Benign Prostatic Hyperplasia

Diagnosis

To diagnose benign prostatic hyperplasia (BPH) Mayo urologists first gather a comprehensive medical history. Afterwards, if BPH is suspected, the physician may use different tests and procedures to analyze the patient's condition. Test results generally are available to the urologist within 24 hours in Mayo's state-of-the-art electronic medical record.

Digital Rectal Exam

Because of the physical location of the prostate, a physician can determine if the prostate is enlarged by inserting a gloved finger into the rectum. This procedure also helps detect prostate cancer.

Urine Analysis

Urine analysis can detect infections, prostatitis, cystitis and other conditions.

Prostate-Specific Antigen (PSA) Blood Test

Higher than normal levels of prostate-specific antigen in the bloodstream may indicate BPH, prostate cancer or prostatitis.

Urinary Flow Test

Ongoing measurement of the strength and amount of urine flow can help the urologist track changes over time.

Post-void Residual Volume Test

Physicians use either a tube inserted into the urethra or ultrasound to check if urine is left in the bladder after normal urination. Ultrasound is more comfortable than inserting a tube in the bladder, but often it is less accurate at determining whether the bladder empties.

Ultrasound

Imaging through ultrasound can be used to estimate the size of the prostate gland. In addition, ultrasound can help detect problems such as a kidney obstruction, stones in the kidneys or prostate, or a tumor in the prostate. The procedure is especially useful when the patient has experienced allergic reactions to other imaging procedures that require contrast dyes injected into the veins. Physicians typically use abdominal ultrasound, which is noninvasive, and transrectal ultrasound, where an ultrasound probe is inserted in the rectum. Transrectal ultrasound results in a fairly accurate assessment of prostate size.

Urodynamic Studies

These studies are used when the urologist thinks that a patient's symptoms may be related to bladder problems rather than BPH. A catheter is threaded through the urethra and into the bladder. Water is then used to measure the internal pressure and contractions of the bladder.

Cystoscopy

A thin tube containing a lens with a light system (cystoscope) is inserted into the urethra so the urologist can view the inside of the urethra and bladder. The procedure, done under local anesthesia, can detect various problems and abnormalities, including BPH.

Intravenous Pyelogram or CT Urogram

In this procedure, dye is injected into a vein, and an X-ray is taken of the kidneys, bladder and ureters. The image helps detect urinary stones, tumors or blockage above the bladder.

Retrograde Pyelography

In this procedure, X-rays of the urinary tract are taken after contrast dyes are injected into the ureters.