What is the most characteristic ultrasound finding in benign prostatic hyperplasia?

In the context of benign prostatic hyperplasia (BPH), the most characteristic ultrasound finding is the presence of an enlarged, symmetrical, homogeneous prostate. BPH is a common condition in older men, characterized by an increase in the size of the prostate gland due to non-cancerous growth of the prostate cells.

On ultrasound, a prostate affected by BPH typically appears enlarged and maintains a symmetrical shape, with homogeneous echogenicity. This finding is important for differentiating BPH from other prostatic conditions that may present with more heterogeneous or irregular features, such as prostate carcinoma, where there may be focal areas of abnormality or asymmetry.

In contrast, conditions like acute prostatitis or prostate cancer present with different ultrasound characteristics, such as changes in echogenicity, fluid collections, or irregular contours. Some conditions may also affect adjacent structures like the seminal vesicles, but these findings are less central to the diagnosis of BPH.

The identification of a homogeneous, enlarged, and symmetrical prostate on ultrasound is crucial for confirming a diagnosis of benign prostatic hyperplasia and guiding further management of the patient’s symptoms.