We are going to talk about seven signs or seven pieces of information that indicate that the prostate is not well, that it has some disease or some pathology. Now in this video we are not going to see treatment, we are not going to do studies because we have already seen that in past videos. We have a video on the management of benign problems and prostate cancer. At the top you will find the links to those videos so that you can consult them in depth. So, in this video we are going to look at these seven facts. These seven data are in the international prostate symptom scale. So the i pss is also there for you to consult. Essentially, we already know that the prostate is a gland that is around the urethra and of course, when it becomes inflamed, when it swells, when it increases in volume, it can compress the urethra and cause problems in the emptying of urine. So, with this, the first point is when we go to urinate, we feel that we do not completely empty the urine that stays in the bladder.

A part of what we wanted to get out and as much as it should be completely free, it doesn't. The second point closely related to the first one is once I go to urinate in the next two hours, I have to go to urinate again. Why? Because I didn't get the bladder completely emptied. There was residual urine left. And then, before two hours have passed, I'm already going to the bathroom again. Point number three is when we are urinating. We have intermittency. That is, we are urinating and it cuts off and we start again. And again it cuts off and we start again. And again it cuts off instead of the normal thing which is that from the time I start to the time I finish, there is a constant flow of urine that is coming out when I have prostatic problems because of this more intense pressure that is put on the urethra, I'm going to have to have this intermittency over and over again, it cuts off and starts over again. Number four is I have a hard time holding back urination.

I have a lot of urgency. Suddenly I feel that urine is going to come out, urine may even come out and this is known as urinary incontinence. And we go back to the same issue that the bladder is suddenly full of urine, when it should not be, when I should have just gone to the bathroom and then suddenly the pressure is overcome and it comes out or I have this super urgent feeling, that is, urgency to urinate. Number five is noticing that the urine stream is not as strong as it used to be. Suddenly it comes out earlier, it is not strong enough and this leads to it cutting off and not being able to empty the urine effectively. Number six. To compensate for all these deficiencies that are causing the excess pressure due to the prostate, we have to push, we have to force, cough or some other maneuver for us to push the urine out of our body, when of course, it should be a practically passive process, which the bladder will manage to empty itself.

So, if we feel this need to push and push to be able to urinate, this, of course, is another indication that the prostate is not well at all. And number seven, when we go to sleep, we wake up at night to urinate. Now, with this you can imagine, intuit some of these I do. It doesn't happen that often, but all of a sudden it happens to me. So it is not enough to have just one of these that has happened to me suddenly, but we are going to need to have this scale and pss that it is a great amount of these data, of these seven essential data and that they are or occur very frequently. And then to each of these seven questions we are going to assign a frequency and a point or an amount of score. If it never happens to me, I will have zero points. If it is happening to me all the time, then I have five points for each of these symptoms that I am manifesting now in between, I will have zero.

Of course, it is none. It never happens to me. One is happens to me less than one in five times that I have the five days of the week, for example. Then one of them I present some alterations. The rest of the four does not happen to me. Two points is if it is less than half, but of course more than one out of five I will put three points. If it is more than half, four points if it is almost always and five points one. Moreover, if I always have some of these data, now even with this frequency and I can have some of these data frequently, for example, I'm always getting up to go to the bathroom when I'm sleeping. Let's then add up points. If I have 1 to 7 points on this scale, for example, I have five because I always stand up to urinate when I'm asleep and all the others I have zero. Okay, five points like this out of about seven is mild symptomatology. It practically does not mean that the prostate is affected or it is affected very very little.

If I have from 8 to 19 points I have moderate symptomatology, from 20 to 35 I have. Severe symptomatology. Of course, if I have five always go without fail, I pass these seven data that I am presenting in the and pss then my prostate is very affected, it is really super squeezing the urethra and not allowing my urinary tract to function properly. Now, in addition to these seven items that we evaluate on the international prostate sign scale and pss we're going to have an extra one which is quality of life and it's basically asking ok, if you were to stay as you are with the way your urinary system is functioning for the rest of your life, how happy would you be? And of course, that reflects to us maybe a great deal of satisfaction. You know I don't have a problem. If I do the rest of my life, I wouldn't complain. Oh, of course, I would be devastated. If this continues to significantly affect the quality of life, then not only are we going to do the escalation and PSS, but we're also going to look at the quality of life and how much it's affected.

And then a scale that's not as high but it affects the quality of life a lot, it may also be worth treating that patient with some medication, with some surgery again and those we saw in the past videos. On the other hand, if she has a lot of average symptoms, you know I will limit myself to due. It's really not affected. I'm not bothered by what's happening to me. So can we better wait a little bit longer? Of course, it's not a malignant process that can get more complicated later on. So these are going to be just the kind of conversations that we need to have with our physician, that we need to have with our patients, and that we as men need to evaluate about our prostate. Of course, as you can see this scale and pss it can be literally you guys can be turned on to the video and depending on the amount of symptoms already know that. Is that clearly if I'm having prostate testing, go to a doctor. The doctors that usually have the prostate are the urologist doctors and of course get us seen as soon as possible so that we don't progress to those more severe versions.

And again, if it were the case, a prostate cancer that is caught early and treated before it becomes much more complicated. And that's basically the information that I had for you today.