Ultrasound of abdomen with full bladder will help determine dimensions, weight and volume of prostate gland.
A urodynamics study can determine extent of bladder outlet obstruction and amount of pressure that develops during voiding.
Following treatment options are there for benign prostatic hypertrophy:
A. Wait and See:
during initial stages of this problem all that has to be done is to wait and see until symptoms have become severe enough and there is strong evidence for intervention on investigations.
B. Medical Management:
Medical management of BPH includes:
Alfa-1 antagonists such as tamsulosin (flomax), alfuzosin, which decrease tone of the smooth muscle in bladder and prostate. These are considered to be first line treatment for BPH and these improve symptoms in 70% of the affected men. Their unwanted effects include dizziness, low blood pressure, dryness of mouth and depression.
5-alfa-reductase inhibitors such as finasteride prevent the conversion of testosterone to dihydrotestosterone, which is known for causing BPH. These medications cause reduction in prostatic size and may not provide relief immediately. Their untoward effects include, erectile dysfunction, loss of libido and gynecomastia.
Combination of above mentioned 2 groups of medications has been recommended for best results, both in terms of symptom relief and reduction in prostate size.
C. Surgical Intervention:
Surgical intervention is recommended when prostate has grown excessively and symptoms cannot be controlled or very high dose of medication is required to control the symptoms. The procedure of choice is transuretheral resection of prostate (TURP).