Causes and Diagnoses

Causes and Diagnoses of Benign Prostatic Hyperplasia

Essentially every man will develop BPH if he lives long enough. Some may develop BPH at a young age (as young as 40), and some have more symptoms than others. The following can affect your risk:

• Age. Symptoms become more common as you get older.
• Lifestyle. A sedentary lifestyle can lead to increased symptoms, while increasing exercise can help improve symptoms. Alcohol and caffeine intake can worsen symptoms of BPH and should be avoided.
• Medications. Certain medications, such as those used to treat allergies and beta-blockers used to treat hypertension, can worsen symptoms.

Diagnosis is usually made by evaluating symptoms and performing a physical exam to check for an enlarged prostate. This finding is usually established by a digital rectal exam.

Additional tests may include:

• A flow test is when the patient urinates into a receptacle while the strength of the stream is recorded.
• The urine may be analyzed for blood components, bacteria and stone crystals.
• A noninvasive ultrasound of the bladder may be performed after urination to check for residual urine.
• A prostate-specific antigen (PSA) blood test and urine analysis are recommended to exclude prostate cancer or other coexisting conditions that could require a different treatment plan.
• If surgical treatment is pursued, an exam using a camera through the penis (cystoscopy) may be recommended to better define the anatomy of the enlarged prostate and determine the optimal treatment options. This exam is performed in the office with local anesthesia and usually takes just two to three minutes.
• A bladder function test may be performed to check the bladder’s ability to contract with sufficient force. This requires the placement of a pressure-flow measuring catheter (a thin plastic tube inserted in the penis). The study takes approximately 20 minutes.
• An ultrasound, computed tomography (CT) scan or magnetic resonance imaging (MRI) of the prostate may be performed to further evaluate the size and structures of the prostate.