Stages of prostate enlargement | Prostate Enlargement

Stages of prostate enlargement

There are three stages of benign prostate enlargement

  • Stage of irritationThere are obstructive and irritative symptoms
  • Residual urine stageThe emptying mechanism can no longer be adequately maintained (decompensation). The frequency of urination increases (pollakiuria). There is a residual urine of 100 – 150 ml on average.
  • Backwater stageThe expulsion function of the bladder fails completely. Increasing residual urine leads to chronic urinary retention with consequent kidney damage.

Diagnosis

Through conversation and the above mentioned questionnaire, a concrete assumption of the cause of the complaint can be made. Further investigations include: Rectal examinationThe doctor feels with his fingers through the anus for the prostate. Size, contour, symmetry and consistency (hardness) can be checked.

UltrasoundThis is one of the most important examinations. The ultrasound can be done through the abdominal wall (abdominal), through the urethra through the bladder (transvesical) and best through the rectum (transrectal). With the latter method, size and structural changes can be detected most accurately.

UroflowmetryThe amount of urine emptied per unit of time is measured (ml/s). This depends on the applied pressure of the bladder and the resistance of the urethra. Total time and average volume per second can be recorded.

In this way, changes in urination (“weak”, “delayed”, “dripping”) that the patient notices can be objectively confirmed. Normal would be at least 15 ml/s for men (women: 20 ml/s). Values below 10 ml/s are certainly abnormal.

Blood testsThere is unfortunately no blood value that would specifically prove prostate enlargement. Creatinine values provide information about the function of the kidney. The prostate-specific antigen (PSA) is important for the differentiation of prostate cancer (prostate cancer).

For values above 4 ng/ml PSA, a tissue sample should be taken for clarity. Urogram: Here, a contrast medium containing iodine is introduced into the vein and then excreted by the kidneys. After 7 and 15 minutes, X-rays are taken, on which the kidneys, renal pelvis, ureter and bladder become visible.

Pathological changes are found in one third of cases. This is a useful addition to the examination procedures in case of symptoms such as blood in the urine, suspected tumor, suspected stones (kidney stones) or urinary retention. Alternatively, endoscopic (camera-controlled) examinations of the urinary diversion system may also be necessary.

MRI of the prostateThe MRI examination of the prostate has become increasingly important in recent years. Especially for the suspected diagnosis of prostate cancer, the MRI of the prostate is of great importance. However, it is now also possible to take samples (biopsies) under MRI control of the prostate.