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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Yes, usually. Video assessment, with a prescription when appropriate.
- An enlarged prostate is common with age and assessed with a symptom score; first-line treatment is usually a tablet, and a sudden inability to pass urine is a medical emergency.
- Benign prostate enlargement is non-cancerous and does not turn into prostate cancer, though symptoms can overlap.
- Alpha-blockers such as tamsulosin often improve the stream within days to weeks; prostate-shrinking tablets take several months.
- Mild to moderate symptoms without red flags suit online assessment, a symptom score and first-line treatment.
Get urgent in-person care, not an online appointment, if you suddenly cannot pass urine at all and your lower abdomen is painful and swollen (acute urinary retention). Also seek prompt in-person assessment for visible blood in your urine, fever with shivering and urinary symptoms (possible infection), or new severe pain. These need hands-on care and tests. For ongoing bothersome urinary symptoms without red flags, an online assessment is a sensible first step.
Can an online doctor treat an enlarged prostate?
Often, for the common cases. Benign prostate enlargement is a non-cancerous growth of the prostate that squeezes the urine tube and causes urinary symptoms. A doctor can measure how severe those symptoms are with a scoring questionnaire, arrange a urine test and discuss a PSA blood test, and prescribe first-line tablets when suitable. Urinary retention, blood in the urine and abnormal test results need in-person urology care.
Mobi Doctor, an online healthcare service with licensed doctors, is well placed for the assessment and the first steps of treatment, because much of BPH care is history, a symptom score and a medicine, all of which work by video. The parts that need a physical examination or specialist tests are referred honestly.
How an online consultation helps with an enlarged prostate
the doctor works through a structured questionnaire (the international prostate symptom score) that turns vague complaints into a number, so you both know whether symptoms are mild, moderate or severe and whether treatment is worth it.[1]
a urine test to rule out infection, and a clear discussion of the PSA blood test, its uses and its limits, so you decide about it with the full picture rather than by default.
from lifestyle changes to an alpha-blocker, to adding a prostate-shrinking tablet for larger glands, with a frank explanation of what each does and how long it takes.[1]
a rectal examination, flow tests and scans happen in person, so anything that needs them, or that points beyond simple BPH, is referred.
What is benign prostate enlargement (BPH)?
The prostate is a small gland that sits below the bladder and surrounds the tube that carries urine out (the urethra). From middle age onward it commonly enlarges, a non-cancerous process called benign prostatic hyperplasia, or BPH. As it grows it can press on the urethra and irritate the bladder, producing the cluster of urinary symptoms often grouped as lower urinary tract symptoms.[1]
Storage symptoms
These come from the bladder reacting to the obstruction: needing to pass urine more often, sudden urgency that is hard to defer, and getting up at night to go, which is called nocturia and is often the symptom that bothers men most.
Voiding symptoms
These come from the narrowed outflow: a weak or slow stream, difficulty getting started (hesitancy), dribbling at the end, and a feeling that the bladder has not emptied fully. An enlarged prostate is common and treatable, and it is not the same as prostate cancer, though the symptoms can overlap, which is exactly why assessment matters.
How is an enlarged prostate assessed?
Assessment starts with your story, scored and structured rather than guessed. The doctor uses a validated symptom-score questionnaire to gauge severity and how much the symptoms interfere with your life, asks about the pattern of storage and voiding symptoms, and reviews your medicines, since some can worsen urinary flow.[1] A urine test checks for infection or blood. A bladder diary, noting how much and how often you pass urine, adds useful detail. A physical prostate examination (a rectal examination), a urine-flow measurement and an ultrasound scan are in-person tests, arranged when the picture calls for them.
PSA testing: an honest discussion
PSA is a protein measured by a blood test, and it deserves a straight explanation rather than a reflex tick-box. PSA can be raised by benign enlargement, by infection or inflammation, and by prostate cancer, so a single result rarely gives a clean answer, and both raised and normal readings can mislead.[2] The doctor talks through what a PSA test can and cannot tell you, so the decision to have one is informed. One practical point matters for anyone taking prostate-shrinking tablets: the 5-alpha-reductase inhibitors roughly halve the PSA level, so results must be interpreted with that in mind, which is part of why this is discussed openly.[2] Interpreting a genuinely abnormal PSA, and deciding on any further tests, is done with in-person urology care.
Is your enlarged prostate suitable for online care?
Many cases are, at least to start. Mild to moderate symptoms without red flags suit online assessment, a symptom score and first-line treatment. Retention, blood in the urine, an abnormal PSA or examination, recurrent infections or treatment that is not working need in-person urology. This is the treatment ladder our doctors use, aligned with the cited guidance.[1]
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| Presentation | Likely first step | Suitable for online care? | When referral or in-person care is needed |
|---|---|---|---|
| Mild symptoms, low score, not very bothered | Lifestyle advice and watchful waiting[1] | Yes | If symptoms progress or red flags appear |
| Moderate symptoms that bother you | An alpha-blocker such as tamsulosin, after assessment[1] | Usually yes | Poor response or new complications |
| Large prostate with progression risk | Add a 5-alpha-reductase inhibitor, with monitoring[1][4] | Yes, with follow-up | Symptoms failing despite treatment |
| Blood in urine, abnormal PSA or exam, recurrent infection | In-person urology assessment | No | Routinely, and sooner if worrying |
| Sudden inability to pass urine | Emergency care, do not wait | No | Same day; call 112 if severe |
Availability of individual medicines and who may prescribe them vary by country; your doctor confirms what applies where you are.
Not sure which row is you? A doctor can tell you in one consultation. €47, exact price shown before payment.
See available times →What the doctor checks in an online enlarged prostate consultation
The consultation is built around scoring the problem and choosing a safe first step. The doctor will typically assess:
- Your symptom score: a structured questionnaire covering stream, urgency, frequency, emptying and how much these interfere with daily life.[1]
- Nights and days: how often you wake to pass urine, and how the pattern affects sleep and routine.
- Storage versus voiding: which type of symptom dominates, since that steers the choice of tablet.
- Fluids and habits: caffeine, alcohol and evening drinking, all of which can be adjusted before or alongside medicine.
- Red flags: any blood in the urine, episodes of not being able to pass urine, or recurrent urinary infections.
- Medicines: including some that worsen flow, and interactions that matter before starting an alpha-blocker.
- PSA and family history: any previous PSA results and a family history of prostate cancer, to inform the PSA discussion.[2]
- Erectile function: because urinary and sexual symptoms often travel together and some treatments affect both.
When we treat an enlarged prostate online, and when we refer you
We treat online: mild to moderate lower urinary tract symptoms suited to lifestyle advice or a first-line tablet; starting an alpha-blocker or, for a larger prostate, a prostate-shrinking tablet with a plan to review; ongoing prescriptions with appropriate monitoring; and a clear, unhurried discussion of PSA testing.[1]
We refer or redirect you: acute urinary retention (a sudden inability to pass urine), which is an emergency; visible blood in the urine, an abnormal PSA or a suspicious prostate examination, which need urology assessment to exclude cancer; recurrent urinary infections, bladder stones or a suspected neurological cause; and men whose symptoms fail despite treatment, who may be candidates for a procedure such as surgery. Where urinary symptoms turn out to be a urinary tract infection rather than prostate enlargement, the doctor treats that instead, and because bladder and sexual symptoms overlap, an online erectile dysfunction assessment can be part of the same conversation.
Treatment options for an enlarged prostate (BPH)
What you can do yourself
Simple changes help a surprising number of men, and are worth trying first for mild symptoms. Cut down on caffeine and alcohol, which irritate the bladder, and reduce fluids in the couple of hours before bed to ease night-time trips without leaving yourself dehydrated.[3] Double voiding, waiting a moment and trying again, can improve emptying, and treating constipation reduces pressure on the bladder. Some over-the-counter decongestants can worsen flow, so it is worth checking labels. None of this shrinks the prostate, but it can meaningfully reduce how much the symptoms intrude.
Prescription treatment after your consultation
A prescription is never issued without a consultation; after assessment, the doctor works up a well-established treatment ladder. Alpha-blockers, such as tamsulosin, relax the muscle at the bladder outlet and usually improve the stream within days to a couple of weeks; they can lower blood pressure and occasionally affect ejaculation, which the doctor explains.[1] For a larger prostate, a 5-alpha-reductase inhibitor such as finasteride or dutasteride can gradually shrink the gland over several months and reduce the risk of complications, at the cost of a slower onset and effects on PSA and sometimes sexual function; the two are sometimes combined.[1][5] When medicines are not enough, a procedure such as transurethral surgery may be the answer, and that is a urology referral rather than an online treatment. Which medicines are available, and who may prescribe and monitor them, varies by country; your doctor confirms what applies to you.
When to get in-person care
A sudden, complete inability to pass urine, with a painful, swollen lower abdomen, is acute urinary retention and a medical emergency: seek urgent in-person care or call 112 without delay, because the bladder needs to be drained promptly. Also seek prompt in-person assessment for visible blood in the urine, fever with shivering and urinary symptoms (a possible infection that can become serious), or severe pain. These situations are not suitable for online care and should not wait.
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Listen · 23 Feb 2026 →How Mobi Doctor works
- Book a time that suits you: open daily 7am–11pm, often the same day, with the exact price, €47, shown before you pay.
- Speak to a licensed doctor about an enlarged prostate (BPH): a private video consultation, from anywhere in Europe and work through the symptom score together.
- Get your plan: lifestyle advice, a first-line prescription where suitable, and a clear steer on any tests or referral. If we can’t help you online, you get a full refund.
Frequently asked questions about an enlarged prostate (BPH)
Can an online doctor prescribe tablets for an enlarged prostate in Europe?
Yes, in suitable cases. After scoring your symptoms and checking your history and medicines by video, the doctor can prescribe a first-line treatment such as an alpha-blocker, sent to a pharmacy near you in most EU countries. Larger prostates may need an added shrinking tablet with monitoring. Red flags such as retention or blood in the urine are referred for in-person care, and prescribing rules vary by country.
How much does an enlarged prostate consultation cost?
A video consultation costs €47. The exact price is shown before payment, and there is no subscription. Any tests or medicines are paid for separately. If the doctor cannot help you online and you need in-person assessment, you get a full refund and clear directions to the right care.
How fast can I speak to a doctor?
Appointments are available daily from 7am to 11pm, often the same day. You choose a slot that suits you, and if a first-line tablet is appropriate you can usually collect it from a local pharmacy within hours.
Do I need a PSA test?
Not automatically. PSA is a blood test that can be raised by benign enlargement, infection or cancer, so a single result rarely gives a clean answer. The doctor talks through what it can and cannot tell you so you can decide with the full picture. If you take a prostate-shrinking tablet, remember it roughly halves the PSA reading, which must be taken into account when interpreting it.
Is an enlarged prostate the same as prostate cancer?
No. Benign prostate enlargement is a non-cancerous growth that is very common with age, and it does not turn into cancer. The symptoms can overlap, though, which is one reason the doctor asks about red flags such as blood in the urine and discusses PSA testing, so that anything needing further assessment is picked up.
How long do the tablets take to work?
Alpha-blockers such as tamsulosin often improve the stream within days to a couple of weeks, while prostate-shrinking tablets work much more slowly, over several months, because they gradually reduce the size of the gland. How long the tablets take depends on the type. The doctor sets a realistic timeline and a review so the plan can be adjusted.
Will treatment affect my sex life?
It can, and the doctor will be upfront about it. Alpha-blockers can sometimes change ejaculation, and prostate-shrinking tablets can affect sexual function in a minority of men. These effects vary, and urinary and sexual symptoms often occur together, so it is worth discussing both in the same consultation and weighing the options that suit you.
- Management of non-neurogenic male lower urinary tract symptoms (LUTS), EAU, European Association of Urology, 2024.
- Suspected cancer: recognition and referral (NG12), NICE, National Institute for Health and Care Excellence, 2015 (updated 2023).
- Lower urinary tract symptoms in men: clinical knowledge summary, NICE, National Institute for Health and Care Excellence, reviewed 2024.
- Finasteride for benign prostatic hyperplasia, Cochrane Database of Systematic Reviews, 2010.
- Finasteride and dutasteride containing medicinal products: EU-wide safety review, EMA, European Medicines Agency, 2025.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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Listen · 23 Feb 2026 →Speak to a doctor about benign prostate enlargement today
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