Chief Bello had been waking up three times a night to urinate for three years. He assumed it was "just ageing." A prostate ultrasound at Mascot Healthcare found his prostate was 58 grams — nearly three times the normal size. Finally, he had an explanation — and treatment options.
Retired, Shomolu. Presented with 3-year history of progressive lower urinary tract symptoms: weak urinary stream, hesitancy, nocturia ×3, post-void dribbling, and sensation of incomplete bladder emptying. PSA: 4.2 ng/mL (mildly elevated). Referred for prostate ultrasound and post-void residual measurement.
Prostate Ultrasound ScanChief Bello had told himself — and his family — that his urinary symptoms were "what happens when you get old." He knew other men his age who woke at night to urinate. He assumed the weak stream was inevitable. He managed: he planned long car journeys around toilet stops, he avoided excess water in the evenings, he sat down to urinate to avoid the effort of waiting.
It was his son — a pharmacist — who asked directly whether he had ever had a prostate check. Chief Bello had not. His son explained that LUTS in a 66-year-old man warranted a PSA blood test and a prostate ultrasound — not acceptance. The PSA came back at 4.2 ng/mL. His son referred him to Mascot Healthcare for a scan.
The ultrasound probe assessed the prostate transabdominally. The prostate appeared on screen as a homogeneous, rounded structure — but visibly large. The measurement came up: 58 grams. Normal for Chief Bello's age: up to approximately 25 grams. His prostate was more than double the expected size.
Benign prostatic hyperplasia (BPH) is the most common cause of lower urinary tract symptoms (LUTS) in men over 50. An enlarged prostate compresses the urethra, causing a predictable cluster of symptoms. A prostate ultrasound measures the gland precisely — and distinguishes BPH from other causes.
Taking 30–60 seconds before urine flow begins — hesitancy caused by the enlarged prostate partially obstructing the urethra.
Waking 3 times per night to urinate — significantly disrupting sleep and quality of life.
Continued dribbling of urine after what should be the end of urination — caused by pooling in the urethra behind the obstruction.
Returning to the toilet 5–10 minutes after urinating — the bladder never feeling completely empty.
PSA mildly elevated above age-adjusted normal — more likely due to large benign prostate than malignancy, but warrants correlation with scan.
Chief Bello's primary concern — though he had not articulated it to his family — was prostate cancer. The PSA of 4.2 ng/mL had alarmed him. He had spent the week before his scan reading about PSA and cancer on his son's medical textbooks.
The Mascot Healthcare doctor explained the nuance: a PSA of 4.2 ng/mL in a man with a 58-gram prostate is most consistent with BPH — a large benign prostate produces more PSA than a normal one. A PSA density (PSA divided by prostate volume) of 0.07 ng/mL/cc is below the threshold of concern. No nodules were identified on the scan. Urology referral was arranged for formal prostate cancer risk assessment, but the scan findings were reassuring.
Prostate volume: 58 mL (calculated by ellipsoid formula) — significantly enlarged (normal for age: 20–30 mL). Prostate echo-texture: homogeneous throughout — no hypoechoic nodules or suspicious focal lesions. Capsule: intact and smooth. Median lobe: mildly prominent — intravesical projection present (a common BPH feature causing the sensation of incomplete emptying).
Bladder wall: mildly trabeculated (thickened, irregular inner wall from years of increased outflow resistance). Post-void residual urine: 95 mL — elevated (normal: < 50 mL); indicates significant outflow obstruction and incomplete bladder emptying.
PSA density: 4.2 ÷ 58 = 0.07 ng/mL/cc (below the 0.15 threshold that would increase cancer concern). Urology referral arranged for formal risk stratification and discussion of medication to relax the prostate and a second medication to reduce its size.
Prostate volume 58 mL — benign hyperplasia. No nodules. Mildly trabeculated bladder. Post-void residual 95 mL. PSA density 0.07 (low risk). Consistent with BPH.
Urology referral for BPH management; a medication to relax the prostate started; a second medication added (to reduce prostate size over 6 months); lifestyle advice (fluid timing, caffeine reduction); repeat PSA and scan in 6 months.
At 3 months on medication: nocturia reduced to ×1; stream significantly improved. At 6 months: post-void residual reduced to 40 mL; prostate volume 52 mL (shrinking on the second medication). PSA 3.1 ng/mL (falling — reassuring).
Chief Bello sleeps through the night consistently for the first time in 3 years. Nocturia: once per night. Stream: strong. He describes the scan as "the day my retirement became enjoyable again."
Weak stream, nocturia, and hesitancy in a man over 50 are not inevitable features of ageing — they are symptoms of BPH, a treatable condition. A prostate ultrasound gives the size, shape, PSA density, and post-void residual — everything needed to plan management.
A mildly elevated PSA in the context of a large benign prostate is usually not cancer. The scan contextualises the PSA — and provides the reassurance or the referral pathway that PSA alone cannot determine.
Waking 3 times at night to urinate is not ageing — it's BPH. A prostate scan takes 15 minutes and gives you the size, the PSA context, and the treatment plan.
Book online or via WhatsApp — same-day scan results, expert sonography, transparent pricing.