Benign Prostatic Hypertrophy (BPH)

Increase in prostate size may cause first irritative symptoms (urge; nocturia), later obstructive symptoms (difficulty initiating stream; dribbling, hesitancy; incomplete emptying; increased risk of infections), and eventually urinary retention with overflow incontinence.

BPH, which is related in part to the presence of endogenous androgens, is rare before the age of 40, but it increases with age to a prevalence of about 90% by age 80. The probability that a 50-year-old man will ultimately require treatment for BPH is 25%.

BPH may be diagnosed on the basis of physical exam, rectal ultrasound, and/or symptoms.

Reasons for treatment, which may be surgical or medical, include the following:

• Voiding symptoms that are irksome to the patient;

• Urinary retention;

• Recurrent urinary tract infections;

• Compromised renal function;

• Recurrent gross hematuria;

• Urge incontinence due to BPH.