📄 SCRS
Benign Prostatic
Hyperplasia (BPH)
Benign Prostatic Hyperplasia ultrasound case study
USG
Benign Prostatic Hyperplasia (BPH) — Ultrasound Case Study
Case Study Record
| SN | Case Name | Report Line |
|---|---|---|
| 1 | Mild Benign Prostatic Hyperplasia (BPH-Grade-1) | View Report Line |
| 2 | Moderate BPH with Median-Lobe Prominence (BPH-Grade-2) | View Report Line |
| 3 | Moderate BPH with Median-Lobe Prominence (BPH-Grade-3) with Significant Post-Void Residual Urine | View Report Line |
CASE–1
Mild Benign Prostatic Hyperplasia [BPH-Grade-1]
Mild Benign Prostatic Hyperplasia [BPH-Grade-1]
Clinical History
A 58-year-old male presented with
increased urinary frequency, nocturia, and mild difficulty in initiating urination
for the past several months. The patient reported a weak urinary stream with occasional
sensation of incomplete bladder emptying. No history of hematuria or acute urinary retention
was reported.
Ultrasound Findings
Ultrasound examination demonstrates
mild enlargement of the prostate gland
with maintained overall contour and relatively homogeneous echotexture.
The transitional zone appears mildly prominent, producing mild enlargement of the
central gland.
The urinary bladder demonstrates mild trabecular prominence without definite intraluminal
mass or calculus. Pre-void urinary bladder volume is within the expected range.
Post-void assessment demonstrates a
small residual urine volume.
No definite focal suspicious prostatic lesion or significant pelvic free fluid is identified
on the present ultrasound examination.
|
| Ultrasound of the prostate. Sonographic image demonstrates mild prostatomegaly with mild prominence of the transitional/central gland and relatively preserved prostatic contour, favoring mild benign prostatic hyperplasia (BPH). |
Report Line
Mild prostatomegaly with prominence of the transitional/central gland,
suggestive of benign prostatic hyperplasia. Prostatic volume 30.41 ml Small post-void residual urine.
Impression
Mild prostatomegaly and benign prostatic hyperplasia (BPH-Grade-1) with small post-void residual urine.
Go To Table
Recommendation
Clinical correlation with lower urinary tract symptoms is advised.
Correlation with serum PSA and digital rectal examination may be performed according to
clinical indication. Urological evaluation may be considered if symptoms persist or
progress.
Key Learning Points
- BPH commonly affects the transitional zone of the prostate.
- Ultrasound may demonstrate enlargement of the central/transitional gland with variable heterogeneity.
- Assessment of the urinary bladder and post-void residual urine is important in patients with lower urinary tract symptoms.
- Prostate volume should preferably be calculated using three orthogonal measurements.
- Clinical correlation is important because prostate size does not always directly correlate with symptom severity.
CASE–2
Moderate Benign prostatic hyperplasia [BPH-Grade-2] with Median-Lobe Prominence
Moderate Benign prostatic hyperplasia [BPH-Grade-2] with Median-Lobe Prominence
Clinical History
A 66-year-old male presented with
progressive lower urinary tract symptoms
including weak urinary stream, increased frequency, nocturia, hesitancy,
and a sensation of incomplete bladder emptying for approximately one year.
Ultrasound Findings
Report Line
Moderate prostatomegaly with prominent transitional-zone enlargement and
intravesical protrusion of the median lobe, consistent with benign prostatic
hyperplasia. Prostatic volume 45.4 ml Moderate post-void residual urine.
Impression
Moderate prostatomegaly and benign prostatic hyperplasia with median-lobe prominence. and
moderate post-void residual urine.
Go To Table
Recommendation
Clinical and urological correlation is recommended.
Correlation with urinary symptoms, PSA level, and other relevant clinical parameters
may be considered. Urological assessment is advised in patients with significant
obstructive symptoms or increasing residual urine volume.
Key Learning Points
- Median-lobe enlargement may project into the bladder lumen.
- Intravesical prostatic protrusion can be assessed sonographically when clinically relevant.
- Bladder wall trabeculation may develop in association with chronic bladder outlet obstruction.
- Post-void residual urine provides useful information regarding bladder emptying.
- BPH should be interpreted together with clinical symptoms rather than prostate size alone.
CASE–3
Severe Benign prostatic hyperplasia [BPH-Grade-3] with Significant Post-Void Residual Urine
Severe Benign prostatic hyperplasia [BPH-Grade-3] with Significant Post-Void Residual Urine
Clinical History
A 72-year-old male presented with
long-standing urinary frequency, nocturia, weak urinary stream,
hesitancy, and marked sensation of incomplete bladder emptying.
The patient reported progressively worsening urinary symptoms.
Ultrasound Findings
Ultrasound demonstrates
marked prostatomegaly with prominent transitional-zone
enlargement and heterogeneous central-gland echotexture.
The prostate produces elevation of the bladder base with associated
intravesical prostatic protrusion.
The urinary bladder is significantly distended with
diffuse wall trabeculation.
Following voiding, a substantial amount of urine remains within the bladder,
consistent with a
significant post-void residual volume.
No definite intravesical calculus or focal bladder mass is identified on the present
examination.
Report Line
Marked prostatomegaly with prominent transitional-zone enlargement and
intravesical prostatic protrusion, compatible with benign prostatic hyperplasia. Prostatic volume 30.41 ml
Diffuse urinary bladder wall trabeculation with significant post-void residual urine,
suggesting impaired bladder emptying.
Impression
Marked benign prostatic hyperplasia with intravesical prostatic protrusion
and significant post-void residual urine.
Go To Table
Recommendation
Urological evaluation is recommended, particularly in view of the significant
post-void residual urine and symptoms of bladder outlet obstruction.
Clinical correlation with renal function, PSA, and other relevant investigations
may be considered according to clinical indication.
If there is acute inability to void, severe suprapubic pain, fever, or other
acute symptoms, urgent clinical assessment is appropriate.
Key Learning Points
- Significant post-void residual urine may indicate impaired bladder emptying.
- Chronic bladder outlet obstruction may be associated with bladder wall trabeculation.
- Intravesical prostatic protrusion can be an important sonographic finding in patients with obstructive lower urinary tract symptoms.
- Ultrasound assessment should include the prostate, urinary bladder, pre-void volume, and post-void residual volume when clinically indicated.
- Renal tract assessment may also be considered in patients with significant or long-standing bladder outlet obstruction.
- Persistent or severe lower urinary tract symptoms warrant appropriate clinical/urological evaluation.
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