A68-year-old man presents to the physician with a complaint of urinary frequency. he states that he has noted increased urgency and frequency for approximately 1 year, but his symptoms have become progressively worse. he states that currently he seems to have to urinate "all the time" and often feels as if he has not completely emptied his bladder. he must get up to urinate three or four times each night. in addition, in the last month, he sometimes has postvoid dribbling. he denies fevers, weight loss, or bone pain. his medical history is notable only for hypertension. his medications include atenolol and aspirin. the family history is negative for malignancy.
on examination, he appears healthy. his vital signs are notable for a blood pressure of 154/192 mm hg. prostate is diffusely enlarged without focal nodule or tenderness. benign prostatic hyperplasia is suspected.
questions:
1. how would you make the diagnosis of benign prostatic hyperplasia?
2. what factors are known to be responsible for the pathogenesis of this disorder?
3. how would you classify this patient's symptoms? what is the mechanism by which benign prostatic hyperplasia causes these symptoms?