Diagnosing BPH early is important because, if left untreated, it can lead to urinary tract infections (UTIs), bladder or kidney damage, kidney stones, and incontinence. Distinguishing BPH from more serious diseases like prostate cancer is important.
To diagnose BPH we generally use a combination of tests, starting with an office visit and then escalating as your situation warrants.
Visit with your Urologist
- Exam – Your urologist will do a physical exam, which will most likely include a digital rectal exam (DRE) to feel for size of the prostate and for lumps or nodules that may be a concern.
- Blood test – A blood test called a PSA (prostate-specific antigen) test is often completed to help determine your risk for prostate cancer. A higher number can indicate an enlarged prostate, infection or cancer.
- Urine test – A urinalysis and/or urine culture can tell us if you have blood or infection in your urine.
Bladder Function Tests
- Urodynamics test – A test to measure the bladder’s ability to fill and empty with the use of a catheter.
- Urocuff test – An easy, in-office test to measure urine flow with the use of a small cuff around the penis.
- Cystoscopy – A small scope, sometimes with a camera, is used to look inside the urethra, prostate and bladder. This will help determine if the prostate is enlarged and blocking the urethra, slowing urine from leaving the bladder. It may also find problems with the bladder such as stones or tumors.
- Transrectal ultrasound – A probe is inserted into the rectum to check the prostate the prostate’s size and for abnormal areas.
- Prostate needle biopsy – A needle is used to take a small sample of prostate tissue to check for cancer. This is only done if your PSA blood test is found to be abnormal or if your prostate exam during the DRE is abnormal. It is not typically done for just an enlarged prostate without any other concerns.
Together, these tests can help your urologist determine the cause of your issues and help create a customized treatment plan.