Benign prostatic hyperplasia, often referred to as enlarged prostate, is a condition that virtually all men will confront by age 50. During BPH, excess prostate tissue proliferates, encroaching on the surrounding urethra and bladder, and resulting in a narrowed urethral lumen and impending urinary outflow. The designation ‘benign’ is important—BPH is a non-malignant process and should not be mistaken for prostate cancer.
Benign prostatic hyperplasia, often referred to as enlarged prostate, is a condition that virtually all men will confront by age 50. During BPH, excess prostate tissue proliferates, encroaching on the surrounding urethra and bladder, and resulting in a narrowed urethral lumen and impending urinary outflow. The designation ‘benign’ is important—BPH is a non-malignant process and should not be mistaken for prostate cancer.
An enlarged prostate does not always correlate with overt urinary symptoms; indeed, the volume of hyperplastic tissue does not predict the severity of clinical presentation. Rather, it is the degree of symptomatic distress—interference with daily activities, sleep disruption, and diminished quality of life—that frequently prompts men to pursue medical evaluation and intervention.
The main symptoms usually presented include the following changes in urination:
– Noticeably weak or slow emission of urine
– The persistent sensation of bladder fullness after voiding
– Initial delay before urination begins
– Increased frequency of urination
– A sudden, strong urge to urinate
– Multiple night-time awakenings to void
– A stream that intermittently ceases and restarts
– Physical exertion required to initiate micturition
– Dribbling that occurs after the main event of voiding
– The necessity to return to the toilet shortly after completing urination
Symptom Questionnaire:
The physician seeks to clarify not only which symptoms are present but also their intensity and the degree to which they interfere with daily living. The International Prostate Symptom Score (IPSS) is a standardized survey frequently employed in the outpatient setting.
Urine Flow Study:
The individual is asked to void fully into a calibrated receptacle, whereupon instruments measure the total volume expelled and the peak velocity. Persistent slowing of the stream relative to normative data raises concern for underlying bladder outlet obstruction frequently caused by benign prostatic enlargement.
DRE Examination:
A trained urologist inserts a lubricated, gloved finger into the rectum to palpate the entire prostate gland. This maneuver permits assessment of prostate enlargement, inconsistency of texture, and any irregularities in contour, all of which assist in rendering a more nuanced diagnosis.
PSA Test
Prostate-Specific Antigen Test (PSA) measures a protein whose production is restricted to prostatic tissue. Typical circulating levels tend to rise with advancing age and increased gland volume; nevertheless, out-of-range values may warrant further evaluation1.
Clinical diagnosis hinges on the character and degree of symptoms, as well as the degree to hich they disturb daily function. Physicians frequently initiate assessment with the International Prostate Symptom Score (IPSS), a concise instrument designed to quantify the impact of lower urinary tract symptoms on a patient’s quality of life2.