BPH Symptoms Caused by Enlarged Prostate in Men Under 45  

by Alex Shteynshlyuger MD

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Prostate Swelling and BPH in Young Men Under Age 45

Symptoms of an enlarged prostate are most common after or around age 50.  However, a considerable number of younger men experience symptoms of BPH and enlarged prostate.  

When symptoms of BPH occur depends on several factors:  genetics seems to play a significant role; environmental factors possibly related to the diet may also affect the age of symptom onset. Obesity can increase the risk of BPH.

Often if symptoms are mild and not bothersome and other problems such as urethral stricture, bladder stones, and cancer are not found, man can defer treatment until symptoms progress.

Sometimes, men as young as in their 30’s and 40’s develop bothersome symptoms of an enlarged prostate.  Commonly there may be a need to wake up to pass urine at night, slow urine stream, sense of urgency and sometimes urge incontinence

For younger men, often, preservation of sexual function and in particular ejaculation (especially if they plan on having children) is of paramount importance.

Prostate Problem vs Bladder or Urethral Problem

In men younger than 45, it is important to clearly define the problem that is causing urinary problems.  While it may often be due to enlarged prostate; it may also be a symptom of urethral problems such as urethral stricture, bladder problems such as bladder cancer or bladder stone or neurological problem.

Full evaluation often requires cystoscopy to look inside the urethra and the urinary bladder, bladder ultrasound with a post-void evaluation of residual urine left after urination.  A urodynamic study that evaluates the pressures within the bladder is often useful as well.

Treatment Option for Young Men with BPH

It is important to recognize that sometimes symptoms of an enlarged prostate are caused by temporary swelling of the prostate from infection or post-infectious inflammation. Sexually transmitted diseases (STDs) or urethritis are often to blame and symptoms improve with treatment. Typically, these symptoms resolve over time as swelling from infection goes away.  Surgical treatment is rarely needed unless a prostate abscess develops.

For younger men with an enlarged prostate that is caused by prostate growth rather than inflammation, a number of options are available.

Can Men in their 20’s and 30s Develop Enlarged Prostate and BPH?

Studies show that men can develop microscopic signs of BPH as early as in their 20’s and 30’s.  However, it is very uncommon for men in their 20’s to experience significant symptoms of BPH or an enlarged prostate.  Typically, urinary symptoms in men aged 20-30 are caused by other problems.   Symptoms may be caused by enlarged prostate but often it’s swollen from infection rather than large from growth.

Symptomatic BPH is not very common in men who are aged 30-39 but a significant enough number of men start to show symptoms of enlarged prostate at this age.  Typically, symptoms are mild but occasionally symptoms are moderate or severe enough that they require treatment.

Treatment Options for Younger Men with BPH

Medications such as alpha-blockers (Flomax, Uroxatral) and Cialis daily are often useful for younger men with BPH symptoms.  Other medications such as finasteride can be used but sometimes can cause sexual side effects. For this reason, at New York Urology Specialists we do not commonly advise alpha-reductase inhibitors such as Proscar (finasteride) for younger men with BPH symptoms.

For men who do not wish to take daily medications or who experience intolerable side effects to oral medications for enlarged prostate (BPH), Urolift procedure or Rezum treatment can be performed.   Urolift procedure is a permanent ‘spring-like’ implant that pushes the prostate away from the urethra.  The benefit that attracts younger men to Urolift as a treatment option is that it does not cause ejaculation problems.  It is particularly important to men who have delayed having children because of career or for other reasons.  Similarly, studies show that the Rezum procedure does not cause sexual or ejaculation side effects.

Why Choose New York Urology Specialists for Treatment of Enlarged Prostate (BPH) and Prostate Swelling?

  • All treatment is performed by a Board certified urologist experienced in treating men with symptoms of BPH using medical therapy, Urolift, lasers and open surgery.
  • Experience Treating Young Men with Symptoms of Enlarged and Swollen Prostate.
  • We offer BPH treatment options under local anesthesia which avoids the risks, costs and recovery from general anesthesia. Most men are able to return to office work and other normal activities the next day.

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Dr. Alex Shteynshlyuger is a fellowship trained board certified urologist with expertise in evaluation and treatment of urinary problems in men.  He uses modern effective and proven treatment methods including Urolift for BPH.  He is highly recommended by top primary care physicians in New York area.

He has successfully performed hundreds of prostate procedures in adults. Urolift procedures are performed in the office under local anesthesia, in surgical center and affiliated hospitals under anesthesia.

If you or someone you know has been experiencing urological symptoms, make an appointment to take advantage of Dr. Shteynshlyuger’s expert advice. Please feel free to Contact Us with any questions.


If you have any questions, to schedule a consultation or if you need a second opinion, please contact us or call: (646) 663-4044

We offer affordable, highest-quality urology care with or without insurance.   Find out our office hours or directions to our office. We offer weekday, weekend, and evening office hours.