Fact-sheet: Benign prostatic hypertrophy
Updated on 10/01/2018 at 10:03 AM
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Definition
A common condition favored by aging and related to the development of a prostatic adenoma causing chronic bladder outlet obstruction.
Clinical features
From the filling phase (irritative symptoms): urinary frequency, nocturia, urgency, incontinence.
From the voiding phase (obstructive symptoms): need to strain, weak stream, interrupted stream, pre-voiding delay.
From the post-voiding phase: terminal dribbling, sensation of incomplete emptying.
Severe complications: urinary retention, hydronephrosis, recurrent urinary tract infections, bladder stones, gross hematuria, renal failure.
Ultrasound
- Increased prostate volume > 30 cc, at the expense of the central gland.
- Variable appearance:
- Nodules (hypo-/iso-/hyperechoic relative to the peripheral gland, surrounded by a hypoechoic rim),
- Calcifications
- Retention cyst
- Caution: overestimation of prostate volume via the transabdominal approach.
- Transrectal approach in case of surgery.
CT
No role.
Value for embolization? For studying the prostatic arteries and their variants.
MRI
No role in BPH.
Management
- Surveillance
- Alpha-blockers, phytotherapy, 5-alpha reductase inhibitor
- Prostiva
- Surgery/laser