Enlarged Prostate Diagnosis
A healthcare provider can diagnose an enlarged prostate based on the results of tests such as a digital rectal exam, PSA test, and cystoscopy. The doctor's choice of which tests to use will vary from patient to patient. In addition to the test results, the patient's symptoms (if any), assist the healthcare provider in making the diagnosis.
You may first notice enlarged prostate symptoms yourself, or your doctor may find that your prostate is enlarged during a routine checkup. When an enlarged prostate (benign prostatic hyperplasia, or BPH) is suspected, you may be referred to a urologist -- a doctor who specializes in problems of the urinary tract and the male reproductive system. Several tests help the doctor make an enlarged prostate diagnosis and decide whether BPH surgery is needed.
The tests required to diagnose an enlarged prostate vary from patient to patient, but the following are the most common:
- Digital rectal exam
- PSA test
- Rectal ultrasound
- Urine flow study
Digital Rectal Exam (DRE)
A digital rectal exam is usually the first test done. The doctor inserts a gloved finger into the rectum and feels the part of the prostate next to the rectum. This exam gives the doctor a general idea of the size and condition of the gland.
Prostate-Specific Antigen (PSA) Blood Test
To rule out cancer as a cause of urinary symptoms, your doctor may recommend a prostate-specific antigen (PSA) test. PSA, a protein produced by prostate cells, is frequently present at elevated levels in the blood of men who have prostate cancer.
The U.S. Food and Drug Administration (FDA) has approved a PSA test for use in conjunction with a digital rectal exam to help detect prostate cancer in men age 50 or older, and for monitoring prostate cancer patients after treatment.
However, much remains unknown about:
- The interpretation of PSA levels
- The test's ability to distinguish cancer from benign prostate conditions
- The best course of action following a finding of elevated PSA.
If there is a suspicion of prostate cancer, your doctor may recommend a rectal ultrasound. In this procedure, a probe inserted in the rectum directs sound waves at the prostate. The echo patterns of the sound waves form an image of the prostate gland on a display screen.