As mentioned in my previous article last Monday, a very useful questionnaire doctors use to find out the severity of your LUTS (lower urinary tract symptoms) is the IPSS (international prostate symptom score). If you haven’t already, get your copy by sending a blank e-mail to firstname.lastname@example.org.
Your doctor may also ask you to perform a uroflow test and post-void residual (PVR) assessment to see how well you are emptying your bladder. Your bladder should be full for this test, so you will be asked to drink liquids until you feel the urge to pass your urine.
When you are ready, you will pass urine into a funnel connected to a small machine, the uroflow meter (see photo below).
The machine will show (on a printed piece of paper) the amount of urine you passed, how fast your urine was flowing (speed in ml/sec) and length of time you took to complete urination. Please note that certain factors or conditions may interfere with the accuracy of this testing like:
• straining with urination
• body movement during urination
• medications that affect the muscles in
The diagram at top right shows a normal urinary curve and a benign prostatic hyperplasia (BPH) curve. Notice how flattened the BPH curve is. For more information on uroflowmetry, send a blank e-mail to email@example.com.
After urinating, you will be asked to lie flat on your back on an examination table and expose the area of your belly just over your bladder. Some clear gel (looks like hair gel) will be placed on your belly and an ultrasound will be taken (see photo at right). This lasts only seconds and is not painful. The ultrasound image will show if there is urine left in your bladder and, if so, how much. These results are helpful in deciding what to do next.
Other tests may be requested by your doctor to confirm a diagnosis.
Again, treatment depends on, among other things, the severity of your symptoms and your readiness to have something done. If symptoms are not too bothersome, a man and his doctor may decide to keep an eye on things and recheck things in a specific time period to see if things are improving or not, without doing anything right away. If you decide on having something done, tablets are usually the first step. Your doctor will suggest what’s best in your particular situation.
The goals when treating BPH are:
• improve or relieve symptoms
• stop the progression of the
• prevent complications that may
result from unmanaged BPH.
Professional associations like the American Urological Association (AUA) and the Canadian Urological Association (CUA) have suggested guidelines for doctors to follow when treating men with BPH that include your IPSS result, the size of your prostate, how bothersome your symptoms are, as well as your readiness to have something done.
Tablets and what to look out for
• Dennis Webster is an oncology-trained nurse and cancer consultant with over 20 years
experience. He has a keen interest in men’s health, with a focus on prostate disease, prostate cancer and prostate cancer risk assessment.
Skype: Brachy4u; blog address:
Editor’s Note: Dennis Webster was
inadvertently referred to last week as
Dr Dennis Webster. The error is regretted.