Which is the earliest symptom of benign hyperophy of prostate –
**Core Concept**
Benign prostatic hyperplasia (BPH) is a common condition in aging men, characterized by the enlargement of the prostate gland, which can compress the urethra and lead to lower urinary tract symptoms (LUTS). The earliest symptoms of BPH are often related to urinary obstruction and retention.
**Why the Correct Answer is Right**
The earliest symptom of BPH is typically **urinary hesitancy**, which is the difficulty in initiating urination. This is due to the compression of the prostatic urethra by the enlarged prostate gland, leading to a decrease in the flow rate of urine. As the prostate gland continues to enlarge, other symptoms such as **frequency**, **urgency**, **weak stream**, and **noturia** may develop.
**Why Each Wrong Option is Incorrect**
**Option A:** **Nocturia** is a symptom of BPH, but it is not the earliest symptom. It typically develops later in the course of the disease.
**Option B:** **Dysuria** is a symptom of BPH, but it is not the earliest symptom. It typically develops later in the course of the disease, often in association with urinary tract infections.
**Option C:** **Hematuria** is a symptom of BPH, but it is not the earliest symptom. It typically develops later in the course of the disease, often in association with urinary tract infections or bladder stones.
**Clinical Pearl / High-Yield Fact**
The symptoms of BPH can be remembered using the acronym **DADs**: **D**ifficulty starting urination (hesitancy), **A**cceleration of urine flow (urgency), **D**elay in urination (frequency), and **s**trong desire to urinate (urgency).
**Correct Answer: C. Dysuria.**