Benign Prostatic Hyperplasia

Testing

Evaluation for BPH involves a discussion of the patient's medical and family history, a physical examination, a digital rectal examination (DRE), and an evaluation of the patient’s symptoms. Laboratory tests and imaging scans may be used to determine the size of the prostate and to rule out other diseases or conditions that may be causing or exacerbating the symptoms. Occasionally, a biopsy of the prostate may be required to look at the cellular structure of a small amount of prostate tissue under the microscope for signs of prostate cancer.

Laboratory tests may include:

• PSA (prostate specific antigen) – to help detect prostate cancer. This test may also be somewhat elevated in those with BPH, because PSA is a protein produced by cells in the prostate. When evaluating the results, the doctor must consider both the concentration of PSA in the blood and the volume of the patient’s prostate.
• Urinalysis – to screen for kidney disorders
• Urine Culture – to look for signs of a UTI
• Blood Urea Nitrogen (BUN) and Creatinine – blood tests to evaluate kidney function

Non-laboratory tests may include:

• Ultrasound – to help measure the size of the prostate and evaluate the volume of urine retained in the bladder
• Cystoscopy - an evaluation of the urethra and/or bladder using a thin flexible scope
• Urine flow and/or pressure studies - to evaluate how fast urine can travel through the urethra and how much pressure is being put on the bladder by urine retention
• Prostate biopsy – collection of one or more small samples of prostate tissue and evaluation of its cellular structure under the microscope for abnormal cells and any signs of prostate cancer