What are the symptoms of prostatic (prostate) issues?

From the Guidelines

Prostatic issues are commonly associated with lower urinary tract symptoms (LUTS), including storage symptoms like daytime frequency and nocturia, and voiding symptoms like weak stream and incomplete emptying, as noted in the 2013 study 1. These symptoms can significantly impact a patient's quality of life, interfering with daily activities and sleep patterns, as highlighted in the 2003 AUA guideline on management of benign prostatic hyperplasia 1.

Common Prostatic Conditions

• Benign prostatic hyperplasia (BPH): causes urinary symptoms due to prostate enlargement
• Prostatitis: an inflammation that may cause pain and urinary symptoms
• Prostate cancer: one of the most common cancers in men

Symptoms of Prostatic Issues

• Frequent urination
• Weak stream
• Incomplete emptying
• Nocturia
• Daytime frequency
• Urgency with or without urgency incontinence As stated in the 2013 study, LUTS may be due to structural or functional abnormalities in one or more parts of the lower urinary tract, and may also be secondary to cardiovascular, respiratory, or renal dysfunction or disease 1.

Management of Prostatic Issues

• Medications like alpha-blockers (tamsulosin 0.4mg daily) or 5-alpha reductase inhibitors (finasteride 5mg daily) for BPH
• Antibiotics for bacterial prostatitis
• Various treatments for prostate cancer ranging from active surveillance to surgery or radiation Regular prostate screening through PSA blood tests and digital rectal exams is recommended for men starting at age 50, or earlier for those with risk factors, to detect problems early when they're most treatable, as suggested by the 2003 AUA guideline 1.

From the FDA Drug Label

Symptoms were quantified using a score similar to the American Urological Association Symptom Score, which evaluated both obstructive symptoms (impairment of size and force of stream, sensation of incomplete bladder emptying, delayed or interrupted urination) and irritative symptoms (nocturia, daytime frequency, need to strain or push the flow of urine) The symptoms of prostatic (prostate) issues include:

• Obstructive symptoms:
  • Impairment of size and force of stream
  • Sensation of incomplete bladder emptying
  • Delayed or interrupted urination
• Irritative symptoms:
  • Nocturia
  • Daytime frequency
  • Need to strain or push the flow of urine 2

From the Research

Symptoms of Prostatic Issues

The symptoms of prostatic issues, particularly Benign Prostatic Hyperplasia (BPH), can be categorized into several key areas:

• Lower urinary tract symptoms (LUTS) 3, 4, 5, 6, 7
• Obstructive symptoms, such as:
  • Weak urine stream 4, 7
  • Hesitancy 4
  • Inability to terminate micturition abruptly 4
  • Sensation of incomplete emptying 4, 7
  • Stop-start urination 7
  • Straining to urinate 7
  • Need to urinate soon after voiding 7
• Irritative symptoms, such as:
  • Nocturia (frequent urination at night) 7
  • Urgency 7
  • Frequency 7
• Other symptoms, such as urinary retention 4 and gross hematuria 6

Evaluation and Diagnosis

The evaluation of BPH symptoms typically involves:

• Lower urinary tract symptoms evaluation with appropriate symptom scores 5
• Digital rectal examination 5
• Voiding charts 5
• Prostate-specific antigen and creatinine measurement 5
• Urinalysis 5
• Imaging of the urinary tract 5
• Assessment using the American Urological Association Symptom Index (AUASI) 6