Bladder outlet obstruction

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Not all of this is from the prostate even in males

Common.

The various causes may be distinguished with measurements of urine flow rate, residual volume (or urine in the bladder after micturition) as well as the history and examination.

Treatment with alpha-adrenergic-blocker drugs such as doxazosin for the hypertensive and alfuzosin for the normotensive may give considerable, or sufficient, relief while waiting or considering surgery to the prostate or bladder neck. If prostatic enlargement is shown to be the cause, finasteride may make it regress sufficiently that surgery is avoided permanently

LogoKeyPointsBox.pngDoxazosin is a poor first choice for hypertension, since heart failure is more common compared to those treated with a thiazide diuretic, however a diuretic is a poor first choice of hypotensive for someone with prostatism. Matching multiple effects of drugs to multiple pathologies of patients, so that several effects are severally beneficial is practising medicine rather than following a cookbook

Investigation

As well as seeking precision of diagnosis, excluding renal impairment which might be due to back-pressure is indicated. Carcinoma of the prostate rarely causes obstruction, but is relatively commonly co-existent with it, and both to avoid embarrassment and confusion and because it is convenient a proportionate effort to identify it if it is present should be made.

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