Benign Prostatic Hyperplasia (BPH)

Your doctor will first want to make sure that your urination problem is caused by benign prostatic hyperplasia (BPH) and not by something else. This can usually be determined from your Reference medical history, a physical exam that focuses on the urinary tract, a urinalysis, and a blood test. A neurological exam should also be done to determine whether your symptoms are related to a problem with the nerves to the bladder. A questionnaire such as the Reference American Urological Association (AUA) symptom index Reference may be used to evaluate how bothersome your symptoms are. It is not used to diagnose BPH.

Tests that are often done

• A Reference digital rectal exam checks the size and firmness of the prostate. But the size of the prostate does not always determine the severity of the symptoms.
• A Reference urinalysis and Reference urine culture check for a urinary tract infection that might be the cause of the symptoms.
• A Reference prostate-specific antigen (PSA) test helps check for prostate cancer, which can cause the same symptoms as BPH.

Tests that are used as needed

If your symptoms are moderate to severe, additional tests, called urodynamic studies, may be done.

• A Reference blood creatinine test checks how well your kidneys are working.
• Reference Post-void residual urine test (PVR) measures the amount of urine left in the bladder after urination. This test is done using Reference ultrasound Opens New Window or a small tube (catheter) put into the bladder through the Reference urethra Opens New Window.
• Pressure flow studies measure pressure in the bladder while urinating. They may help distinguish between urinary symptoms caused by obstruction, such as BPH, and those caused by a problem affecting the bladder muscles or nerves.
• Reference Cystometrogram measures the bladder's pressure, compliance, and capacity during urinary storage. This may include a Reference uroflowmetry test, which measures how fast the urine flows out of the bladder.

Tests that may be done

The following tests may be done if you have Reference complications of BPH or if there is a need to look for other causes of the symptoms.

• Reference Ultrasound uses sound waves to check the size and structure of the kidneys, bladder, and prostate. A small device called a transducer is inserted into the rectum (transrectal ultrasound) to evaluate the prostate.
• Reference Cystoscopy allows the doctor to look inside the urethra and bladder. This may allow the doctor to find out how much an enlarged prostate is blocking the urethra.
• Reference Intravenous pyelogram (IVP) uses X-rays to show the function of the kidneys and the flow of urine from the kidneys to the bladder.
• Spiral (helical) Reference computed tomography (CT) scan uses X-rays to make detailed pictures of structures inside the body. These scanners can check for an enlarged Reference prostate gland Opens New Window Reference Opens New Window, blockage, and urine flow from the kidneys.

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