassweiler – Heilbronn, Germany
  • Ms. Maria Russo – Orbassano, Turin, Italy
  • Dr. Roman Sosnowski – Warsaw, Poland
  • Prof. Andrea Tubaro – Rome, Italy