You may first notice symptoms of an enlarged prostate yourself, or your doctor may find that your prostate is enlarged during a routine checkup. When an enlarged prostate 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 identify the problem and decide whether surgery is needed. The tests vary from patient to patient, but the following are the most common:
- Digital Rectal Exam (DRE). This exam is usually the first test performed. 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 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 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, and the best course of action following a finding of elevated PSA.
- Rectal Ultrasound. If there is a suspicion of prostate cancer, your doctor may recommend a test with 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.
- Urine Flow Study. Sometimes the doctor will ask a patient to urinate into a special device that measures how quickly the urine is flowing. A reduced flow often suggests BPH.
- Cystoscopy. In this exam, the doctor inserts a small tube through the opening of the urethra in the penis. This procedure is done after a solution numbs the inside of the penis so all sensation is lost. The tube, called a cystoscope, contains a lens and a light system, which help the doctor see the inside of the urethra and the bladder. This test allows the doctor to determine the size of the gland and identify the location and degree of the obstruction.
(Click Enlarged Prostate Diagnosis for more information.)