Differentials
Your Organizational Guidance
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Recommendations nationales de bonne pratique pour la prise en charge du cancer localisé de la prostate: première partiePublished by: KCELast published: 2014Nationale praktijkrichtlijn voor de aanpak van gelokaliseerde prostaatkanker: deel 1Published by: KCELast published: 2014Benign prostatic hyperplasia
SIGNS / SYMPTOMS
Symptoms of benign prostatic hyperplasia (BPH) are often identical to later-stage prostate cancer (e.g., nocturia, urinary frequency, urinary hesitancy, dysuria, hematuria).
Typically, with BPH the prostate feels rubbery with no palpable nodules. Hard nodules suggest malignancy.
INVESTIGATIONS
A positive prostate biopsy is the most sensitive and specific test to differentiate between prostate cancer and BPH.
Chronic prostatitis
SIGNS / SYMPTOMS
Chronic prostatitis manifests over an extended period of more than 3 months to several years' duration with symptoms of urinary frequency, dysuria, male dyspareunia, and occasionally hematospermia.
INVESTIGATIONS
Microscopic exam of the expressed prostatic secretions may reveal the presence of leukocytes indicative of inflammation. Serum prostate-specific antigen (PSA) is typically mildly elevated in chronic prostatitis. In cases where clinical suspicion is high for chronic prostatitis, it may be useful to treat the patient with a course of antibiotics and repeat the PSA to assess for response prior to recommending prostate biopsy to rule out prostate cancer.
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