How are prostate problems diagnosed?

To diagnose prostate problems a doctor will ask questions about a man's urinary health and may or may not use a gloved finger to feel the prostate gland itself (digital rectal exam). Some prostate problems can be diagnosed by this history and physical exam alone. Blood tests can also be used to evaluate the prostate, but it is controversial whether these tests should be used on asymptomatic men to screen for cancer. If abnormalities are found on these initial tests, an ultrasound and/or biopsy of the prostate might be necessary for diagnosis.

If you are having symptoms of prostate problems, your doctor will ask you about your medical history and your symptoms and then perform a physical examination which will include a digital rectal examination (DRE). The doctor inserts a gloved, lubricated finger into the rectum to feel the back part of your prostate. He feels for hard or lumpy areas. The exam takes only a minute or so to do and causes only a little discomfort. He also may order a blood test called a prostate-specific antigen (PSA) test. The level of PSA in the blood rises when a man has prostate cancer, benign prostatic hyperplasia (BPH), or an infection.

The doctor also will check your urine for any sign of blood or infection. If any abnormalities are suspected he will probably order an ultrasound of your prostate, called a transrectal ultrasound (TRUS). He may perform a cystoscopy, in which he looks into the urethra through a thin, lighted tube. Last, if cancer cannot be ruled out, the doctor may recommend a biopsy, in which he inserts a needle into the prostate, guided by ultrasound, to remove a small piece of tissue in the area of the apparent abnormality. This is the only sure way to know if the problem is 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.