Case Study: Diagnosing and Managing BPH in a Male Patient With Urinary Symptoms

Opinion
Video

Dean Elterman, MD, discusses how a comprehensive approach to diagnosing and managing benign prostatic hyperplasia (BPH) involves a combination of symptom assessment, lifestyle modifications, pharmacotherapy, and regular follow-up to optimize patient outcomes.

Video content above is prompted by the following:

  • Patient Case Example: A man in his late 60s who presents with the following:
    • History of straining to initiate and maintain a urinary stream, a weak and intermittent urinary stream, a sensation of incomplete bladder emptying after urination, and nocturia; absence of hematuria or dysuria.
    • Past Medical History:
      • No history of urinary tract infections or other urological conditions
      • Hypertension (well-controlled with medication)
      • Hyperlipidemia
      • No previous surgical history
    • Physical Examination:
      • Digital rectal examination reveals an enlarged, nonnodular prostate (approximately 50 g); no other significant findings.
    • Laboratory and Diagnostic Tests: Serum prostate-specific antigen level: 2.5 ng/mL; urinalysis: normal; uroflowmetry: peak flow rate of 8 mL/sec (borderline obstructed); post-void residual urine volume: 120 mL; transrectal ultrasound: prostate volume estimated at 55 g.
  • Please describe your approach to diagnosing, treating, and managing this patient.
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