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Enlarged Prostate : Disease Information & Treatments  


Benign Prostatic Hyperplasia (BPH) is mistaken to be simply a case of too many prostate cells. In reality, there is no cure for BPH and once prostate growth starts, it often continues, unless medical therapy is started.
Prostate grows in two different ways. In the first type of growth, cells multiply around the urethra and squeeze it, much like you can squeeze a straw. The second type of growth is the middle-lobe prostate growth, in which cells grow into the urethra and the bladder outlet area. This type of growth typically requires surgery.

Signs & Symptoms

  1. Blood in the urine (i.e. haematuria), caused by straining to void
  2. Dribbling after voiding
  3. Feeling that the bladder has not emptied completely after urination
  4. Frequent urination, particularly at night (i.e. nocturia)
  5. Hesitant, interrupted or weak urine stream caused by decreased force
  6. Leakage of urine (i.e. overflow incontinence)
  7. Pushing or straining to begin urination
  8. Recurrent, sudden, urgent need to urinate

In severe cases of BPH, another symptom i.e. Acute Urinary Retention (inability to urinate), can result. Acute Urinary Retention causes severe pain and discomfort. Catheterization may be necessary to drain urine from the bladder to obtain relief.


A physical examination and evaluation of symptoms provide the basis for a diagnosis of Benign Prostatic Hyperplasia. The physical examination includes a digital rectal examination (DRE), and symptom evaluation is obtained from the results of the AUA Symptom Index

Digital Rectal Examination (DRE)

DRE typically takes less than a minute to perform. The doctor inserts a lubricated, gloved finger into the patient's rectum to feel the surface of the prostate gland through the rectal wall to assess its size, shape, and consistency. Healthy prostate tissue is soft, like the fleshy tissue of the hand where the thumb joins the palm. Malignant tissue is firm, hard, and often asymmetrical or stony, like the bridge of the nose. If the examination reveals the presence of unhealthy tissue, additional tests are performed to determine the nature of the abnormality.

AUA Symptom Index

The AUA (American Urological Association) Symptom Index is a questionnaire designed to determine the seriousness of a man's urinary problems and to help diagnose BPH. The patient answers seven questions related to common symptoms of benign prostatic hyperplasia. How frequently the patient experiences each symptom is rated on a scale of 1 to 5. These numbers added together provide a score that is used to evaluate the condition. An AUA score of 0 to 7 means the condition is mild; 8 to 19, moderate; and 20 to 35, severe.


Blood test to check the levels of prostate specific antigen (PSA) in a patient who may have benign prostatic hyperplasia helps the Doctor to eliminate a diagnosis of prostate cancer.


This is a simple test performed which records urine flow to determine how quickly and completely the bladder can be emptied. With a full bladder, the patient urinates into a device that measures the amount of urine, the time it takes for urination, and the rate of urine flow. Patients with stress or urge incontinence usually have a normal or increased urinary flow rate, unless there is an obstruction in the urinary tract. A reduced flow rate may indicate BPH.

Post-void residual (PVR)

This test measures the amount of urine that remains in the bladder after urination. The patient is asked to urinate immediately prior to the test and the residual urine is determined by ultrasound. PVR, less than 50 ml. generally indicates adequate bladder emptying and measurements of 100 to 200 ml. or higher often indicate blockage




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