A male patient with a PSA (prostate specific antigen level) index greater than 4 on a blood test was referred to the urology department. “Is this cancer?” she asked nervously.
I explained to the patient: “The PSA number reflects the proteins secreted by the prostate. An index of 4 to 10 has a one in 5 chance of cancer; 10 to 20 a greater chance of cancer. Don’t worry though, because the number Higher levels are not necessarily caused by cancer, but can be caused by prostatic inflammation or benign prostatic hyperplasia.
Hyperplasia of the prostate (hypertrophy) is mainly a natural phenomenon of aging and is very common. The most basic tests are urine and blood tests. If there are bacteria in the urine, it means that the urinary system is inflamed and can be treated with antibiotics. Also, a blood test can check for kidney problems that interfere with urination.
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Urination is also the basis for diagnosis. The normal size of the prostate gland is like a walnut: if it grows, it compresses the bladder and urethra, causing lower urinary tract symptoms. The patient said: “I have had difficulty urinating for the past few years. I have to urinate continuously, I have a sudden urge and sometimes the urination is intermittent, runny and unclear …” However, the urination situation is a subjective feeling, and even doctors have methods. Objectify the data.
For example, the doctor instructs the patient to keep a “urine diary” to record the frequency of urination between meals, the status of nocturia, the amount of urine measured by the measuring cup and whether there is a leak of urine, etc. Three days are usually enough. Medically, it is normal to urinate two liters and urinate 6 to 9 times a day. Some patients “believe” their bathroom habits are normal only after they finish their diary, but it’s just hypochondria. There are also patients who urinate dozens of times a day, hundreds of milliliters each time, which is abnormal and can be related to diabetes or a lack of hormones.
Additionally, a urine velocity test can also help diagnose symptoms. If urine flow is too slow, it could be because an enlarged prostate is pressing on the urethra. During the examination, the patient can drain urine into a device with a funnel device and measure the patient’s urine flow and intensity. After the test, your doctor may use an ultrasound to check for any urine left in the bladder for further evaluation.
General benign prostatic hyperplasia can be treated with medication, but if the drug does not work well and the patient has persistent urination problems, further examination is required. For example, transrectal ultrasound consists of inserting the instrument probe from the anus into the rectum and using ultrasound to measure the size of the prostate, if there is a tumor, or to observe the residual volume of urine in the bladder, if there are calculations, and so on. If the doctor suspects that the patient has bladder disease, a cystoscopy (cystoscopy) is required, which is inserted through the urethra to examine the condition of the urethra and bladder. Finally, if prostate cancer is suspected, a biopsy of the prostate tissue is done to see if there are cancer cells under a microscope.
After diagnosis, the patient was found to have prostate gland hyperplasia. As the drug failed to improve the urination problem, he underwent an “electrocution” operation to treat prostate tissue hyperplasia. . After the patient was diagnosed with prostate cancer, he was relieved, but still nervously asked, “Can benign prostatic hyperplasia become cancer?” I replied: “Don’t worry! Prostatic hyperplasia is benign tissue growth, while prostate cancer is abnormal cells … Cleavage. There is no absolute relationship between these two diseases and most benign prostatic hyperplasia is benign. and they don’t cause cancer.
▲ Wang Mingxi, urology specialist.
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Written by: Urology Specialist, Wang Minghao Hong Kong Medical Center