Conditions
Enlarged prostate: symptoms, treatment and refills by video
An enlarged prostate (benign prostatic hyperplasia, BPH) is the most common prostate problem in men over 50, and it is not cancer. It causes a weak stream, needing to pee often and getting up at night. The doctor evaluates you by video, gives you a lab order if needed and, if appropriate, prescribes and we send your prescription to your pharmacy.
Is it an emergency? Call 911.
Is this an emergency?
This is not an emergency service. Call 911 or go to the nearest emergency room if you have:
- You cannot pee at all
- Painful, frequent and urgent need to pee, with fever and chills
- Blood or clots in your urine
- Severe pain or discomfort in your lower belly or urinary tract
Help lines
At a glance
Enlarged prostate (BPH)
Common symptoms
- Trouble starting to pee or emptying your bladder
- A weak or interrupted stream, or dribbling at the end
- Getting up at night to pee
- Needing to pee often or urgently
- Pain when you pee
- Other names
- Benign prostatic hyperplasia · BPH
- Usual test
- Urinalysis and, after a shared decision, PSA, by lab order
- Treatment
- Lifestyle changes and, if appropriate, alpha blockers or 5-alpha reductase inhibitors
- Possible complication
- Being unable to pee (acute urinary retention), infections and bladder stones
On this page(9)
What is an enlarged prostate?
The prostate is a gland that wraps around the urethra, the tube urine flows through. It grows with age, and as it grows it can squeeze the urethra and make it hard to pee. That is why many men need to pee often, especially at night. According to the NIH, that is benign prostatic hyperplasia (BPH): growth that is not cancer.
According to the NIH, BPH is the most common prostate problem in men over 50: it affects 5% to 6% of men aged 40 to 64, and 29% to 33% of men 65 and older. It rarely causes symptoms before 40.
How we care for an enlarged prostate by video
You see Dr. Diana Nieves Castro, MD, a Puerto Rico–licensed general practice physician with several years of emergency-department experience, in English or Spanish.
The doctor asks about your symptoms, how often you get up at night, whether it burns or there is blood, and what medicines you take, because, according to the NIH, some make symptoms worse (such as cold-medicine decongestants and antihistamines). If needed, we give you a lab order for a urinalysis, kidney function and, if you decide on it together, a PSA. If appropriate, the doctor prescribes and we send your prescription to your pharmacy.
A prostate exam, ultrasound and other bladder tests are done in person: if you need them, the doctor refers you to a urologist. If you already take a prostate medicine and are running out, a prescription refill is a US$49 follow-up visit.
Your doctor
Dr. Diana Nieves Castro, MD
General practice physician
Several years of emergency-department experience.
Founding Executive Director of The Health Initiative.
Your visit in 3 steps
Request a visit online 24/7 — we confirm your time by email or text See how our online doctor visit works.
Request your visit.
Book a visit and choose "Doctor visit", or "Follow-up visit" if you only need a refill.
See the doctor by video.
We send you a secure video link. It works on your phone, tablet or computer.
Get your plan.
If appropriate, the doctor prescribes and we send your prescription to your pharmacy. If needed, you get a lab order or a referral.
Price
A doctor visit costs US$79, with no membership. A refill of a medicine you already take is a US$49 follow-up visit. You pay by card when you request the visit, and you get a full refund if the visit can’t take place. The lab charges for tests separately. See all prices.
Video visit
Doctor visit
US$79
For a new problem, urgent care (non-emergencies), primary care, children, birth control, STIs, skin and acne, and visitors. Includes a doctor's note if you need one.
- You’re charged when you request the visit.
- Full refund if the visit can’t take place
Enlarged prostate symptoms
According to the NIH, the most common symptoms are:
- Trouble starting to pee or emptying your bladder
- A weak or interrupted stream, or dribbling at the end
- Getting up at night to pee
- Needing to pee often or urgently
- Pain when you pee
Treatment, and when a PSA is ordered
According to the NIH, lifestyle changes help: drink less before going out or going to bed, cut back on alcohol and caffeine, and stay active. There are two main kinds of medicine: ones that relax the muscles of the bladder neck and prostate (alpha blockers) and ones that stop the prostate growing or shrink it (5-alpha reductase inhibitors). The doctor decides with you whether one fits. Some cases need a procedure with a urologist.
The PSA. PSA (prostate-specific antigen) is a prostate blood test. The US Preventive Services Task Force (USPSTF) says that for men 55 to 69, PSA screening for cancer is an individual decision made after discussing benefits and harms with your doctor, and it recommends against routine screening at 70 and older; that recommendation dates from 2018 and is being updated. The doctor talks it through with you and, if you decide on it, gives you the order.
If you have already been told your PSA is high, the doctor reviews the result with you and refers you to a urologist when needed.
Prostatitis: when the prostate is inflamed
Prostatitis is inflammation of the prostate. According to the NIH, there are several types. Acute bacterial prostatitis comes on suddenly, with fever, chills, urgency, burning when you pee and pain in the genitals, groin, lower belly or lower back: it needs care right away. Chronic prostatitis, or chronic pelvic pain syndrome, causes discomfort that comes and goes for months.
If you have burning without fever, read urinary tract infection. If you have fever with chills and pain when you pee, go to the ER.
When to go to the ER
According to the NIH, get care right away if you have any of these signs. For your safety, go to the emergency room or call 911. See when to go to the ER.
- You cannot pee at all
- Painful, frequent and urgent need to pee, with fever and chills
- Blood or clots in your urine
- Severe pain or discomfort in your lower belly or urinary tract
How we care for you
We evaluate, diagnose and treat; if needed, we give you a lab order for a lab near you.
We see adults and children of all ages. Patients under 21: a parent with patria potestad (parental authority) or a legal guardian is on camera for the whole visit and shows photo ID.
Real-time video visit. We send you a secure video link. It works on your phone, tablet or computer.
If appropriate, the doctor prescribes and we send your prescription to your pharmacy. We do not prescribe controlled substances.
You must be physically in Puerto Rico during the visit (visitors, tourists and cruise passengers are welcome).
In an emergency, call 911.
Frequently asked questions
Is an enlarged prostate cancer?
Can I get a refill of my prostate medicine?
Should I get a PSA test?
When is it an emergency?
About this page
Author: The Health Initiative
Medical care provided by Dr. Diana Nieves Castro, MD (PR license 24027)
Disclosure: Founding Executive Director of The Health Initiative
Published: 2026-10-02 · Updated: 2026-10-02
Sources (4)
- Prostate Enlargement (Benign Prostatic Hyperplasia) (NIDDK, NIH) (opens in a new tab) (accessed 2026-10-02)
- Prostatitis: Inflammation of the Prostate (NIDDK, NIH) (opens in a new tab) (accessed 2026-10-02)
- Prostate Cancer: Screening (USPSTF, 2018) (opens in a new tab) (accessed 2026-10-02)
- Frequent or urgent urination (MedlinePlus, NIH) (opens in a new tab) (accessed 2026-10-02)