Enlarged Prostate

CLINICAL DIAGNOSTIC MANUAL

An enlarged prostate, known as prostatic hypertrophy, is a common condition in men, especially with aging. This enlargement can be benign or malignant and may cause a variety of urinary symptoms that affect the patient’s quality of life.

An enlarged prostate can result from inflammation (prostatitis), benign growth (benign prostatic hyperplasia, BPH), or neoplasia (prostate carcinoma). Evaluating the symptoms, along with appropriate diagnostic tests, is essential to differentiate between these conditions and establish an appropriate treatment plan.

Pathology	Symptoms and Clinical Signs	Suspicion Diagnosis	Confirmatory Diagnosis
Prostatitis	Dysuria, pelvic pain, urinary urgency, fever, general malaise	Clinical history, physical examination, digital rectal exam (DRE)	Urinalysis, urine culture, elevated PSA, transrectal ultrasound
Benign Prostatic Hyperplasia (BPH)	Urinary urgency, frequency, nocturia, weak urinary stream, sensation of incomplete emptying	Clinical history, physical examination, DRE	PSA, transrectal ultrasound, uroflowmetry
Prostate Carcinoma	Urinary symptoms similar to BPH, hematuria, bone pain in advanced cases, weight loss	Clinical history, physical examination, DRE, elevated PSA	Elevated PSA, prostate biopsy, transrectal ultrasound, multiparametric MRI (mpMRI)