Benign prostatic enlargement is a nonmalignant overgrowth of the prostate gland that is common with aging; the pathologic diagnosis is known as benign prostatic hyperplasia (BPH). The size of the gland does not necessarily correlate with the degree of symptoms. Symptoms can include urinary urgency, frequency, nocturia, decreased force of stream, intermittency, and hematuria. Symptoms can progress from having difficulty with voiding to completion to having outright urinary retention. Diagnosis can usually be made by clinical symptoms, physical exam, and an objective measurement tool such as the American Urology Association Symptom Score. If the patient desires treatment, management initially starts with medical therapies, including an alpha-blocker sometimes with a 5-alpha reductase inhibitor if the gland size is larger (typically > 40 g based on exam or ultrasound). If medical therapies fail, surgical therapies such as transurethral resection of the prostate, transurethral needle ablation of the prostate, or simple prostatectomy can be considered.
See benign prostatic hyperplasia (bph) in The Manuals
References:
Pearson R, Williams PM. Common questions about the diagnosis and management of benign prostatic hyperplasia. Am Fam Physician. 2014;90(11):769-74.
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