Many men notice changes in urinary habits as they age. They may feel like they need to go more often or wake up in the middle of the night to urinate. Some get the uncomfortable feeling that their bladder is never completely empty. These symptoms often lead to a BPH diagnosis.
Benign prostatic hyperplasia (BPH) means that the prostate has enlarged. When it's large enough, it can press against the urethra, making urination difficult or uncomfortable. While the symptoms can be frustrating, an accurate BPH diagnosis is the first step toward relief.
BPH Diagnosis
Diagnosing BPH usually begins with a thorough medical history and physical exam. Your doctor will ask about urinary symptoms, how long you’ve had them, and how much they interfere with daily life. Most symptoms experienced with BPH are related to urination and include:
- Frequent urination: needing to go more often, particularly at night (nocturia)
- Urgency: a sudden, strong need to urinate that may be hard to control
- Weak stream: a slower or interrupted flow of urine
- Difficulty starting urination, including straining or hesitation
- Incomplete bladder emptying
- Continued leaking after finishing urination
While these symptoms are common with an enlarged prostate, they are not specific to BPH alone. That's why further evaluation is needed.
A BPH diagnosis begins with a physical examination. This may include a digital rectal examination (DRE).
To perform a DRE, the doctor gently inserts a gloved finger into the rectum to feel the size and shape of the prostate. This test helps identify enlargement or irregularities. Additional tests may include:
- A urinalysis to check for infection or blood in the urine
- A urinary flow test, which measures the strength and speed of your stream
- A post-void residual test, which uses ultrasound or catheterization to see how much urine is left in the bladder after urinating
Sometimes imaging, such as an ultrasound, is done to get an accurate measurement of prostate volume.
Another important step is a prostate-specific antigen (PSA) blood test.
PSA is a protein produced by the prostate. Elevated levels can be linked to prostate cancer, but they may also rise due to BPH or other conditions. Checking PSA helps your doctor distinguish between BPH and the possibility of prostate cancer.
In some cases, more advanced studies may be recommended if the diagnosis remains unclear. These might include:
- Cystoscopy, or looking inside the urethra and bladder with a small scope
- Urodynamic testing to evaluate bladder pressure and function
Why BPH Diagnosis Matters
Although BPH is not cancer, the symptoms can mimic those of more serious conditions like bladder stones, strictures, or prostate cancer. Without evaluation, you may miss an underlying problem or let a treatable condition progress.
Having an accurate diagnosis gives you more treatment options. Knowing you have BPH is the first step in finding relief and protecting your urinary health.
If you are experiencing urinary changes, it is time to talk to a specialist. A urologist is trained to diagnose and manage prostate and urinary conditions. They can determine if your symptoms are due to BPH or another cause, check your PSA level, and help you find the best treatment plan.
If you're suffering from unwanted urinary symptoms, visit the expert urologists in the greater Des Moines area in Clive, IA, to get a BPH diagnosis. Schedule an appointment today!