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Johns Hopkins Health Alert

Special Diagnostic Tests for BPH

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If you experience moderate to severe symptoms of benign prostatic hyperplasia or BPH, your doctor may order one or more of the following tests to aid in diagnosis and rule out other conditions that mimic BPH.

 

  • Uroflowmetry for BPH.In this noninvasive test, a man urinates into an electronic device that measures the speed of his urine flow. A slow flow rate suggests an obstruction of the urethra; if the flow rate is high, urethral obstruction is unlikely, and therapy for BPH will not be effective in most instances. A normal urine flow rate is 15 mL per second or higher.
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  • Pressure-flow urodynamic studies for BPH. These studies measure bladder pressure during urination by placing a recording device into the bladder and often into the rectum. The difference in pressure between the bladder and the rectum indicates the pressure generated when the bladder muscle contracts. A high pressure accompanied by a low urine flow rate indicates urethral obstruction. A low pressure with a low urine flow rate signals an abnormality in the bladder itself, such as one related to a neurological disorder.
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  • Imaging studies for BPH. In general, imaging studies are done only in patients who have blood in their urine, a urinary tract infection, abnormal kidney function, previous urinary tract surgery, or a history of urinary tract stones.

     

    Ultrasonography is the imaging study used most often in men with lower urinary tract symptoms. The test involves pressing a microphone- sized device (transducer) onto the skin of the lower abdomen. As the device is passed over the area, it emits sound waves that reflect off the internal organs. The pattern of the reflected sound waves is used to create an image of each organ. Ultrasonography can be used to detect structural abnormalities in the kidneys or bladder, determine the amount of residual urine in the bladder, detect the presence of bladder stones, and estimate the size of the prostate.

     

  • Filling cystometry for BPH. This test involves filling the bladder with fluid and measuring how much pressure builds up and how full the bladder is when the urge to urinate occurs. It is recommended for evaluating bladder function only in men who have a prior history of urological disease or neurological problems that could be affecting bladder function.
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  • Cystoscopy for BPH. In this procedure, a cystoscope (a small lighted viewing device) is passed through the urethra into the bladder to directly view the two structures. Cystoscopy is usually performed just before prostate surgery to guide the surgeon in performing the procedure or to look for abnormalities of the urethra or bladder.

 

Posted in Enlarged Prostate on September 28, 2010
Reviewed January 2011


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