PCRI's resident moderator Mark Moyad, MD, MPH, sits down with urologist Steven Gange, MD, FACS, to discuss the process of diagnosing Benign Prostatic Hyperplasia (BPH) and the potential consequences of leaving it untreated. Dr. Steven Gange graduated from the UCLA School of Medicine in 1986. After his Urology residency training at the University of Kentucky in 1991, he entered the US Army as an academic urologist, teaching, and training residents. He joined Western Urological Clinic (now Summit Urology Group) in Salt Lake City, UT, in 1996. With over 25 years of clinical and research experience, he has developed an expertise in Men’s Health Urology, emphasizing minimally invasive procedures. He continues to be active as a Clinical Researcher and as such was the first Urologist in North America to perform the NeoTract UroLift for BPH, and the first in the world to perform UroLift under local anesthesia.
0:05 The diagnostic procedure for BPH will generally start with a questionnaire to determine the severity of the symptoms. A digital rectal exam (DRE, or "finger test") and a PSA will routinely be performed to exclude the possibility of prostate cancer.
0:39 Some urologists will test a patient's urinary flow rate by performing a test called a "QMax" in which a man will urinate into a calibrated toilet. Dr. Gange performs this test in his research practice, but not in his office since it is impractical.
1:17 Instead of the Qmax, Dr. Gange uses a Post-Void Residual test (PVR), also known as a Bladder Scan. This is an ultrasound of the bladder that is performed after a man urinates to see how much urine is left in the bladder. BPH can constrict the urethra, preventing the expulsion of urine, and causing deterioration of the urinary system.
2:38 Untreated BPH can cause bladder stones, urinary infection, deterioration of kidney function. In the past, before there were treatments available for BPH, the condition could be fatal due to kidney failure.
3:46 Physicians will also test a patient's urine for any indication of other potential conditions. In some cases, if a PVR detects a lot of urine left in a patient's bladder, then Dr. Gange will perform a Creatinine test to test kidney function.
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