Benign Prostatic Hypertrophy

Benign prostatic hypertrophy is a common cause of urinary tract obstruction.

Benign adenomas are usually an incidental finding, presenting as a space-occupying lesion on excretion urography. They seldom cause symptoms. On urography they may be difficult to distinguish from a renal cell carcinoma.

If a space-occupying lesion is a chance finding on excretion urography in a patient with no relevant symptoms and no haematuria, ultrasonography should be carried out.

If the lesion is transonic with no features suggesting a tumour, no further investigation is required. If haematuria has been present, a needle should be inserted into the transonic lesion and cyst fluid aspirated and examined for malignant cells.

Contrast medium may be injected to delineate the walls of the cyst. Lesions shown to be solid or non-homogeneous on ultrasonography require further investigation by CT or MRI.