More than half of men with benign prostatic hyperplasia (BPH) do not experience any symptoms. However, obstruction of the urethra (the canal that carries urine and semen out of the body) and loss of bladder function associated with BPH cause various problems with urination for many others. Some men may experience a weak or interrupted urine stream. Others may leak or dribble urine.

Other signs of BPH include increased urgency to urinate or more frequent urination, particularly at night. Some men may also experience pain or bleeding during urination. Others may develop pelvic pain or experience sexual pain during ejaculation. Symptoms of BPH are sometimes referred to as lower urinary tract symptoms (LUTS).

In some cases, no symptoms will appear until a man suddenly finds himself unable to urinate at all. This condition is called acute urinary retention and may be triggered by use of certain over-the-counter cold, allergy, sleep or analgesic medications that contain a decongestant (sympathomimetic) which prevents the opening of the bladder from relaxing. Alcohol, cold temperatures and long periods of immobility can also cause this condition. It is an emergency and needs medical attention immediately to prevent permanent damage. Placing a urethral catheter can relieve the symptoms.