Urinary symptoms
The most common symptoms are a weak stream, difficulty starting urination, a feeling of incomplete emptying, dribbling at the end, and needing to urinate several times during the night. They are not an inevitable sign of ageing: they can be treated.
Importantly, BPH symptoms are not related to prostate cancer, although both problems can coexist — which is why both are assessed together.
Diagnosis
The assessment includes the medical history and validated questionnaires, examination, urine and PSA tests, urine flow study (uroflowmetry) and ultrasound, which measures prostate size and post-void residual urine.
Treatment
The first step is medication, with drugs that relax the prostate or reduce its volume. When medication is not enough or complications appear (urinary retention, stones, bleeding or kidney involvement), surgery is considered.
Surgery today is endoscopic and minimally invasive: resection or enucleation of the prostate through the natural route (urethra), with no incisions. Outpatient techniques also exist for selected prostates. The choice depends on prostate size and each patient's preferences.