As men age, they are at greater risk of developing an enlarged prostate--a condition also known as benign prostatic hyperplasia. Doctors may conduct a variety of tests in an effort to confirm the presence of an enlarged prostate; determine the extent of urinary blockage; and rule out other causes for the symptoms, such as urinary stones or prostate cancer.
Digital Rectal Exam
During a digital rectal exam, the doctor inserts a finger into the rectum to feel for any physical abnormalities--such as bumps or hard or soft spots--in the adjacent prostate. According to the National Kidney and Urologic Diseases Information Clearinghouse, men with suspected enlarged prostates often undergo this test first, and it is routine for men over the age of 50. Though uncomfortable, the procedure is usually very brief. The doctor may also massage the prostate to induce secretion of fluid for microscopic evaluation.
Urine and Bladder Tests
A physician may conduct one or more urine tests to evaluate the severity of the enlarged prostate. According to MedlinePlus, patients often undergo a urine culture and urinalysis to check for a bacterial or fungal infection. The doctor may also examine the urine specimen for the presence of blood--a condition known as hematuria that can be a sign of abnormal bleeding in the genitourinary tract.
Some patients may also complete a urine flow test to measure the force and volume of urine output. The test helps to determine to what extent the enlarged prostate is obstructing the passage of urine. To monitor the stability or worsening of the condition over time, the doctor may ask the patient to repeat this exam periodically, according to MayoClinic.com.
Some individuals may also undergo a post-void residual volume test to determine whether the enlarged prostate is interfering with the ability to empty the bladder completely. By inserting a catheter into the bladder after urination, the doctor can obtain a measurement of how much urine remains. Alternatively, he may use an imaging method called ultrasound to view the remaining bladder contents.
According to MedlinePlus, some men may also undergo cystoscopy--a procedure in which the doctor inserts a cystoscope, or tube with a camera on the end, into the tip of the penis in order to look for blockages in the urethra or bladder.
Should a doctor have concerns that a tumor or urinary stones are blocking the flow of urine, he may conduct an intravenous pyelogram--a procedure in which a contrast dye is injected into a vein and x-rays are taken of the bladder, ureters and kidneys. The resulting images can show whether there is a mass in any of the essential drainage tubes.
Prostate-Specific Antigen Blood Test
Prostate-specific antigen, or PSA, is a protein produced by the prostate. Though men normally have a certain amount of PSA in the bloodstream, high levels can sometimes suggest the presence of prostate cancer. According to the National Kidney and Urologic Diseases Information Clearinghouse, high levels of PSA do not necessarily signify prostate cancer; however, doctors use the results of this test in combination with a digital rectal exam to help interpret the findings.
Prostate Biopsy
Physicians may perform a prostate biopsy if there is suspicion of prostate cancer. To collect tissue from the prostate, the doctor typically uses a transrectal ultrasound procedure, during which he inserts a probe into the rectum that projects high-frequency sound waves. These sound waves form echo patterns that create detailed images of the size and shape of the prostate. According to the National Kidney and Urologic Diseases Information Clearinghouse, these images assist the doctor in using the probe to guide a needle to the suspicious tissue and take a sample for biopsy.
