Tests to Diagnose BPH
Tests to Diagnose BPH as part of a general examination may involve various tests, an analysis of any BPH symptoms as well as discussion of any indications of BPH arising from answers to a Prostate Symptoms Test. Men should also be questioned about their medical and social history for any neurological issues, problems with mobility, and dietary habits that may be irritating the prostate.
The Digital Rectal Examination (DRE) is one of the standard and necessary Tests to Diagnose BPH when it comes to detecting problems with the prostate including BPH. During the DRE, a doctor will insert his or her finger into your rectum and press on the prostate to feel for any irregularities in shape and size. If your doctor detects any abnormalities during the DRE, your doctor will order other tests designed to confirm the diagnosis of BPH, determine the extent of the problem, and/or rule out other causes of your symptoms, such as prostatitis and prostate cancer.
Another one of the tests to diagnose BPH is a blood test used to detect prostate problems and to identify the amount of prostate specific antigen in your bloodstream; which rises in response to aggravation or disease of the prostate (What Causes a High PSA?). Note there is no absolute correlation between an elevated PSA and BPH, because prostate infections and prostate cancer can raise your PSA level as well. In addition, if you normally have a small prostate and a lower PSA level, the PSA test results may remain within normal limits even after the prostate has grown and your level has risen. On the other hand, if you normally have a large prostate and a slightly higher PSA, even a small increase may make your level look high. The bottom line is, although the PSA is an important diagnostic test, its results are not always definitive.
A urinalysis is another one of the routine tests to diagnose BPH as part of a physical examination and involves collecting a urine sample in a cup from the patient and then examining the sample under a microscope. It may be the only test your doctor orders if you have mild symptoms and your medical history and physical examination do not show any other abnormalities. Although a urinalysis cannot produce a definitive diagnosis of BPH, it can tell the doctor if the urine contains red blood cells (which indicates bleeding in the urinary tract), white blood cells (an indication of an infection such as a urinary tract infection), proteins (a sign of a problem with the kidneys), bacteria, or other warning signals.
Your doctor may order a blood test if you have severe or chronic symptoms of BPH as one of the tests to diagnose BPH. In such cases, a blood test can identify signs of kidney damage or anemia, such as abnormalities in creatinine, hemoglobin, or blood urea nitrogen levels.
Uroflowmetry measures how “long and strong” your urinary flow is. The types of equipment used can vary, but the main idea is that you urinate into a funnel that is attached to a device that measures the flow rate and flow time, the amount of urine you void from your bladder, and so on. A normal flow rate is 15 milliliters per second or greater, and men must void at least 125 to 150 milliliters. If you demonstrate a slow flow rate, this suggests you have an obstructed urethra or bladder decompensation (loss of bladder function) and resulting BPH. If your flow rate is high, you likely do not have a urethral obstruction and treatment for BPH will probably not be effective.
In this procedure, the doctor uses a cystoscope, a long thin tube with a light that is inserted into the penis and pushed through the urethra until it enters the bladder. When the doctor looks through the tube, he or she can visually inspect the urethra and bladder and get an idea of how vigorously the prostate is squeezing the urethra as well as how much, if any, urine remains in the bladder after voiding. It can also determine whether there are prostate stones or diverticulae (tiny pouches in the prostate) and rule out urethral stricture. Cystoscopy is usually performed before prostate surgery to help guide the surgeon.
In this test, the doctor fills your bladder with fluid and measures the amount of pressure that builds up in your bladder. This test is typically only done in men who have a history of urological or neurological problems that could affect bladder function.
This is a series of studies your doctor may perform that measure the bladder’s ability to empty steadily and completely and its pressure during urination. A cystometrogram measures how much urine your bladder can hold, how much pressure builds up when it stores urine, and how full it is when you feel the urge to urinate. This test involves using a catheter to empty your bladder, and then another catheter to measure pressure in the bladder, and yet another catheter in the rectum to measure pressure there as well. The differences in pressure between the bladder and the rectum provide useful information. A high pressure along with a low urine flow rate suggests a urethral obstruction, while low pressure with a low urine flow rate indicates an abnormality in the bladder, like ones associated with a neurological disorder.
Your doctor can also order ultrasound or other imaging tests to diagnose BPH to visualize the prostate, bladder, and kidneys to look for any symptoms of prostate disease (such as urinary retention in the bladder). Ultrasound is usually performed in men who have lower urinary tract symptoms. Your doctor may use a hand-held device called a transducer that is passed over the pelvic area and emits sound waves. Ultrasonography can detect structural abnormalities in the bladder and kidneys, identify bladder stones, estimate the size of the prostate, and determine how much urine remains in the bladder. Imaging studies are generally reserved for men who have blood in their urine, a urinary tract infection, abnormal kidney function, or a history of urinary tract surgery or urinary tract stones.