Darius is 63 years old and began to wake up at night to urinate. When he went to the bathroom, he had to strain to initiate the flow, and the stream of urine was weak. Over time, the pattern became more apparent during the day; he often had a sense of urgency and felt he was going to the bathroom frequently. When he did, however, he did not always feel he had emptied his bladder, and he tended to dribble throughout the day. Much to his reluctance, his wife urged him to see a physician. At the doctor’s office, his case history was carefully taken, a digital rectal exam was performed, and lab work was ordered. His blood results were unremarkable, but his urinalysis showed an elevated white blood cell count and bacteria. His physician diagnosed Darius with benign prostatic hyperplasia and urinary tract infection.
- How does BPH contribute to the signs and symptoms of bladder dysfunction, and how was Darius prone to developing a urinary tract infection?
- What are the static and dynamic components of BPH? Why are α1-adrenergic receptor blockers sometimes used to treat prostatic hyperplasia?
- How does the prostate feel during a digital rectal exam with benign prostatic hyperplasia, acute bacterial prostatitis, and prostate cancer?
- Why does the patient with prostate cancer present with symptoms later in the disease?