Benign Prostatic Hyperplasia (BPH)

There are many tests for BPH. The following tests are used to diagnose and track BPH.

Symptom Score Index

If you have any urinary changes or symptoms, your doctor may talk to you about the BPH Symptom Score Index. The American Urological Association (AUA) developed this test to assess urinary symptoms.

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This is often the first step to diagnose BPH. The score can rate BPH as being mild to severe. You and your health care provider may talk about your results and your medical history. This is sometimes also called the International Prostate Symptom Score (IPSS.)

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Rate your symptoms with the BPH Symptom Score Index below!

Physical Exam

A digital rectal exam (DRE) is often the next step. During a DRE, you lie on your side or bend over. The doctor inserts a gloved, lubricated finger into your rectum to feel the back wall of the prostate gland. The health care provider is looking for enlargement, tenderness, lumps or hard spots. This 10-15 second exam is an important way to find problems.

Urine Tests

These tests are done to measure how well you release urine. This shows the doctor if the urethra is blocked or obstructed. There are several types:

• Urinalysis tests your urine sample to check for important things such as blood, signs of infection, glucose (sugar), protein and other factors that can tell your urologist the cause of your symptoms. Urine tests are also used to screen for bladder cancer. If you have blood in your urine, pain or burning when you pass urine, or you cannot pass urine, it is important to see your doctor right away.
• Post-void residual volume (PVR) measures urine left in the bladder after passing urine. This is done to diagnose the problem. It may also be done before surgery.
• Uroflowmetry measures how fast urine flows. This is done to diagnose the problem. It may also be done before surgery.
• Urodynamic pressure flow study tests pressure in the bladder during urination.

Scans

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These tests are done to see the size and shape of the prostate. Some BPH scans include:

• Ultrasounds look inside the body and see the size and shape of the prostate.
• Cystoscopy is an exam used to look at the urethra or bladder with a scope.
• Magnetic resonance imaging (MRI) and computed tomography (CT) are more detailed scans. These are done if surgery is necessary to reopen the flow of urine. These scans provide a very clear image of the prostate and surrounding area. It shows exactly how and where the prostate is enlarged.

Blood Tests

If cancer is suspected, blood tests may be done.

• Prostate-specific antigen (PSA) blood tests are used to screen for prostate cancer. The PSA blood test checks the level of PSA, a protein made only by the prostate gland. This blood test can be done in a lab, hospital or a provider’s office. Avoid sexual activity several days prior to the test, as this may artificially increase the PSA reading.

When the prostate is healthy, very little PSA is found in the blood. A rapid rise in PSA may be a sign that something is wrong. A benign (non-cancer) enlargement of the prostate can cause a rise in PSA levels, as can inflammation of the prostate (prostatitis).The most serious cause of a rise in PSA is cancer.

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