How to Make the Diagnosis of Benign Prostatic Disease

We have a number of clinical points which we can use to assess whether or not a man with symptoms suffers from benign prostatic enlargement and/or bladder outlet obstruction due to benign prostatic hyperplasia. These clinical points are lower urinary tract symptoms, digital rectal examination, ultrasound of the prostate and bladder (measuring prostate volume and bladder wall thickness), flow rates, residual urine, and pressure–flow studies. The diagnosis of symptomatic BPE and the decision of whether or not specific treatment is advisable will be based on the combination of several of these examinations, of which some are more important than others. # 2009 European Association of Urology. Published by Elsevier B.V. All rights reserved.