Name of the Condition

• Nodular Prostate with Lower Urinary Tract Symptoms (N40.3)
• Also known as Benign Prostatic Hyperplasia (BPH) with LUTS

Summary

Nodular prostate with lower urinary tract symptoms, commonly referred to as Benign Prostatic Hyperplasia (BPH), is a non-cancerous enlargement of the prostate gland. This condition frequently causes urinary problems in older men due to the compression of the urethra, resulting in lower urinary tract symptoms.

Causes

The exact cause of BPH is not completely understood. It is believed to be associated with hormonal changes as men age, particularly involving testosterone and dihydrotestosterone (DHT).

Risk Factors

• Aging: Most common in men over 50.
• Family History: A family history of prostate problems may increase the risk.
• Lifestyle: Obesity, lack of physical activity, and heart disease can contribute.
• Diabetes and heart disease can also be risk factors due to their impact on hormonal and circulatory health.

Symptoms

• Frequent or urgent need to urinate
• Increased frequency of urination at night (nocturia)
• Difficulty starting urination
• Weak urine stream or a stream that stops and starts
• Inability to completely empty the bladder

Diagnosis

• Digital Rectal Examination (DRE)
• Urinary flow test
• Post-void residual volume test
• Prostate-specific antigen (PSA) blood test
• Ultrasound or cystoscopy in some cases

Treatment Options

• Medications such as alpha blockers and 5-alpha reductase inhibitors to relieve symptoms or reduce prostate size.
• Minimally invasive therapies like transurethral microwave therapy (TUMT) or transurethral needle ablation (TUNA).
• Surgical options including transurethral resection of the prostate (TURP) for severe cases.

Prognosis and Follow-Up

BPH is not cancerous and does not usually pose a severe health threat. Symptoms may improve with treatment, but regular follow-ups are essential for managing symptoms and monitoring any progression of the condition.

Complications

• Acute urinary retention (inability to urinate)
• Urinary tract infections
• Bladder stones
• Bladder damage
• Kidney damage

Lifestyle & Prevention

• Regular exercise and maintaining a healthy weight
• Reducing intake of caffeinated drinks and alcohol
• Avoiding medications that can exacerbate symptoms, such as certain decongestants
• Maintaining a well-balanced diet

When to Seek Professional Help

Seek immediate medical attention if you experience:

• Inability to urinate
• Painful urination
• Blood in urine
• Severe discomfort in lower abdomen or urinary tract

Additional Resources

• American Urological Association (AUA) Website
• National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Website

Tips for Medical Coders

• Ensure correct coding by confirming the presence of both nodular prostate hyperplasia and associated lower urinary tract symptoms.
• Avoid confusion with other prostatic disorders; N40.3 specifically refers to nodular prostate with LUTS.
• Double-check for documentation specifying urinary symptoms linked to the nodular prostate to ensure accurate coding.