The symptoms of BPH can be divided into those caused directly by urethral obstruction and those due to secondary changes in the bladder.

Typical obstructive symptoms are:

  • difficulty in starting to urinate despite pushing and straining
  • a weak stream of urine; several interruptions in the stream
  • dribbling at the end of urination

Bladder changes cause:

  • a sudden strong desire to urinate (urgency)
  • frequent urination
  • the sensation that the bladder is not empty after urination is completed
  • frequent awakening at night to urinate (nocturia)

As the bladder becomes more sensitive to retained urine, a man, may become incontinent (unable to control the bladder causing bed wetting at night, or inability to respond quickly enough to urinary urgency).

Burning or pain during urination can occur if a bladder infection or stone is present. Blood in the urine (hematuria) may herald BPH, but most men with BPH do not have hematuria.