Benign prostatic hyperplasia (BPH)

What it means

The prostate is a small gland that sits just below the bladder and wraps around the tube that carries urine out of the body. Benign prostatic hyperplasia, usually shortened to BPH, is simply the gland growing larger over time as the number of cells inside it increases. "Benign" means it is not cancer, and "hyperplasia" just means an increase in cell numbers. It is an extremely common change, not a disease in the way an infection or tumour is.

Why it appears on a CT or MRI report

Radiologists note prostate enlargement when a scan of the pelvis or abdomen happens to include the gland, even if that was not the reason for the scan. The report usually gives an estimated size or volume and may describe the gland as symmetrically enlarged, which is the typical pattern for BPH, as opposed to an irregular or asymmetric area that would prompt a closer look for something else. This is often listed as an incidental finding — something noticed along the way rather than the focus of the exam.

What it usually means

Prostate enlargement becomes more common with every decade of life after 40, and by the 60s and 70s a large majority of men show at least some degree of it. Because the gland wraps around the urine tube, a bigger prostate can gradually narrow that channel, which is why BPH is linked to urinary symptoms — a slower stream, needing to go more often (especially at night), a feeling of not fully emptying the bladder, or having to strain a little. Many men with an enlarged prostate on imaging have few or no symptoms, and the size seen on a scan does not always match how much trouble someone has urinating. BPH does not raise the risk of prostate cancer, and the two are evaluated separately.

When to follow up

If you're having urinary symptoms — a weak stream, frequent nighttime trips to the bathroom, urgency, or a sense of incomplete emptying — it's worth discussing with your doctor, since there are effective medications and, if needed, procedures that can help. Everyday BPH found incidentally on a scan with no symptoms usually needs no treatment at all. Seek prompt medical attention if you suddenly cannot urinate at all, see blood in your urine, or have pain, fever, or chills alongside urinary symptoms, since these need timely evaluation.

A plain-language way to picture it

Imagine a garden hose running straight through the middle of an orange. As the orange slowly grows bigger with age, its flesh presses in on the hose from all sides, gradually narrowing the channel water can flow through — even though the hose itself is perfectly fine. The prostate grows around the urine tube in much the same gradual, all-around way, which is why the main effect is on the flow rather than any damage to the gland itself.