Diagnosis of Benign Prostatic Hyperplasia (BPH)
by Ricker Polsdorfer, MD
You will be asked about your medical history. A physical exam will be done. The symptoms of BPH can be similar to other urinary tract issues, from infections to cancer. Tests may be done to rule these out.
A digital rectal exam will be done. The doctor inserts a gloved finger into the rectum. The surface of the prostate can be felt against the rectum. The doctor will be able to check the size of prostate. They will also be able to check for any other issues, such as inflammation or tumors.
Other tests may include:
General tests —blood or urine tests to show how well the kidneys are working. Urine may be checked with a dipstick.
Prostate specific antigen (PSA) —PSA is a protein made by the prostate gland. PSA levels may increase when prostate cancer is present and with other noncancerous conditions like BPH. It is not used by itself to diagnose BPH or cancer but will be part of a group of tests.
Residual urine determination —The amount of urine left in your bladder after you have urinated is measured. An abdominal ultrasound can be used to do the measure. A catheter may be sent into the bladder if an exact measure is needed.
Urine flow study —The pressure and flow of urine is measured. Low flow suggests problems with the bladder or a blockage in the urethra.
Cystoscopic examination—A long, thin scope is inserted through the penis and into the bladder. The scope will allow the doctor to see inside the urethra, prostate, and bladder.
Cystometrogram —This test measures urine flow and bladder pressure. It is most often used when deciding on surgery.
Transrectal ultrasound —An ultrasound can create images of organs. A transrectal ultrasound uses a wand that is inserted into the rectum. This puts it closer to the prostate which will create better details in the images.
American Urological Association (AUA) Practice Guidelines Committee. AUA guideline on management of benign prostatic hyperplasia. Available at:
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Accessed September 21, 2020.
Benign prostatic hyperplasia (BPH). EBSCO DynaMed website. Available at: https://www.dyname.... Accessed September 21, 2020.
Pearson R, Williams PM. Common questions about the diagnosis and management of benign prostatic hyperplasia. Am Fam Physician. 2014;90(11):769-774.
Prostate enlargement: benign prostatic hyperplasia. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/health-topics/urologic-disease/benign-prostatic-hyperplasia-bph/Pages/facts.aspx. Accessed September 21, 2020.
Last reviewed September 2020 by EBSCO Medical Review Board Adrienne Carmack, MD
Last Updated: 11/3/2020
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