Prostate Enlargement

Enlargement of the prostate is a mostly benign enlargement of the male prostate (prostate gland). The medical name for this is benign prostatic hyperplasia (BPH). This is differentiated from malignant prostate enlargement or prostate cancer.

What is the prostate?

The prostate is the prostate gland in men. It surrounds the part of the male urethra that is just in front of the bladder. The prostate secretes a secretion that triggers the mobility of the semen. From around the age of 50, the internal prostate tissue often overgrows, which leads to benign prostate enlargement.


The symptoms of an enlarged prostate are mainly expressed in the form of discomfort when urinating.

The nocturnal urge to urinate

The nocturnal urge to urinate and delayed urination are the first symptoms of prostate enlargement. The urine stream also becomes weaker and only extends to the tip of the shoe. The flow of urine is often interrupted and it takes much longer to empty the bladder. After urination, dribbling occurs. Since the bladder muscles have to do extra work, they are permanently damaged. A so-called bar bladder (trabecular bladder or diverticular bladder) develops.

Incomplete Emptying Of The Bladder

In the further course, complete emptying of the bladder is no longer possible and residual urine builds up in the bladder. The congestion of the urine, in turn, promotes infections of the bladder such as cystitis or urethritis. In addition, the kidneys are damaged in the long run.

Urinary Retention And Complications

If left untreated, an enlarged prostate can cause complete urinary retention, i.e. prevent urination altogether. This is associated not only with pain and urinary incontinence but with significant risks. At this stage of prostate enlargement, the risk of damage to the ureter and kidneys from backwater is particularly high. If not treated immediately, kidney weakness (chronic kidney insufficiency) up to kidney failure (acute kidney insufficiency) can develop.

Another cause of the prostate enlargement symptoms described here is a malignant growth of the prostate gland (prostate cancer).

The cause of prostate enlargement is an age-related change in hormone production. An imbalance between the male (testosterone) and female (estrogen) sex hormones seems to cause the tissue of the prostate to grow.

The prostate symptoms such as the urge to urinate at night are triggered because the enlarged prostate develops increasing pressure on the urethra or directly on the bladder.

Prostate Enlargement


Medical therapy for prostate enlargement is initially carried out with medication. Surgery is necessary in around 20 percent of those affected. In the event of urinary retention, a urinary catheter must be inserted through which the urine can drain.

Drug Treatment Of Prostate Enlargement

In the drug treatment of prostate enlargement, different active ingredients are used for different purposes. So-called alpha blockers relax the muscles in the urogenital tract and can thus make urination easier. Frequently used active substances from this group against prostate complaints are alfuzosin, doxazosin, tamsulosin, and terazosin. However, these only reduce the discomfort. The enlarged prostate itself is not affected.

Warnings About Finasteride

Active ingredients from the group of 5-alpha reductase inhibitors such as finasteride and dutasteride slow down the growth of the prostate. Both active ingredients can have serious side effects. Studies (see study situation) prove erectile dysfunction, loss of libido, and ejaculation problems that sometimes last for years.

The Federal Office for Drugs and Medical Devices warns in a so-called Rote-Hand-Brief (see study situation) that patients should be made aware of the possibility of mood changes including depressive moods, depression, and suicidal thoughts before taking finasteride. The European Medicines Agency has also made it necessary to mention fear as a new side effect of finasteride in the package insert.

Surgical Procedures For Prostate Enlargement

Urogenital surgery knows various surgical procedures for prostate enlargement. Basically, the procedure should always be kept as small as necessary to avoid complications such as incontinence or erectile dysfunction. You can find more information on the surgical techniques in the prostate cancer disease picture.

Self Help

Herbal medicines are enjoying increasing popularity in self-help with prostate enlargement – also thanks to aggressive advertising. It has not been scientifically proven whether over-the-counter drugs for prostate enlargement such as sitosterol, sabal fruits, rye pollen, or nettle root can swell the prostate.

It is known, however, from extracts from pumpkin seeds influence the metabolic processes in the prostate tissue. How and whether this slows down prostate enlargement is not yet known.

All over-the-counter active ingredients are designed to make urination easier and reduce the need to urinate at night. However, the funds are often relatively expensive. Medication prescribed by a doctor, on the other hand, is usually reimbursable. In addition, over-the-counter agents for prostate enlargement sometimes differ extremely in their composition and active ingredient concentration.

The self-treatment of nocturnal urge to urinate does not always make sense for another reason. Persistent urination discomfort can be a symptom of a developing prostate lump. You should therefore be clarified by a doctor. If this does not happen, self-treatment delays early detection and thus increases the risk that prostate cancer can no longer be treated successfully.

More self-help tips

    • Avoid alcohol and cold carbonated drinks and hot spices.
    • Empty the bladder frequently and completely.
    • Do not suppress the urge to urinate so that the bladder does not become overfilled.
    • Make sure you have regular bowel movements so that there is no additional pressure on the bladder and urinary tract.
    • Occasionally take warm Sitz baths.


Specific prevention of prostate enlargement is not known. Still a few tips:

    • Maintain a normal body weight. Because being overweight can adversely affect prostate enlargement.
    • Urologists recommend a balanced, fresh, high-fiber diet as well as regular physical activity and adequate exercise.
    • From the age of 45, you should regularly have an early detection examination of the prostate once a year.
    • If you have any complaints, answer the questions in our self-test on prostate prevention at regular intervals.