Other Diagnostic Tests Table 522

• Decreased peak and mean urinary flow rate (less than 10-15 mL/s) on uroflow-metry; decreased urinary flow rate is not specific for BPH; it can also be due to other urologic disorders (e.g., urethral stricture, meatal stenosis, or bladder hypotonicity)

• Increased postvoid residual urine volume (PVR) (more than 50 mL)

• DRE to check for an enlarged prostate (more than 15-20 g) (0.5-0.7 oz)

• Transurethral cytoscopy reveals an enlarged prostate, which decreases urethral lumen caliber; information from this procedure helps the surgeon decide on the best surgical approach

• Transrectal ultrasound of the prostate; a transrectal probe is inserted to evaluate prostate size and best surgical approach

• Transrectal prostate needle biopsy to be done if the patient has areas of nodularity or induration on DRE; tissue biopsy can document the presence ofprostate cancer, which can also cause enlargement of the prostate

• IV pyelogram (IVP) will show retention of radiocontrast in the bladder if the patient has bladder outlet obstruction due to an enlarged prostate; only indicated in patients with recurrent hematuria, recurrent urinary tract infection, renal insufficiency, and urolithiasis

• Filling cystometry provides information on bladder capacity, detrusor contractility, and the presence of uninhibited bladder contractions, which could also cause LUTS

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