Enlarged prostate

Alternative Names

BPH; Benign prostatic hypertrophy (hyperplasia); Prostate - enlarged

Symptoms

Less than half of all men with BPH have symptoms of the disease, which include:

• Slowed or delayed start of the urinary stream
• Weak urine stream
• Dribbling after urinating
• Straining to urinate
• Strong and sudden urge to urinate
• Incomplete emptying of your bladder
• Needing to urinate two or more times per night
• Urinary retention (complete inability to urinate)
• Incontinence
• Pain with urination or bloody urine (these may indicate infection)

Exams and Tests

After taking a complete medical history, your doctor will perform a digital rectal exam to feel the prostate gland. The following tests may also be performed:

• Urine flow rate
• Post-void residual urine test to see how much urine is left in your bladder after urination
• Pressure flow studies to measure the pressure in the bladder as you urinate
• An IVP (an x-ray study) to confirm BPH or look for blockage
• Urinalysis to check for blood or infection
• Urine culture to check for infection
• A prostate-specific antigen (PSA) blood test to screen for prostate cancer
• Cystoscopy

In addition, you may be asked to complete a form to evaluate the severity of your symptoms and their impact on your daily life. Your score may be compared to past records to determine if the condition is getting worse.

References

Hormone Foundation. Hormones & you. Patient information page. Benign prostatic hyperplasia (enlarged prostate). J Clin Endocrinol Metab. 2005;90(10):2.

AUA Practice Guidelines Committee. AUA guideline on management of benign prostatic hyperplasia (2003). Chapter 1: Diagnosis and treatment recommendations. J Urol. 2003;170:530-547.

Bent S, Kane C, Shinohara K, et. al. Saw palmetto for benign prostatic hyperplasia. NEJM. 2006; 354:557-566.