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Opinions of Thursday, 7 September 2017

Columnist: Dr. Raphael Nyarkotey Obu

International Prostate Symptom Score

Every man is advised to take the test Every man is advised to take the test

Are you waking up more than once during the night to urinate?

Do you have to go frequently during the day?

Do you void a small amount and then need to go again soon after?

Do you have to strain and push to release?

Does it take a long time to get your flow going?

Does it hurt sometimes when you do go?

Do you dribble after you go more and more?

Did you have a sudden feeling of blockage and then finally you could go?

Do you have pain in the pubic bone region?

Does it hurt in that region after you ride a bike?

Is there occasional blood spotting in your urine?

Have you had a reaction in the prostate region after taking a new medication or anti-histamine? or a sudden hesitancy or worse?

Have you had a sudden complete blockage that finally released a bit at a time?

Does it burn when you pee?

If you answer "yes" to any of these questions, then you can suspect you may have signs of enlarged prostate.

Of course, there may be other contributing factors like extra stress or a reaction to a food or a cold remedy but besides the prostate, a bladder infection can cause a reaction that affects your urination.

A prostate examination will help answer these questions so you know what is happening. At that point, you will need to learn a lot more about your options because conventional medicine's treatments for a prostate problem, assuming that is the case, have very marked side effects that doctors tend to minimize.

International Prostate Symptom Score

The International Prostate Symptom Score (IPSS) is an international questionnaire. The IPSS questions will help you assess the severity of your prostate symptoms and help you identify signs of enlarged prostate gland.

Answer each question honestly, and then total your score at the end.

Incomplete emptying: Over the past month, how often have you had the sensation of not emptying your bladder completely after you have finished urinating?

0 = not at all
1 = less than 1 time in 5
2 = less than half the time
3 = about half the time
4 = more than half the time
5 = almost always

Frequency: Over the past month, how often have you had to urinate again less than 2 hours after you finished urinating?

0 = not at all
1 = less than 1 time in 5
2 = less than half the time
3 = about half the time
4 = more than half the time
5 = almost always

Intermittency: Over the past month, how often have you stopped and started again several times when urinating?

0 = not at all
1 = less than 1 time in 5
2 = less than half the time
3 = about half the time
4 = more than half the time
5 = almost always

Urgency: Over the past month, how often have you found it difficult to postpone urination?

0 = not at all
1 = less than 1 time in 5
2 = less than half the time
3 = about half the time
4 = more than half the time
5 = almost always

Weak stream: Over the past month, how often have you had a weak urinary stream?
0 = not at all
1 = less than 1 time in 5
2 = less than half the time
3 = about half the time
4 = more than half the time
5 = almost always
Straining: Over the past month, how often have you had to push or strain to begin urination?

0 = not at all
1 = less than 1 time in 5
2 = less than half the time
3 = about half the time
4 = more than half the time
5 = almost always

Nocturia: Over the past month, how many times did you most typically get up to urinate from the time you went to bed until the time you got up in the morning?

0 = never
1 = once
2 = twice
3 = thrice
4 = 4 times or more
5 = 5 times

Results / Signs of Enlarged Prostate
Enter your total score here ________
Results are classified as:
0 - 7 (mildly symptomatic)
8 - 19 (moderately symptomatic)
20 - 35 (severely symptomatic)

An additional question is how bothersome are your symptoms?

Bother Score: This helps assess your perceived quality of life due to your urinary symptoms, and the score ranges from 0 (delighted) to 6 (terrible).

How would you feel if you were to spend the rest of your life with your urinary condition just the way it is now?

0 = Delighted
1 = Pleased
2 = Mostly satisfied
3 = Mixed
4 = Mostly dissatisfied
5 = Unhappy

The following is standard medical approach to your signs of prostate problems.

"The IPSS is used globally and is based on both the presence and severity of signs of enlarged prostate. Its purpose isn't to be used alone. In combination with other tests, the IPSS can help determine the stages of BPH for patients. These stages are:

Patients do not need immediate treatment, as they don't have any bothersome symptoms or significant urine obstruction. Their physicians will observe them closely over time.

Bothersome symptoms are present, but no significant urine obstruction. At this stage, symptoms are treatable with medication.

There is significant urine obstruction of less than 10ml of urine released per second (ml/s) and persistent residual urine of more than 100 ml. A TURP (transurethral resection of the prostate) surgery may be recommended by the physician.

Complications of BPH are present, such as chronic retention of stones in the bladder. In this case a TURP would definitely be required."

The above conclusions are what your urologist will recommend. I would suggest you learn the causes of your signs of enlarged prostate.

Take the test and let discuss at the column page.