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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)


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