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Ultrasound reports showed BHP Grade II. Causes? Treatment?

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General & Family Physician
Practicing since : 2007
Answered : 1649 Questions
Ultrasound report:
Prostate measures 46mmx42mmx31mm. Weight is 31 gms. Echotexture is homogeneous. Prostate is heterogeneous with prominenet calcification. Residual urine 50 ml. RT and LT kidney size normal.
Imp: BHP Grade II
Your opinion about report and causes and treatment
Posted Sun, 3 Nov 2013 in Men's Health
Answered by Dr. Lohit K 1 hour later
Brief Answer:
Needs further evaluation. BPH: medical treatment

Detailed Answer:
Hi Thanks for using XXXXXXX

I went through the query and understand your concern.

1. The report suggest that the prostate size & weight are increased (normal up to 20 gm) and has smooth outline that suggest benign hyperplasia of the prostate gland (BPH). The cause may be due to heriditary, hormonal or unknown etiology.

2. But since the echo texture is heterogeneous we need to rule out tumors (20%-40% patients with heterogeneous echo texture may have malignancy). Usually central heterogeneity is benign condition but peripheral heterogeneity the chance of malignancy are more. So it’s tough to comment weather it is a BPH or malignancy by seeing this ultrasonography (USG) report. So I suggest you to get done blood level for prostate specific antigen (PSA). If PSA level is more than 10 ng/ml then trans- rectal biopsy of prostate gland has to be taken to confirm if it is malignancy or not.

3. In BPH, the size of the prostate gland is increased, which compresses the bladder neck leading to various Urinary symptoms like urgency, hesitancy and residual urine.

4. For the management while urinating be relaxed and don't put any pressure as this can make the bladder neck to compress.
Medications like alpha1 blockers relaxes the bladder muscles & provides immediate relief from the urinary symptoms but does not cause reduction in size of the prostate. Finasteride inhibits formation of the hormone which causes prostate enlargement. This drug will help in reducing the size but their effect is not immediate & may take 4-6 months.
If the symptoms are more bothering and if it affects kidney then you can consider non surgical approach like laser therapy or surgery (TURP) for its management.

So, kindly consult an Urologist & discuss regarding the management plan.
I hope this information has been both informative and helpful for you. Feel free to ask if any related query and I will be glad to answer them.
If you like my answers kindly rate it, and write a review as well. Wish you a very happy life and good health.

Above answer was peer-reviewed by
Follow-up: Ultrasound reports showed BHP Grade II. Causes? Treatment? 15 hours later
Dr. Echotecture is homogeneous not heterogeneous. See medical history submitted yesterday.
So your opinion again
Answered by Dr. Lohit K 3 hours later
Brief Answer:
Needs further evaluation.

Detailed Answer:
Hi thanks for the followup..

Even with the heterogeneity of Prostate with prominent calcification the same measures and steps has to be followed to rule out carcinoma and has to follow the steps for management of BPH as explained yesterday.

Prostatic calcifications do not increase the risk of prostate cancer. But their presence does not exclude the possibility of cancer. An elevated PSA, a prostate nodule felt by your doctor on per rectal examination will guide us the need for further evaluation and possible biopsy.

Hope this clarified the doubt and helps you in the management. I apologize for that mistake (echotecture). So I advice you to get evaluated further and the management.

Wish you good health. Feel free to discuss if any related query. I will be glad to answer them.

Above answer was peer-reviewed by
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