History and exam

Key diagnostic factors

common

storage symptoms

Frequency, urgency, and nocturia.

voiding symptoms

Weak stream, hesitancy, intermittency, straining, incomplete emptying, and postvoid dribbling.

Other diagnostic factors

uncommon

fever with dysuria

Suggestive of complicated urinary tract infection.

urinary retention

Acute complication.

Risk factors

strong

age over 50 years

Histologic and lower urinary tract voiding symptoms increase with age.[8]

Men ages 65-74 years account for 42% of BPH cases, with age-specific prevalence highest in men ages 75-79 years (24,300 per 100,000).[4]

weak

family history of BPH

Men with an affected family relative, diagnosed with BPH before age 60 years, are at an increased risk.[9] In addition, twin studies indicate a 3.3-fold higher risk in monozygotic twins with affected siblings.[10]

non-Asian race

Asian men have smaller prostates at any given age with less need for invasive surgery compared with white or black men in the US.[11]

cigarette smoking

A potential causal relation has been associated with lower urinary tract symptoms.[12][13]

male pattern baldness

A potential causal relation has been associated with lower urinary tract symptoms.[12][13]

metabolic syndrome

A potential causal relation has been associated with lower urinary tract symptoms.[14]

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