Benign Prostatic Hyperplasia (BPH) Diagnosis
At the Barbara and Maurice Deane Prostate Health and Research Center at Mount Sinai’s Department of Urology, we offer the most up-to-date services available for diagnosing BPH. The entire evaluation can be performed within the Deane Center on an outpatient basis.
The goals of an evaluation are to exclude other causes that might be responsible for a patient's symptoms and to gauge the extent or seriousness of the condition. These two factors are important when considering various treatment options.
Initial evaluation will include:
- A detailed history of symptoms
- A physical examination including a digital rectal exam (DRE)
- A prostate specific antigen (PSA) blood test, and a urinalysis
Often a standardized questionnaire is used to measure symptoms on a numbered scale, but it is optional. The primary reason for the DRE, PSA test, and urinalysis is to rule out prostate cancer or an inflammatory condition, such as prostatitis, as additional conditions.
These tests also give valuable information about the size of the prostate gland. In many men with BPH, a residual urine volume will be checked using sonography (a diagnostic technique that uses ultrasound). In some cases, a urinary flow rate test (a test to see how fast you pass urine) may be performed so that the degree of obstruction can be measured more objectively. Patients who have more severe symptoms, residual urine in the bladder, or very poor flow rates, should have renal ultrasound done to ensure that lack of kidney function is not involved.
In severe cases, a urodynamic study may be performed to analyze bladder function in the face of BPH-related obstruction. This study is performed in the physician’s office by placing a small tube into the bladder. The tube records bladder volumes and pressures when the bladder is full and the patient is urinating.
Patients with have a history of blood in the urine or who are found to have blood on a urinalysis will undergo flexible cystoscopy to ensure that no other lesions, such as bladder cancer, are present.