Differentiate between lower urinary tract symptoms caused by benign prostatic hyperplasia (BPH) and detrusor overactivity in terms of predominant symptom patterns.

• A. BPH presents mainly with storage symptoms; detrusor overactivity mainly with voiding symptoms
• B. BPH presents mainly with voiding symptoms; detrusor overactivity with urge, frequency, nocturia
• C. BPH causes no nocturia; detrusor overactivity never causes leakage
• D. BPH only occurs in women; detrusor overactivity only occurs in men

Answer: (B)

The main idea is that the pattern of symptoms distinguishes bladder outlet obstruction from bladder overactivity. When the prostate enlarges, it tends to block the urine flow, so the dominant issues are with voiding—hesitancy, a weak or interrupted stream, straining, and a feeling of incomplete emptying. Detrusor overactivity causes storage problems: sudden urge to urinate, increased frequency, and nocturia, due to involuntary bladder contractions, and it may include urge incontinence.

This is why the best answer describes BPH as mainly producing voiding symptoms, while detrusor overactivity presents with urge, frequency, and nocturia. Keep in mind that nocturia can appear in both conditions, and BPH can have some storage symptoms, but the predominant pattern is the distinguishing feature. The other options blur these patterns or make incorrect claims about who can be affected, which isn’t consistent with how these conditions present clinically.