BPH is more common with age and usually occurs in men over the age of 50. Other risk factors include obesity, lack of physical activity, erectile dysfunction, alcohol consumption, smoking, diabetes, and family history of BPH.
Smooth, symmetric, firm enlargement of the prostate is found on digital rectal exam.
Patients often complain of a feeling of incomplete emptying of the bladder related to urinary retention. Incomplete voiding results in stasis of bacteria in the bladder, which increases the risk of developing urinary tract infection. Additionally, calculi may develop in the bladder due to the alkalinization of the residual urine.
Compression of the urethra presents as problems with urination such as inability to start or maintain a constant strong urine stream or dribbling of urine. Problems maintaining a strong stream of urine is an early presentation of BPH.
Compression of the urethra can lead to increased urinary frequency in patients.
Along with frequency, urinary urgency may occur, which manifests as a need to pass urine quickly for fear of incontinence.
Compression of the urethra can also lead to nocturia, which is the need to void at night. Nocturia may contribute to insomnia.
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