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Benign prostatic enlargement (BPE) can affect the way you normally urinate. This happens because the enlarged prostate puts pressure on the urethra at the outlet of the bladder (Fig. 1a and 1b).

Sometimes the symptoms are mild. For example, you may need to urinate more often or find it more difficult to empty your bladder completely. These mild symptoms are a normal part of the ageing process – just like a decline in mobility, memory, or flexibility. It is possible that your doctor will not recommend treatment for mild symptoms.

Sometimes the symptoms are very bothersome and can have a negative effect on your quality of life. In this case, you may benefit from treatment.

The symptoms which are often called lower urinary tract symptoms (LUTS) may be caused by BPE and may be due to other conditions which affect the urinary system.

Fig. 1a: A healthy prostate in the lower urinary tract.
Fig. 1a: A healthy prostate in the lower urinary tract.
Fig. 1b: An enlarged prostate compresses the urethra and bladder.
Fig. 1b: An enlarged prostate compresses the urethra and bladder.

Types of symptoms

In men with BPE, the symptoms can affect urination in different ways:

  • The way you hold the urine in the bladder (storage)
  • The way you urinate (voiding)
  • How you feel after you urinate (post-micturition)

Storage symptoms include:

  • The need to urinate more often than usual
  • The need to wake up at night to urinate
  • The sudden need to urinate and having trouble holding it
  • Any involuntary loss of urine (incontinence)

Voiding symptoms include:

  • A weak stream of urine
  • Splitting or spraying of the urine stream
  • The flow of urine starts and stops (intermittent)
  • Straining when urinating
  • It takes a while before the urinary flow starts
  • It takes longer to finish urinating
  • In rare cases acute or chronic urinary retention

Post-micturition symptoms include:

  • The feeling that the bladder is not completely empty
  • Involuntary loss or dribbling of urine into your underwear shortly after leaving the toilet