Can BPH cause an assymetrical enlargement....

I know that some biopsy cores and not others can show evidence of hyperplasia. So the growth doesn't have to be uniform throughout. The most common place of origination is the transition zone. From there it can push forward against the urethra and cause the anterior to bulge, and it can cause growth as far up as the bladder, preventing urine flow, and semen flow. Because it can push into the center, the apparent prostate size may not change as much as the real increase in tissue.