Diagnosis of Benign Prostatic Hyperplasia (BPH)
The doctor will ask about symptoms and past health. A physical exam will be done. The symptoms of BPH can be similar to other urinary tract issues, from infections to cancer. Tests may be done to rule these out.
A digital rectal exam will be done. The doctor inserts a lubricated, gloved finger into the rectum. The surface of the prostate can be felt against the rectum. The doctor will be able to check the size of prostate. They will also check for any other issues, such as inflammation or tumors.
Other tests may include:
General tests—blood or urine (pee) tests to show how well the kidneys are working. Urine may be checked with a dipstick.
Prostate specific antigen (PSA) —PSA is a protein made by the prostate gland. PSA levels may increase when a person has prostate cancer. It can also increase with other noncancerous conditions like BPH. It is not used by itself to diagnose BPH or cancer. It is part of a group of tests.
Residual urine determination—This measures the amount of urine left in the bladder after urination (peeing). This can be done with an abdominal ultrasound. A tube (catheter) may put into the bladder if an exact measure is needed.
Urine flow study—The pressure and flow of urine is measured. Low flow means there may be problems with the bladder. It could also mean a blockage in the urethra.
Cystoscopy—A long, thin scope is put through the penis into the bladder. The scope will help the doctor to see inside the urethra, prostate, and bladder.
Cystometrogram —This test measures urine flow and bladder pressure. It is most often used when deciding on surgery.
Transrectal ultrasound—An ultrasound can create images of organs. This type uses a wand inserted into the rectum. This puts it closer to the prostate. It helps make better details in the images.
- Benign prostatic hyperplasia (BPH). EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/benign-prostatic-hyperplasia-bph.
- Lerner LB, McVary KT, et al. Management of lower urinary tract symptoms attributed to benign prostatic hyperplasia: AUA GUIDELINE PART I-Initial Work-up and Medical Management. J Urol. 2021;206(4):806-817.
- Management of benign prostatic hyperplasia/ lower urinary tract symptoms (2021). American Urological Association website. Available at: https://www.auanet.org/guidelines-and-quality/guidelines/benign-prostatic-hyperplasia-(bph)-guideline.
- Prostate enlargement (benign prostatic hyperplasia). National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/urologic-diseases/prostate-problems/prostate-enlargement-benign-prostatic-hyperplasia.
- Mark D. Arredondo, MD
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