Benign Prostatic Hyperplasia: Symptoms and Diagnosis

Q: Benign Prostatic Hyperplasia: Symptoms and Diagnosis

Hello： In response to your question, individuals under 40 may also experience symptoms of prostate obstruction. <br>Possible causes include poor coordination between the bladder detrusor muscle and the sphincter. <br>Typically, this can be improved with medication, and in severe

Benign Prostatic Hyperplasia (BPH) Issues

Doctor, I have been experiencing frequent urination, more than ten times a day, for over a year now, with a maximum of about 14 to 15 times.
My abdomen is also larger than it was before I turned 30.
I have consulted several urologists who diagnosed me with overactive bladder and prescribed medication, but there has been little improvement.
Later, when I asked the doctor to check my prostate, I was told that prostate enlargement is only a concern after the age of 40, so no examination was performed.
Is there an easier way to get checked? I found information online suggesting that prostate enlargement can occur in men aged 30 to 40 as well.
Unfortunately, the doctors I encountered have subjectively dismissed my concerns, delaying my treatment.
Thank you.

ken, 30~39 year old female. Ask Date: 2010/03/07

Dr. Xu Wencang reply Urology

Hello: In response to your question, individuals under 40 may also experience symptoms of prostate obstruction.
Possible causes include poor coordination between the bladder detrusor muscle and the sphincter.
Typically, this can be improved with medication, and in severe cases, bladder function tests may be necessary.
The urge to urinate frequently before bedtime may also be caused by pre-sleep anxiety, which can also be treated with medication.

Reply Date: 2010/03/07

More Info

Benign Prostatic Hyperplasia (BPH), commonly known as prostate enlargement, is a condition that affects many men as they age. It is characterized by the non-cancerous growth of the prostate gland, which can lead to various urinary symptoms. Understanding the symptoms, diagnosis, and management of BPH is crucial for those experiencing related issues.

Symptoms of BPH
The symptoms of BPH can significantly impact a man's quality of life. Common symptoms include:
1. Frequent Urination: Many men with BPH experience an increased need to urinate, especially at night (nocturia). This can lead to waking up multiple times during the night to urinate, as you mentioned experiencing up to 14-15 times.

2. Urgency: A sudden, strong urge to urinate that may be difficult to control.

3. Weak Urine Stream: The flow of urine may be weak or interrupted, making it difficult to fully empty the bladder.

4. Difficulty Starting Urination: Men may find it challenging to initiate urination, which can be frustrating.

5. Incomplete Emptying: After urination, there may be a sensation that the bladder is not completely empty.

6. Straining: Some men may need to strain to begin urination.

Diagnosis of BPH
Diagnosing BPH typically involves a combination of medical history, physical examination, and specific tests:
1. Medical History: The doctor will ask about your symptoms, their duration, and their impact on your daily life.

2. Physical Examination: A digital rectal exam (DRE) may be performed to assess the size and condition of the prostate.

3. Urinary Tests: A urinalysis can help rule out infections or other conditions.
4. PSA Test: A prostate-specific antigen (PSA) blood test may be conducted to check for prostate cancer, as elevated levels can indicate both BPH and prostate cancer.

5. Urodynamic Tests: These tests measure how well the bladder and urethra are functioning.

6. Imaging Tests: In some cases, an ultrasound may be performed to visualize the prostate and assess its size.

Management of BPH
If diagnosed with BPH, treatment options vary based on the severity of symptoms and their impact on quality of life:
1. Watchful Waiting: If symptoms are mild, doctors may recommend monitoring the condition without immediate treatment.

2. Medications: Alpha-blockers (like tamsulosin) can help relax the muscles around the prostate and bladder neck, improving urine flow. 5-alpha-reductase inhibitors (like finasteride) can shrink the prostate over time.

3. Minimally Invasive Procedures: If medications are ineffective, procedures such as transurethral resection of the prostate (TURP) or laser therapy may be considered to remove excess prostate tissue.

4. Surgery: In severe cases, surgical options may be necessary to relieve symptoms.

Seeking Further Evaluation
Given your ongoing symptoms and the lack of improvement with medication, it is essential to advocate for your health. If you feel that your concerns are not being adequately addressed, consider the following steps:
- Seek a Second Opinion: If your current urologist is not taking your symptoms seriously, it may be beneficial to consult another urologist who specializes in BPH or prostate health.

- Request Specific Tests: You can ask for specific tests, such as a prostate ultrasound or a more detailed evaluation of your urinary function.

- Document Symptoms: Keep a record of your symptoms, including frequency, urgency, and any changes. This information can help your doctor understand the severity of your condition.

- Discuss Your Concerns: Be open about your worries regarding BPH at a younger age and the impact it has on your life. A good physician will take your concerns seriously and work with you to find a solution.

In conclusion, BPH is a common condition that can significantly affect men, even those in their 30s and 40s. If you are experiencing symptoms, it is crucial to seek appropriate medical evaluation and treatment. Don't hesitate to advocate for yourself and pursue further testing if necessary. Your health and well-being are paramount.

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