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How is BPH Diagnosed?

See your doctor if you have symptoms that might be BPH. See your doctor right away if you have blood in your urine, pain or burning when you urinate, or if you cannot urinate.

Your doctor can diagnose BPH based on

  • Personal or family history
  • A physical exam
  • Medical tests

The American Urological Association (AUA) has built a BPH Symptom Score Index. It’s a series of questions about how often urinary symptoms happen. The score rates BPH from mild to severe. Take the test and talk with your doctor about your results.

Your doctor will review your Symptom Score and take a medical history. You will also have a physical exam that involves a digital rectal exam (DRE). Your doctor may also want you to have some or all of these tests:

  • Cystoscopy to look at the urethra or bladder with a scope
  • Post-void residual volume to measure urine left in the bladder after urinating
  • PSA blood test to screen for prostate cancer
  • Ultrasound of the prostate
  • Urinalysis (urine test)
  • Uroflowmetry to measure how fast urine flows
  • Urodynamic pressure to test pressure in the bladder during urinating
  • Urinary blood test to screen for bladder cancer

PSA Blood Test

Prostate-specific antigen (PSA) is a protein that is made only by the prostate. When the prostate is healthy, very little PSA is found in the blood.

The PSA blood test measures the level of PSA in the blood. The test can be done in a lab, hospital, or doctor's office. No special preparation is needed. The PSA test should be done before the doctor does a DRE. You should not ejaculate for 2 days before a PSA test. That’s because ejaculation can raise the PSA level for 24 to 48 hours.

A low PSA is better for prostate health. A rapid rise in PSA may be a sign that something is wrong. BPH is one possible cause of a high PSA level. Inflammation of the prostate, or prostatitis, is another common cause of a high PSA level.

Digital Rectal Exam of the Prostate
Digital Rectal Exam of the Prostate

Digital Rectal Exam

The DRE is done with the man bending over or lying curled on his side. The doctor puts a lubricated, gloved finger into the rectum to feel the shape and thickness of the prostate. The DRE can help your doctor find prostate problems.