Causes & Diagnosis

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Cause

The prostate is a walnut-sized gland that forms part of the male reproductive system. The prostate secretes fluid that carries sperm. It surrounds the urethra, the canal which carries urine from the bladder out of the body.

With age and time, the prostate enlarges causing pressure on the urethra, similar to a clamp on a garden hose. This causes problems with urination.

Diagnosis

You may first notice symptoms of BPH yourself, or your doctor may find that your prostate is enlarged during a routine checkup. When BPH is suspected, you may be referred to an urologist. Several tests help the doctor identify the problem and decide the best course of treatment. The tests vary from patient to patient, but the following are the most common.


Digital Rectal Exam (DRE)

This exam is usually the first test done. The doctor inserts a gloved finger into the rectum and feels the part of the prostate next to the rectum. This exam gives the doctor a general idea of the size and condition of the gland.

Prostate Specific Antigen (PSA) Blood Test

In order to rule out cancer as a cause of urinary symptoms, your doctor may recommend a PSA blood test. PSA, a protein produced by prostate cells, is frequently present at elevated levels in the blood of men who have prostate cancer. The U.S. Food and Drug Administration has approved a PSA test for use in conjunction with a digital rectal exam to help detect prostate cancer in men age 50 or older and for monitoring prostate cancer patients after treatment.

Rectal Ultrasound

If there is a suspicion of prostate cancer, your doctor may recommend a test with rectal ultrasound. In this procedure, a probe inserted in the rectum directs sound waves at the prostate. The echo patterns of the sound waves form an image of the prostate gland on a display screen.

Urine Flow Study

Sometimes the doctor will ask a patient to urinate into a special device which measures how quickly the urine is flowing. A reduced flow often suggests BPH.

Intravenous Pyelogram (IVP)

IVP is an x-ray of the urinary tract. In this test, a dye is injected into a vein, and the x-ray is taken. The dye makes the urine visible on the x-ray and shows any obstruction or blockage in the urinary tract.

Cystoscopy

In this exam, the doctor inserts a small tube through the opening of the urethra in the penis. This test allows the doctor to determine the size of the gland and identify the location and degree of the obstruction.