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How an enlarged prostate (BPH) affects your bladder

The prostate is located inside the male body, just below the bladder. The urethra, through which all urine passes, goes straight through the prostate. When the prostate grows, which it normally does when men get older, it squeezes the urethra, which can make it hard or even impossible to empty the bladder, or to resits the urge to urinate.

By the age of 50, one in two males experiences prostate enlargement and by the age of 80, this figure reaches about 90%. Why men's prostates become enlarged is uncertain, but the known risk factors are age and functioning testes (testicles that still produce sperm and the male sex hormone testosterone).

Enlarged prostate BPH full width

Emptying problems

  • Difficulty in starting to empty
  • Weak urine flow 
  • Feeling that your bladder has not been completely emptied 
  • Your bladder is not completely emptied after urination

Trouble resisting the urge to urinate

  • Need to urinate often 
  • Need to urinate at night 
  • Severe urgings that lead to urine leakage 

Sometimes these emptying problems can lead to a complete stop of urine flow and urinary tract infections that are difficult to treat. The symptoms described above can also be due to other illnesses in the lower urinary system, so you should always consult your doctor before starting any treatment. 

You can also find additional information in our enCATHopedia Leaflet.

Resulting problems

Because the urethra is being squeezed, your bladder needs to apply higher pressure to get the urine out. This leads to a thickening of the bladder walls, which makes it less flexible and less elastic. This in turn means that the bladder cannot pull itself together as well as it used to, so all the urine inside can't be squeezed out. Residual urine can be the breeding ground for bacteria that lead to urinary tract infections. 

Alan's story

Watch Alan talking about being diagnosed with BPH.


There are many treatments for enlarged prostates, depending on the severity of symptoms. In mild cases, your health care provider might opt for a “wait and monitor” approach to see if it improves on its own or requires intervention. For more serious conditions, the options go from medication to shrink the prostate to removal of prostate tissue in surgery.

At any stage, your doctor might recommend symptom relief with periodic or ongoing use of a catheter. This is a good option as it empties the bladder completely - if you catheterise before going to bed, for instance, you won’t have the urge to go in the middle of the night. You’ll also be able to relieve that feeling of having to go but not being able to on your own, in the privacy of your bathroom, quickly and easily. And since you’ll be draining the bladder completely, you won’t have to worry about embarrassing leaks when you’re out and about.

Indwelling versus intermittent catheters

There are two types of urinary catheters, indwelling catheters and intermittent self catheters (ISC). Indwelling catheters are left for longer periods of time inside the body. They may be suitable under some circumstances, but are not recommended since they are known to cause leakage and complications such as inflammation, urinary tract infections, bladder stones and urethral strictures. 

An intermittent catheter is inserted into the urethra only when the bladder needs to be emptied and is removed immediately afterwards. It mimics the natural way of bladder voiding in intervals and continence can be maintained between urinations. Disposable catheters are also often used while waiting for medication to take effect or in anticipation of an operation. 

Intermittent catheters can have a very positive effect on quality of life. In particular, they can help improve sex life, as there is no equipment to remove and less worry about leakage, leading to better confidence and spontaneity.

The Urology Care foundation is the official foundation of the American Urological Association. The website provides information on the different conditions, research, patient magazine and tips on healthy living.
Find information about events, news and education for both healthcare professionals and people with urinary, bowel or pelvic disorders on the International Continence Society's portal.
The Prostate Cancer Foundation was established to combat prostate cancer through funding of research.
This website was create by a prostate cancer patient intended to help fellow sufferers with a journal of treatment options, advice and information.
Prostate Cancer UK's mission is to stop men dying from prostate cancer through offering information, support, events and a chance to donate to further research in the field.