How Is Benign Prostatic Hyperplasia Diagnosed?
Your doctor learns about your medical history by asking questions, and sometimes by asking you to fill out forms. Your doctor will ask you what your urinary symptoms are, when you first noticed them, and how painful or disturbing they are.
You may be asked questions about your overall condition, other medical problems, family history of BPH, and lifestyle habits. This information helps the doctor understand what treatments may work for you, what other conditions may be causing your symptoms (or may interfere with treatment), and what your risk factors are.
It is important for you to come prepared to explain what medications (and supplements, if any) you are taking. Bring a list or bring the actual medications in a shoebox if that works better. Also come prepared to describe what other treatment you’ve had for BPH or other medical problems.
The doctor may want to evaluate your urinary symptoms in detail with the help of standard questionnaires developed for this purpose. One example is the American Urological Association Symptom Index. Another is the International Prostate Symptom Score.
When you see the doctor, you may want to be prepared to answer the following questions:
- How often do you have the feeling that your bladder doesn’t empty completely after urinating?
- How often do you find you have to urinate again, less than 2 hours after urinating?
- How often do you find that you can’t postpone going to the bathroom to urinate?
- How often do you urinate with a weak flow of urine?
- How often do you have to strain to urinate?
- How many times do you have to get up at night to urinate?
- Do your urinary problems cause you physical discomfort?
- Are you unable to carry out some of your usual activities because of urinary problems?
It may be that you first experience symptoms of benign prostatic hyperplasia (BPH), or your physician may notice that your prostate is enlarged during a routine physical examination. If your doctor suspects you have BPH, he or she may refer you to a urologist. As part of a complete physical examination, one of the first tests your doctor is likely to perform is a digital rectal examination. Digital rectal examination is performed by the doctor inserting a gloved finger, which has been coated with lubricating gel, into the anus to feel the prostate through the rectum.
If the prostate is enlarged or has lumps, it may be possible for the doctor to feel them through this examination. Although not perfect, this technique can help the doctor decide whether more tests are needed. A number of laboratory and imaging tests are also available to help the doctor evaluate your condition and recommend the right treatment, though not all tests are necessary for all patients.
Laboratory and other diagnostic tests