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How is BPH Diagnosed?

The American Urological Association (AUA) developed a BPH Symptom Score Index. It asks how often urinary symptoms happen. The score rates BPH as mild to severe. Take the test and talk with your healthcare provider about your results.

Your health care provider will review your Symptom Score and take a medical history. There will be a physical exam with a digital rectal exam (DRE). You may also have:

  • Urinalysis (urine test)
  • PSA blood test to screen for prostate cancer
  • Urinary blood test to screen for bladder cancer
  • Post-void residual volume (PVR) to measure urine left in the bladder after urinating
  • Uroflowmetry to measure how fast urine flows
  • Cystoscopy to look at the urethra or bladder with a scope
  • Urodynamic pressure to test pressure in the bladder during urinating
  • Ultrasound of the prostate

You should see your health care provider if you have symptoms. See your health care provider right away if you have blood in your urine , pain or burning when you urinate, or you cannot urinate.

PSA Test

The prostate-specific antigen (PSA) blood test, tests the level of prostate-specific antigen (PSA) in the blood. PSA is a protein made only by the prostate gland. The PSA test can be done in a lab, hospital or health care provider's office. There is no special preparation. The PSA test should come before the health care provider does a DRE. Ejaculation can raise the PSA level for 24 to 48 hours. So the patient should not ejaculate for two days before a PSA test.

Very little PSA is found in the blood of a man with a healthy prostate. A low PSA is better for prostate health. A rapid rise in PSA may be a sign that something is wrong. One possible cause of a high PSA level is benign (non-cancer) enlargement of the prostate . Inflammation of the prostate, called prostatitis is one more common cause of high PSA levels.

Digital Rectal Exam of the Prostate
Digital Rectal Exam of the Prostate
Alan Hoofring (Illustrator), National Cancer Institute

DRE

The digital rectal examination (DRE) is done with the man bending over or lying curled on his side. The health care provider puts a lubricated gloved finger into the rectum. The health care provider will feel the prostate. They will be looking for abnormal shape or thickness in the prostate, The DRE can help your health care provider find prostate problems.