As the prostate enlarges, the urethra becomes narrower. The bladder will get stronger to compensate, but eventually normal outflow of urine is obstructed. Symptoms usually appear gradually over time.
The Prostate and Surrounding Structures
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These symptoms are indications that your bladder is not emptying completely: Incomplete emptying—a sensation of not emptying your bladder completely after you finish urinatingFrequency—having to urinate again less than two hours after you finished urinatingUrgency—having a strong urge to urinate that is difficult to postponeNocturia—having to get up out of bed to urinate during the night
Nighttime urination can be a sign of incomplete emptying. In addition to heart failure, nighttime urination can also be a sign of other medical conditions, so see your doctor if it persists.
Other common symptoms include: Intermittency—frequent stopping and starting of your urine flow during a single urination periodHesitancy—having the urge to urinate, but needing to wait until the flow actually startsWeak stream—urine that trickles out rather than flows stronglyStraining—having to push or strain in order to urinateIncontinence—inability to control urination (leaking)Difficulty starting to urinateDribbling at end of urinationDeep discomfort in the lower abdomen
An obstructed urine flow often means that there is some urine stuck in the bladder (called residual urine). Having residual urine makes you vulnerable to urinary tract infections (UTIs), which can be either frequent or chronic. If you have a UTI, you may have additional symptoms, such as burning when you pass urine. UTIs by themselves also cause urgency and frequent urinating.
There is at least one common exception to the usual gradual development of symptoms. Sudden complete urine obstruction may occur in an elderly person due to dementia, inability to get out of bed, or drug side effects. The bladder may stretch to the size of a six-month pregnancy and fill the lower half of the abdomen. In such a case, emergency catheterization is required.
American Urological Association Practice Guidelines Committee. AUA guideline on management of benign prostatic hyperplasia. J Urol 2003; 170:530-47
Burnett AL, Wein AJ. Benign prostatic hyperplasia in primary care: what you need to know.
Dull P, Reagan RW Jr, et al. Managing benign prostatic hyperplasia.
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National Kidney and Urologic Diseases Information Clearinghouse
website. Available at:
Last reviewed September 2014 by Adrienne Carmack, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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