How is benign prostatic hypertrophy (BPH) diagnosed?

Marc B. Garnick, MD
Hematology & Oncology
During an initial evaluation for benign prostatic hyperplasia (BPH) -- a noncancerous enlargement of the prostate that can interfere with urination -- your doctor will take a medical history. Expect questions about your urinary flow problems, how long your symptoms have been present, and any prior genitourinary surgery or procedures. Most likely, he or she will ask about your health habits and any medications that may have made the symptoms worse. Your doctor may also ask you to complete a questionnaire, such as the American Urological Association Urinary Symptom Score, to help evaluate the severity of your BPH.

An adequate physical exam and diagnostic workup includes a digital rectal examination (DRE) and, if you and your doctor concur, a prostate-specific antigen (PSA) test. It also includes several other laboratory tests, such as a urinalysis. This allows your doctor to rule out bacterial infections and look for untreated diabetes, which can produce frequent urination, particularly at night.
Benign prostatic hyperplasia (BPH) diagnosis usually occurs when a man goes to his primary healthcare practitioner with complaints of bothersome urinary problems. To diagnose BPH, the doctor will
  • Have you fill out a questionnaire about your urinary problems -- to determine if you have the classic symptoms and to judge how severe the symptoms are.
  • Take your past and current medical history to determine if there are other conditions that could be causing urinary symptoms.
  • Check your prostate gland using a procedure called a direct rectal examination (DRE) that helps to determine if the prostate is enlarged and if any abnormalities exist that require further investigation.
  • Give you a physical exam to determine if any undetected medical problems could be causing your symptoms.
  • Check your urine for blood or signs of infection.

In addition, the doctor may test your blood for creatinine to determine if your kidneys have been affected. He or she also may recommend a test known as the prostate-specific antigen test to check for cancer.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.