International Prostate Symptom Score
You’ll be asked to complete a questionnaire to assess your symptoms. Each question has five possible answers that carry a score, and your overall score is used to assess the severity of your symptoms.
The checklist includes the following questions.
Over the past month:
- How often have you had the sensation of not completely emptying your bladder after urinating?
- How often have you had to urinate again less than two hours after finishing urinating?
- How often have you found that you stopped and started again when urinating?
- How often have you found it difficult to postpone urination?
- How often have you had a weak stream of urine?
- How often have you had to push or strain to begin urinating during the course of one night?
- How often have you had to get up during the night to urinate?
After your GP has assessed the severity your symptoms, they’ll aim to rule out other conditions with similar symptoms using certain tests.
Technique And Anesthetic Agents Used For The Periprostatic Nerve Block
The technique for the periprostatic nerve block is based on the original method described by Nash et al. in 1996 for basal injections. The procedure can be performed in an out-patient setting, but resuscitation facilities should be available. The same protocol used for pre-procedure preparation of TRUS-guided prostate biopsy is followed. The bladder is emptied before the procedure to prevent urinary retention .
The optimal patient position for performing the periprostatic nerve block is the left lateral decubitus position with buttocks at or slightly beyond the side of the table, the left leg in a straight position, and the right leg flexed so as to touch the abdomen. The lithotomy position is an alternative, but it is associated with more discomfort .
Optimal position of ultrasound transrectal transducer with biopsy-guide attachment for periprostatic nerve block. Tip of ultrasound transducer is pressed against prostate and anterior rectal mucosa. Transducer is manipulated to direct needle towards neurovascular bundles at base and apex of prostate and local anesthetic drug is injected around bundles.
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How To Tell The Difference Between Kidney Pain And Back Pain
Kidney Pain vs. Back Pain: How to Tell the Difference 1 Where the pain is located. Kidney pain is felt in your flank, which is the area on either side 2 Type of pain. Kidney pain is usually sharp if you have a kidney stone and a dull ache 3 Radiation of the pain. Sometimes the pain spreads to your inner thigh or lower abdomen.
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Surgical Treatment For Enlarged Prostate
Transurethral resection of the prostate . In this surgery, the inner portion of the prostate is removed. Used 90% of the time, this is the most commonly used surgical procedure for BPH.
Open prostatectomy .The surgeon makes an incision and removes the enlarged tissue from the prostate.
Laser surgery Laser surgery uses laser energy to destroy prostate tissue and shrink the prostate.
Transurethral incision of the prostate .This surgery does not involve removing prostate tissue. A few small cuts are made in the prostate gland to reduce the prostates pressure on the urethra, making urination easier.
Symptoms Of Benign Prostate Enlargement
The prostate is a small gland, located in the pelvis, between the penis and bladder.
If the prostate becomes enlarged, it can place pressure on the bladder and the urethra, which is the tube that urine passes through.
This can affect how you pee and may cause:
- difficulty starting to pee
- a frequent need to pee
- difficulty fully emptying your bladder
In some men, the symptoms are mild and do not need treatment. In others, they can be very troublesome.
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Medications For Enlarged Prostate
There are two main classes of pharmaceuticals that work to alleviate enlarged prostate symptoms: alpha blockers and alpha reductase inhibitors
Alpha Blockers. Alpha blockers relax the smooth muscle around the bladder neck and within the urethra.
Inhibitors. Inhibitors stop the conversion of the male hormone testosterone to DHT to reduce the prostate’s size, eliminating blockage.
Dont be surprised if your physician prescribes a combination of the two medications, as they have been shown to work more effectively together than alone. The downside is that combination therapy may increase the likelihood of experiencing side effects from the medications. Be sure to work with your doctor to assess the benefits and costs before starting on combination therapy.
Problems With Enlarged Prostate Gland
Benign enlargement of the prostate gland is more common as men get older. It can cause troublesome symptoms, although it doesnt always.
The urethra passes through the prostate gland, so men may have problems urinating if the enlarged gland restricts the flow of urine. If the flow stops completely, a catheter is required to empty the bladder. It is rare for this form of acute urinary retention to cause kidney damage.
An enlarged prostate doesn’t always cause urinary problems. Studies indicate that the size of a man’s prostate gland has little influence on the type or severity of his urination problems. BPH is just one possible cause of urinary symptoms.
Another cause of urinary symptoms can be changes to the muscular wall of the bladder, which may cause spasms of the bladder or weaken the bladder, causing problems passing urine.
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What Are Benign Prostate Conditions
The prostate gland lies underneath the bladder and in front of the rectum deep in the male pelvis. It surrounds the urethra, the tube that transports urine from the bladder. The prostate is normally the size of a walnut and functions to secrete fluid that nourishes sperm. Common benign conditions that can affect the prostate gland are benign prostatic hyperplasia and prostatitis.
How Do I Empty My Bladder With An Enlarged Prostate
Go with the FlowKeep yourself active. Lack of physical activity can make you retain urine. Do Kegel exercises. Stand at or sit on the toilet and contract the muscle that allows you to stop and start the flow of pee. Meditate. Nervousness and tension cause some men to urinate more often. Try double voiding.Sep 6, 2019
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How Doctors Determine Whether To Recommend A Prostate Biopsy
No two patients are alike, and a urologist needs to take many variables into account before recommending a prostate biopsy, including a patients:
- Age and life expectancy
- Change in PSA values across time.
The decision of whether to undergo a prostate biopsy should be determined after an individual conversation with your doctor during which he or she presents you with the big picture of your situation.
Compare, for example, the case of two 50-year-old men: One of them has been diagnosed with heart failure and is in poor overall health. The other has no pre-existing health conditions. I probably wouldnt advise a prostate biopsy for the 50-year-old with heart failure because prostate cancer is unlikely to cause his death within the next five years.
But I would recommend that the healthy 50-year-old get a prostate biopsy, because even if his cancer isnt aggressive right now, missing a prostate cancer diagnosis may result in his death from the disease in 15 years. In his case, it would be better to risk the prostate biopsy to catch the cancer early and improve his chances of long-term survival.
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Benefits Of Getting A Prostate Biopsy
A prostate biopsy is the only way to definitively determine whether you have prostate cancer and, if you do, how aggressive it is.
While prostate biopsies arent always conclusive, in general, a biopsy gives men the reassurance of knowing whether they have cancer or not. If you know you have prostate cancer, youre more likely to be appropriately treated.
Appropriate prostate cancer treatment options depend on several factors, including the stage of the cancer, your age, your general health and which risk category your cancer falls into.
Localized prostate cancer is categorized into six risk categories, which range from very low-risk to very high-risk. The risk group is determined by the stage of your cancer, your PSA levels and the Gleason score obtained from the biopsy pathology report.
The National Comprehensive Cancer Network guidelines outline appropriate treatment options based on risk categories and whether the cancer has already metastasized.
Patients whose cancer is confined to the prostate and falls into the very low-risk and low-risk categories tend to have slow-growing cancers. Treatment options for these patients often include active surveillance, radiation therapy or surgery. Similar treatment options may be recommended to patients in the low-risk and favorable intermediate prostate cancer risk categories.
The NCCN guidelines recommend immediate treatment for patients with high-risk disease or those patients whose cancer has metastasized.
Can I Prevent Prostatitis
Prostatitis is a condition that causes your prostate gland to become swollen, tender, and inflamed. It can be quite painful, especially when you pee or ejaculate . The most common locations of pain were the perineum , testes , suprapubic area , and penis
Doctors arenât always sure what causes prostatitis. Common causes vary depending on whether it is acute vs. chronic and/or infectious vs inflammation. Sometimes, an infection in your urinary tract is to blame. Other times, itâs due to an injury or nerve damage. In many cases, doctors never find the cause.
Because of that, treatment for prostatitis can be a challenge. For some men, it can take months or even years to recover.
Thereâs no sure way to prevent getting this condition, but many small lifestyle changes can help keep your prostate gland healthy. They may also help to lower your risk of prostatitis. If you already have problems with your prostate, try these tips to ease your symptoms and keep your issue from getting worse.
Have good hygiene. Keep your penis and the area around it clean to prevent infection.
Stand up when possible. When you sit for long periods, it puts pressure on your prostate gland and inflames it over time. Try to avoid long bike rides and sitting down for too long.
Eat more fruits and veggies. Theyâre high in nutrients that can keep your body healthy and help you fight off infections and inflammation.
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Tests Used To Check The Prostate
This first step lets your doctor hear and understand the story of your prostate concerns. Youll be asked whether you have symptoms, how long youve had them, and how much they affect your lifestyle. Your personal medical history also includes any risk factors, pain, fever, or trouble passing urine. You may be asked to give a urine sample for testing.
Do Prostatitis And Bph Cause Pain
Both BPH and prostatitis may cause pain. However, if BPH causes pain, it usually occurs with urination .
Prostatitis may cause painful urination, painful ejaculations, and generalized groin/abdominal pain. Prostatitis pain may be more constant and may be due to the inflammation of the prostatic tissue and/or adjacent tissues. Experts point out that often the source of pain from prostatitis is unclear.
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What Is The Prognosis For People Who Have Prostatitis
Antibiotics can cure acute bacterial prostatitis. These medications also ease chronic bacterial prostatitis symptoms in approximately 30% to 60% of men. Up to 80% of men with chronic pelvic pain syndrome feel better after receiving appropriate treatments for their symptoms using the UPOINT system. Men with asymptomatic inflammatory prostatitis dont need treatment.
What Is A Prostate Biopsy
The prostate gland is found only in males. It sits below the bladder andwraps around the urethra . Theprostate helps make semen.
A biopsy is a procedure used to remove a small piece of tissue or cellsfrom the body so it can be examined under a microscope.
In a prostate biopsy, prostate gland tissue is taken out with a biopsyneedle or during surgery. The tissue is checked to see if there are canceror other abnormal cells in the prostate gland.
A prostate biopsy may be done in several different ways:
Transrectal method. This is done through the rectum and is the most common.
Perineal method. This is done through the skin between the scrotum and the rectum.
Transurethral method. This is done through the urethra using a cystoscope .
Ultrasound is usually used to look at the prostate gland and guide thebiopsy needle.
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Can Having An Enlarged Prostate Cause Painful Ejaculation
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What Are Symptoms Of Bph
Symptoms from BPH can include difficulty starting to urinate, a weak urinary stream, increased frequency of urination, increased night time urination, leakage of urine, incomplete emptying of the bladder, and retention of urine. The diagnosis can usually be made by a physician after taking a history and carefully examining the prostate gland. A urine sample is usually checked to make sure there is no blood or infection. A uroflowmetry test is also done sometimes to check the flow rate and a post-void residual is done to measure how much urine is being retained in the bladder.
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Comparison Of Pain Scores Between Groups
Our study showed that patients reported a higher pain score at insertion of the TRUS probe in the PPNB group compared to the CB group, though this was not statistically significant. Similarly, Urabe et al. reported a statistically significant higher average pain score at the point of probe insertion for PPNB+IRLA group compared to the CB+IRLA group. This is probably due to the fact that insertion of the TRUS probe precedes the administration of the PPNB in the PPNB group, while the administration of CB preceded probe insertion which also had the effect of relaxing the anal sphincter. This point may confer an advantage on CB over PPNB as analgesia for prostate biopsy.
There was no significant difference in the experience of pain at administration of block in our study. However, Urabe et al. reported a significantly higher average pain score of 2.9±2.1 in the CB+IRLA group than in the PPNB+IRLA group at the moment of administering the analgesia. This could have been as a result of the fact that in their study, IRLA was instilled prior to the administration of PPNB.
Table 4 Protocols, findings and conclusions of studies that compared CB with PPNB
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How Common Is Prostatitis
Prostatitis is the most common urinary tract problem for men younger than age 50 and the third most common urinary tract problem for men older than age 50.1 Prostatitis accounts for about two million visits to health care providers in the United States each year.2
Chronic prostatitis or chronic pelvic pain syndrome is
- the most common and least understood form of prostatitis.
- can occur in men of any age group.
- affects 10 to 15 percent of the U.S. male population.3
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What Are Common Prostate Problems What Are The Symptoms And Signs
Here are some examples of non-cancer prostate problems:
Benign prostatic hyperplasia, or BPH, means your prostate is enlarged, but is not cancerous. It is very common in older men. An enlarged prostate may make it very difficult to urinate or cause dribbling after you urinate. You may feel the need to urinate a lot, often at night. See your family doctor for an exam. Treatments for BPH include:
- Watchful waiting, also called active surveillance. If your symptoms are not too bad, your doctor may tell you to wait before starting any treatment to see if the problem gets worse. Your doctor will tell you how often you need to return for checkups. You can start treatment later if your symptoms worsen.
- Medications. There are medicines that can help shrink the prostate or help relax muscles near your prostate to ease your symptoms. Talk with your doctor about possible side effects.
- Surgery. If nothing else has worked, your doctor may suggest surgery to help urine flow. There are many types of BPH surgery. Talk with your doctor about the risks. Regular checkups are important after surgery.
- Other treatments. Sometimes radio waves, microwaves, or lasers are used to treat urinary problems caused by BPH. These methods use different kinds of heat to reduce extra prostate tissue.
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Should I Be Concerned About An Enlarged Prostate
Posted on by Summit Urology Group
Benign prostatic hyperplasia or BPH is what is known as an enlarged prostate. It may sound scary, but should you be concerned about an enlarged prostate? This depends on your age, whether you are symptomatic, and how severe those symptoms are. Heres a bit more detail!
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