Gahah

1. Case Presentation: Benign
Prostatic Hyperplasia (BPH)
Postgraduate Seminar

2. Case Details
• 65-year-old male
• Primary complaints: Increased urinary
frequency and nocturia × 6 months
• Associated: weak stream, hesitancy,
intermittency, terminal dribbling

3. History of Presenting Illness
• Symptoms began gradually 6 months ago
• Daytime frequency: 8–10 times/day
• Nocturia disturbing sleep: 3–4 episodes/night
• Hesitancy lasting 10–15 seconds before urine
starts
• Straining required at times
• Sensation of incomplete emptying after
voiding
• Intermittent urinary stream with reduced flow

4. Detailed Medical History
• Known case of Hypertension × 10 years; on
Amlodipine
• No diabetes mellitus
• No COPD or cardiac failure
• No prior history of UTI or urinary stones
• No prior prostate surgery
• No neurological disorders affecting bladder
function

5. Lifestyle & Social History
• Normal fluid intake (~2 L/day)
• No alcohol; occasional tea/coffee
• Sedentary lifestyle
• Sleep disturbed due to nocturia

6. Drug & Sexual History
• No use of over-the-counter decongestants
(sympathomimetics)
• No long-term anticholinergic medication
• Erectile function normal; no painful
ejaculation
• No history of STDs

7. Family History
• No family history of prostate cancer
• No hereditary urinary disorders

8. Physical Examination
• Vitals stable
• Per abdomen: bladder non-palpable
• DRE: enlarged, smooth, firm, non-tender
prostate

9. Investigations
• Urine routine: normal
• PSA: 2.6 ng/mL
• Renal function: normal
• Ultrasound: prostate 45cc, PVR 80 mL

10. Diagnosis
• Benign Prostatic Hyperplasia with moderate
LUTS