Diagnosis of Enlarged Prostate
The diagnosis of enlarged prostate begins with a careful review of symptoms, medical history, and a physical examination. Since an enlarged prostate shares symptoms with other conditions—like prostate cancer or urinary tract infections—accurate diagnosis is crucial for choosing the right treatment.
Patient History and Symptom Assessment
The doctor will ask about:
Urinary habits (frequency, urgency, night-time urination)
Strength and flow of urine
Any difficulty starting or stopping urination
Sensation of incomplete bladder emptying
Lifestyle and existing health conditions
A standard questionnaire, like the International Prostate Symptom Score (IPSS), is often used to measure the severity of symptoms and their impact on daily life.
Physical Examination
A digital rectal exam (DRE) is a key part of the assessment. The doctor inserts a gloved, lubricated finger into the rectum to feel the size, shape, and consistency of the prostate. While not always comfortable, the test is quick and important for detecting abnormalities.
Additional Tests
Urinalysis – Checks for blood, infection, or sugar in the urine, ruling out other causes of symptoms.
Prostate-specific antigen (PSA) test – Measures PSA levels in the blood. Elevated PSA may indicate BPH, prostate inflammation, or prostate cancer.
Bladder scan – Uses ultrasound to measure how much urine remains in the bladder after urination.
Uroflowmetry – Measures the speed and strength of urine flow.
Cystoscopy – A thin tube with a camera is inserted into the urethra to examine the bladder and prostate. This is usually done if surgery is being considered.
Urodynamic testing – Evaluates bladder pressure and function if the diagnosis is unclear.
Diagnosis of Enlarged Prostate
In South Africa, public clinics and hospitals often start with basic symptom assessments and DRE. Limited access to PSA testing and scans in rural areas may delay diagnosis. Doctors should refer men with prolonged symptoms to urologists for further evaluation.
Doctors can usually diagnose an enlarged prostate quickly and non-invasively. Once confirmed, treatment can begin to relieve symptoms and prevent long-term bladder problems.
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