Fast Five Quiz: Test Your Knowledge of Benign Prostatic Hyperplasia

Bradley Schwartz, DO


March 09, 2017

The diagnosis of BPH can often be suggested on the basis of the history alone. Special attention to the following features is essential to making the correct diagnosis:

  • Onset and duration of symptoms

  • General health issues (including sexual history)

  • Fitness for any possible surgical interventions

  • Severity of symptoms and how they are affecting quality of life

  • Medications

  • Previously attempted treatments

Symptoms often attributed to BPH can be caused by other disease processes, and a history and physical examination are essential in ruling out other etiologies of LUTS.

When the prostate enlarges, it may act like a "clamp on a hose," constricting the flow of urine. Nerves within the prostate and bladder may also play a role in causing the following common symptoms:

  • Urinary frequency: The need to urinate frequently during the day or night (nocturia), usually voiding only small amounts of urine with each episode

  • Urinary urgency: The sudden, urgent need to urinate, owing to the sensation of imminent loss of urine without control

  • Hesitancy: Difficulty initiating the urinary stream; interrupted, weak stream

  • Incomplete bladder emptying: The feeling of persistent residual urine, regardless of the frequency of urination

  • Straining: The need strain or push (Valsalva maneuver) to initiate and maintain urination in order to more fully evacuate the bladder

  • Decreased force of stream: The subjective loss of force of the urinary stream over time

  • Dribbling: The loss of small amounts of urine due to a poor urinary stream

A sexual history is important, as epidemiologic studies have identified LUTS as an independent risk factor for erectile dysfunction and ejaculatory dysfunction.

For more on the presentation of BPH, read here.


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