Rising PSA levels due to BPH do not rise as high as elevated PSA levels due to prostate cancer. They also tend to rise more slowly.
NIDDK - BPH Diagnosis
A recent international conference supported by the World Health Organization has recommended the following tests during an initial evaluation of men with symptoms of BPH.
An adequate patient history consists of 2 parts:
A focussed physical examination should be performed to assess the suprapubic area and motor and sensory function.
A digital rectal examination should also be performed. A urologist or family physician will insert a lubricated, gloved finger into the rectum. An enlarged prostate can be felt with this method, as can abnormalities such as lumps.
The DRE should be performed on a yearly basis in conjunction with the PSA blood test. These tests will allow your doctor to monitor the growth of the prostate and evaluate if your treatment plan should be adapted.