Diagnosis of BPH obstruction

  • Clinical history: A specialist will ask a series of questions regarding the urinary symptoms that the patient is experiencing and any medications that he is taking that may affect urination. Also, they will pose a series of questions through the I-PSS (International Prostate Symptom Score) questionnaire, where they score problems with urination (0-35 points) and the impact that the symptoms have on the patient’s quality of life (0-6 points).
  • Analysis: Beginning at 40 years of age, it is recommended to periodically assess blood PSA levels (total and free) for the early diagnosis of prostate cancer. PSA levels may increase due to age, benign enlargement of the prostate, or infections of the prostate, which the specialist should consider in each case. A urine analysis is also carried out to evaluate the presence of blood or infection.
  • Digital rectal exam: This is done to evaluate the consistency and size of the prostate, and check for any suspicious areas. When PSA levels are low, a rectal exam is not considered necessary for diagnosis.
  • Urodynamic testing: The patient urinates into an apparatus that measures the urination flow with respect to a series of parameters (maximal flow, average flow, rate of flow, etc.) that allows us to determine the degree of obstruction.
  • Urologic ultrasound: The specialist performs a full ultrasound study of the kidneys, the bladder and the prostate. This can show if the bladder has changes in its thickness due to obstruction and can evaluate for the presence of residual liquid after urination. It also shows greater detail of the prostate, evaluating its size and shape of growth. In some cases, a rectal prostate ultrasound is also carried out, which allows for more precise study of the prostate gland.