Benign prostatic hyperplasia: diagnosis

General Tests
Physical Examination and Digital Rectal Examination
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. This should be performed on a yearly basis in conjunction with the PSA blood test (see PSA Testing).

Urinalysis
The urine should be analyzed for blood, protein, or sugar .

Residual Urine/Transabdominal Ultrasound
After you empty your bladder, a urologist will place an ultrasound probe covered with gel above your bladder on your lower abdomen. The ultrasound scanner will show whether you are retaining urine in your bladder, which could indicate an obstruction, such as an enlarged prostate.

Flow Rate Recording
Your doctor will have you urinate into a small funnel like machine when you have a full bladder. This special container measures the amount of urine, strength of flow, length of time it takes to urinate, and can determine the severity of the blockage caused by the enlarged prostate.

Urine Flow Study
A urologist will ask you to fill your bladder, and urinate into a funnel like container.

Blood Tests
Renal Function
A simple test of kidney function can be determined by a blood analysis called serum creatinine.

Serum PSA (prostate specific antigen)
is the most effective single method to detect prostate cancer. It is a simple blood test. The World Health Organization, The American Cancer Society, and others suggest that this test be part of a yearly process to detect prostate cancer at its earliest stage. This test is not perfect. There are many times when the test suggests there is cancer when it does not exist and equally there are cases when prostate cancer is found when there is a normal PSA. Moreover, some people are not certain that the early detection of prostate cancer will actually increase life. Because of this many other organizations believe that each man should consider the advantages and potential disadvantages of the use of PSA. If you need more information see PSA Testing.

Optional Tests
The following tests are considered to be optional or not recommended. They should only be performed on selected patients:

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