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●      lifestyle changes

●      medications

●      minimally invasive procedures

●      surgery

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Medical tests

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Physical exam

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A personal and family medical history

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●      Difficulty starting to urinate despite pushing and straining

●      A weak stream of urine; several interruptions in the stream

●      Dribbling at the end of urination

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4. The bladder may gradually weaken and lose the ability to empty completely, leading to increased residual urine volume and, possibly, acute or chronic urinary retention

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3. As the prostate enlarges, the surrounding capsule prevents it from radially expanding, potentially resulting in urethral compression. However, obstruction-induced bladder dysfunction contributes significantly to LUTS

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2. Other possible  factors include the metabolic syndrome, hyperinsulinemia, norepinephrine, angiotensin II, and insulin-like growth factors

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1. In the prostate gland, type II 5-alpha-reductase metabolizes circulating testosterone into DHT, which works locally, not systemically. DHT binds to androgen receptors in the cell nuclei, potentially resulting in BPH

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BPH is a common problem that affects the quality of life in approximately one third of men older than 50 years.

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Related to a proliferation of prostate cells that derives from a decrease, with age, in the testosterone-sterone/estrogen ratio.

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Grade 4 prostate hyperplasia: when the size is greater than four times the normal size .

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Grade 3 prostate hyperplasia: when the size of the prostate is four times the usual size (80 cc)

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Grade 2 prostate hyperplasia: if the size of the prostate has tripled (60 cc)

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Grade 1 prostate hyperplasia: when the size of the prostate has doubled (40 cc).

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Benign prostatic hyperplasia—also called BPH—is a condition in men in which the prostate gland is enlarged and not cancerous.

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the prostatic syndrome