Clinical manifestations and diagnostic evaluation of benign prostatic hyperplasia
- Glenn R Cunningham, MD
Glenn R Cunningham, MD
- Distinguished Professor Emeritus, Department of Medicine
- Baylor College of Medicine
- Dov Kadmon, MD
Dov Kadmon, MD
- Professor of Urology
- Baylor College of Medicine
Benign prostatic hyperplasia (BPH) is a common disorder that increases in prevalence with age (figure 1). The clinical manifestations and the diagnostic approach to patients suspected of having BPH will be addressed here.
The epidemiology, pathogenesis, and treatment of this disorder are discussed separately. (See "Epidemiology and pathogenesis of benign prostatic hyperplasia" and "Medical treatment of benign prostatic hyperplasia" and "Transurethral procedures for treating benign prostatic hyperplasia".)
Asymptomatic BPH — Benign prostatic hyperplasia (BPH) is a histologic diagnosis that becomes more prevalent with age (figure 1), but some men with BPH are asymptomatic . The correlation between symptoms and the presence of prostatic enlargement on physical examination or by transrectal ultrasonographic assessment of prostate size is poor.
Typical presentation — Approximately 50 percent of men at age 50 and up to 80 percent of men at age 80 have lower urinary tract symptoms (LUTS) attributable to BPH [2,3]. Common manifestations include:
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- CLINICAL MANIFESTATIONS
- Asymptomatic BPH
- Typical presentation
- Progression of symptoms
- BPH and prostate cancer
- DIFFERENTIAL DIAGNOSIS
- DIAGNOSTIC EVALUATION
- Physical examination
- Laboratory studies
- - Urinalysis
- - Serum creatinine
- - Prostate-specific antigen
- SYMPTOM SCORING
- ADDITIONAL TESTS FOR SELECTED PATIENTS
- Urine cytology
- Genoitourinary ultrasonography
- Post-void residual urine volume
- Seldom indicated studies
- SUMMARY AND RECOMMENDATIONS