Benign Prostatic Hyperplasia (BPH)
A healthcare provider will ask about:
- Symptoms, when they started, and how severe they are.
- Medications, including any over-the-counter medications or supplements.
Tests that the provider may do include:
- Digital rectal examination. The healthcare provider inserts a finger into the rectum to feel the size and shape of the prostate.
- Urinalysis. A urine sample will show whether a urinary tract infection is present.
- Blood tests. They can show the level of prostate-specific antigen (PSA, a protein that the prostate makes). This level can be high if a person has BPH.
- Urodynamic testing. This includes several tests that help show how the bladder and urethra are working.
- Ultrasound. An ultrasound on the abdomen can show whether the bladder is emptying after urination. An ultrasound through the rectum can show the size of the prostate gland.
Prostatitis
A healthcare provider will diagnose prostatitis by asking about symptoms and medical history. Tests the provider may do include:
- Urinalysis. A urine sample can show a possible urinary tract infection.
- Blood tests. Blood tests may be done to check for other signs of infection or prostate disease.
- Digital Rectal Exam. The healthcare provider inserts a finger into the rectum to see if the prostate is swollen or tender. However, this test can be harmful if a man does have prostatitis. It can cause bacteremia (a serious blood infection).
- A CT or ultrasound scan may be done to see the prostate.
Prostate Cancer
Screening
Treatment of early stage prostate cancer is likely to be successful. However, men with early stage disease usually have no symptoms. Many healthcare professionals and medical organizations believe that routine screening for prostate cancer may not be necessary because:
- Early detection does not seem to reduce the risk of early death.
- Most men with prostate cancer die from something else.
- Early detection may result in unnecessary treatments, severe complications, and needless worry.
Screening for prostate cancer involves a discussion of the associated risks and benefits of such screening with the patient and their physician. Visit the U.S. Preventive Service Task Force website for screening guidelines:
Referral to a urologist for further recommendations is appropriate.
Screening over age 75
Older men are less likely to benefit from screening, and many organizations now recommend against screening men over the age of 75.
The person’s decision to be screened needs to be made by:
- Talking with the healthcare provider
- Discussing choices
- Considering personal risk factors
- Understanding benefits and harms from treatment
Diagnosis
The most common tests for prostate cancer are:
- Prostate-specific antigen (PSA) blood test. When prostate cancer is present, the PSA tends to be high. However, PSA can be high for other reasons, including age, BPH, or prostatitis. If PSA levels are very elevated, or if they are rising rapidly, your healthcare provider may recommend additional tests.
- Prostate biopsy. If the PSA test is positive, the next test is likely a prostate biopsy. This test uses a rectal ultrasound and a needle to obtain tissue samples from the prostate. The tissue is then examined to see if any cancer cells are present.
Prostate Cancer Grading and Staging
If the prostate biopsy shows cancer cells, the next step is to determine the size of the tumor, how aggressive it is, and how much it has spread. This information helps determine the best treatment.
Prostate cancer’s stage depends on how large the tumor is and how much it has spread. A number of different tests may be used for staging:
- Ultrasound of the prostate
- Computerized tomography (CT or CAT) scan
- Magnetic resonance imaging (MRI) scan
- Positron emission tomography (PET) scan
- Bone scan
Last Updated March 2023