Post Date April, 15 2023
We say that the main clinical manifestation of prostatic hypertrophy is dysuria, but dysuria is not just prostatic hypertrophy. Many prostate diseases, such as prostate stones, tuberculosis, cysts, inflammation, fibrosis and tumors; Some bladder diseases, such as bladder neck contracture, bladder triangle hypertrophy, neurogenic bladder dysfunction, bladder neck tumors, bladder stones, and some urethral diseases.
For example, urethral stricture, hypertrophy of seminal caruncle, etc. may cause obstruction at the bladder outlet, and its symptoms are very similar to prostatic hypertrophy, which should be differentiated. In addition to common obstructive symptoms, these diseases also have their own characteristics. According to medical history analysis, physical examination, laboratory tests and various diagnostic procedures, most of them can make a clear diagnosis.
Several examples illustrate the diagnosis points of the above diseases:
Prostatitis: When the prostate is infected, the gland in the anal examination may be enlarged. The changes of cystoscopy and X-ray radiography are sometimes similar to those of prostatic hypertrophy, which may cause misdiagnosis. However, prostatitis often occurs in young and middle-aged people, and may have inflammatory changes such as fever, elevated white blood cells or rapid erythrocyte sedimentation rate. Prostate fluid examination can find most pus balls, and the symptoms can be relieved after anti-inflammatory treatment.
Neurogenic bladder dysfunction: Neurogenic bladder dysfunction caused by spinal cord injury or spinal cord sclerosis. Its symptoms are very similar to bladder neck obstruction caused by prostatic hypertrophy. However, the prostate does not increase in the anal examination, and the anal sphincter can be felt to relax, and the contraction ability is weakened or disappeared. Combined with the systemic and neurological examination, it can be identified.
Prostate tuberculosis and calculus: When suffering from tuberculosis of the reproductive system, the prostate can also increase, but the patient is younger, and other organs of the reproductive system, such as seminal vesicle and vas deferens. Epididymis also often accompanied by lesions, which is helpful for differential diagnosis. When palpation of prostate stones, the volume is increased, slightly hard, and there is a sense of twist. Stone shadow can be seen on X-ray film.
Prostate fibrosis: the clinical symptoms of atrophy and sclerosis of prostate or bladder neck are very similar to prostatic hypertrophy, but the size of prostate is normal in anal examination. Cystourethrography and cystoscopy showed a stiff and narrow bladder neck.
Urethral stricture: Most patients have urethritis. History of trauma or urethral instrument examination. The urethral probe was used for examination. The urethral caliber was reduced and the probe was blocked.
Prostate cancer: Some prostate cancer and prostatic hypertrophy are difficult to distinguish, and correct diagnosis needs to be made by pathology. In a typical case, when the prostate was examined in the anus, it was found that the surface was uneven and hard as stone. The acid phosphatase in blood test can be increased. In the late stage, osteogenic bone metastasis can also be seen in X-ray examination.
