How Is An Enlarged Prostate Diagnosed?

The prostate is a small, muscular gland that is part of the male reproductive system. It slowly swells as a man gets older, squeezing the urethra and limiting the flow of urine. An enlarged prostate is known as Benign Prostatic Hyperplasia or BPH.

Accompanying symptoms can be mild to severe and usually get worse over time. Diagnosis helps to rule out other more serious conditions and can help to manage the symptoms and treat the condition.

Initial Tests For BPH

Your urologist will perform initial tests to diagnose an enlarged prostate.

• A urine test will rule out any infection or other issues.
• A PSA blood test looks for levels of a Protein Specific Antigen found only in the prostate gland. This protein should be at a low level for a healthy prostate. Higher levels can indicate an inflammation known as prostatitis, BPH, or prostate cancer. This is a routine test for men over age 50.
• A DRE is a digital rectal exam performed by the doctor using a lubricated glove. As the man bends forward or lies on his side, the doctor inserts one finger into the rectum to feel the prostate and determine if it has an abnormal shape or thickness.

Some additional tests may be ordered. Among them are a uroflowmetry test, measuring how fast the urine flows, a PVR or post-void residual test to determine how much urine is left in the bladder after urination, and an ultrasound of the prostate, plus others.

Routine Protocols For BPH Diagnosis

The FDA has approved the combination of PSA and DRE for men aged 50 or older to detect prostate cancer and to monitor patients after cancer treatments.

Typical Symptoms Of BPH

All men may not have the same symptoms, and the size of the prostate does not necessarily determine how severe the symptoms might be. Some men with only a slightly enlarged prostate may have acute symptoms.

Symptoms of BPH Include

• Frequent or urgent need to urinate which increases at night
• A weak stream
• Difficulty starting to urinate, or starting and stopping
• Dribbling stream at the end
• Inability to empty bladder.

If you experience any of these symptoms, or especially if you find blood in your urine, you should see your healthcare professional as soon as possible for a diagnosis.