men s health issues
Benign Prostatic Hyperplasia (BPH)
Diagnosis of BPH
Rectal examination Sometimes uroflowmetry Sometimes biopsy or magnetic resonance imaging (MRI) By feeling the prostate during a rectal examination, doctors can usually determine if it is enlarged. Doctors insert a gloved and lubricated finger into the rectum. The prostate can be felt just in front of the rectum. A prostate affected by benign prostatic hyperplasia (BPH) feels enlarged, symmetrical, and smooth but is not painful to the touch. Firm or hard areas may indicate Prostate Cancer . A urine sample should be examined (urinalysis) to make sure there is no infection or bleeding. When an examination reveals an enlarged prostate or a man has symptoms of urine blockage, doctors typically also do a test to measure the level of prostate-specific antigen (PSA) in the blood. The PSA level can be elevated in men with BPH and also in men with prostate cancer. If the PSA level is elevated or the prostate is hard or lumpy to the touch, other tests may then be required to determine if cancer is present. Men who have symptoms of urine blockage may be asked to urinate into a device that measures the volume and rate of urine flow (a test called uroflowmetry). Immediately after the uroflowmetry, doctors do a bladder ultrasound examination to determine how completely the bladder has emptied. Both these tests help diagnose the presence and severity of urine blockage. If doctors suspect prostate cancer, they may use transrectal ultrasonography (TRUS) to help identify the areas most likely to have cancer and target them for biopsy. Identifying these areas not only increases the chances of finding the cancer, but it may also decrease the number of samples necessary. Because higher numbers of samples increase the risk of infection, minimizing the number of samples taken helps minimize the risk of infection. In men with high or increasing PSA levels, a newer technology called multiparametric MRI may be used to enhance diagnosis and treatment of BPH. Occasionally, cystoscopy is done to exclude other causes of urine blockage, such as a urethral stricture, or to help plan the best approach for surgery. 