How is Benign Prostatic Hyperplasia (BPH) Diagnosed?

Published On: May, 16, 2022

How is Benign Prostatic Hyperplasia (BPH) Diagnosed?


The doctor will begin the diagnosis of benign prostatic hyperplasia by asking detailed questions about your symptoms and performing a physical examination. The first examination usually includes:


Digital Rectal Exam

Here the doctor will insert a finger into the rectum to check the extent of the prostate enlargement


Urine Test

The doctor will also perform a urine test to help rule out other conditions or infections that may cause similar symptoms. 

Blood Test

The test is conducted to help diagnose other conditions such as kidney problems. Prostate-specific antigen (PSA) blood test is another standardized test that is used in diagnosing BPH. The prostate produces prostate-specific antigen. When you have an enlarged prostate, the PSA levels tend to increase. However, increased PSA levels can also indicate infections or prostate cancer. The doctor may also recommend additional tests to help confirm BPH and rule out other conditions. 

Urinary Flow Test

The test involves urinating into a receptacle that is attached to a machine that calculates the strength and amount of your urine flow. This test is crucial, especially when determining whether your condition is improving or deteriorating. 

Postvoid Residual Volume Test

These test results show your ability to empty your bladder. It is done by inserting a catheter into the bladder or using an ultrasound to measure how much urine is left after you urinate. 

24-hour Voiding Diary

The test is beneficial, especially for people who frequently urinate at night. It involves recording the frequency and amount of urine. For complex conditions, your doctor may recommend the following additional tests. 

Transrectal Ultrasound

The test involves inserting an ultrasound probe into the rectum to measure and evaluate your prostate. 

Prostate Biopsy

The transrectal ultrasound is used in guiding the needles that take the tissue samples of the prostate. Examining the sample will help the doctor in ruling out or diagnosing prostate cancer. 

Urodynamic and Pressure-Flow Studies

While a bit complex, this test is essential, especially for men with neurological problems and those who had undergone a previous prostate procedure but still have symptoms. The procedure involves threading a catheter through the urethra into the bladder. Water or air is injected into the bladder slowly. The test will help measure the bladder pressure and how effective your bladder muscles are responding.


A cystoscopy is a light, flexible instrument inserted into the urethra, enabling the doctor to see inside the bladder and urethra. A local anesthetic is necessary before the test. 


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