Seeing A Doctor For An Enlarged Prostate

December 1, 2009 by  
Filed under Education

If you have symptoms that bother you, see a doctor. He or she can find out if BPH — or another disease — is the cause. If you do have BPH, your doctor can also see if it has caused other problems. How is BPH Diagnosed?

During your visit, the doctor will most likely:

  • Give you a list of questions about your symptoms. These questions are important. Your answers will help the doctor decide if your symptoms are mild, moderate, or severe.
  • Take your medical history. Your doctor will ask you about past and current medical problems.
  • Examine your prostate gland by inserting a gloved, lubricated finger into your rectum.
  • Do a physical exam to see if other medical problems may be causing your symptoms.
  • Check your urine for blood or signs of infection (a urinalysis).
  • Test your blood to see if the prostate has affected your kidneys. Your doctor may also recommend a blood test to help detect prostate cancer.

These tests are not painful or costly. They are done to help confirm that you have BPH and to find any problems it has caused. But tests used to diagnose your condition cannot predict if BPH will cause problems later if not treated now.

Your doctor may also recommend other tests. They may help find if BPH has affected your bladder or kidneys and make sure your problems are not caused by cancer. These tests may help some patients but not everyone:

    Uroflowmetry measures how fast your urine flows and how much you pass. This test can help find how much the urine is blocked.

    Residual urine measurement shows how much urine is left in your bladder after you urinate. This test can help find out how much your bladder has been affected by BPH. The test can be done several ways. You and your doctor should talk about the method used.

    Pressure-flow studies measure the pressure in your bladder as you urinate. Some doctors feel this test is the best way to find out how much your urine is blocked. The test can help most if results of other tests are confusing or if your doctor thinks you have bladder problems. In the test, a small tube called a catheter is inserted into the penis, through the urethra, and into the bladder. The test may cause discomfort for a short time. In a few men, it may cause a urinary tract infection.

    Prostate-specific antigen (PSA) is a blood test that can help find prostate cancer. BPH does not cause cancer. But some men do have BPH and cancer at the same time.

    The PSA test is not always accurate. PSA test results can suggest cancer in BPH patients who do not have prostate cancer. The results can also sometimes suggest no cancer in men who do have cancer.

    Not all doctors agree that being tested for PSA levels lowers a patient’s chance of dying from prostate cancer. Each man with BPH is different. You and your doctor may want to discuss this test.

Your doctor may also suggest other tests such as x-rays, cystoscopy, and ultrasound. Many men do not need these tests. They are costly and not very helpful for most men with BPH. Also, cystoscopy and x-rays can cause discomfort or problems for some men. But the tests can help patients with some BPH problems or men with other problems such as blood in the urine.

    Cystoscopy lets the doctor look directly at the prostate and bladder. This test helps the doctor find the best method in men who choose invasive treatments (such as surgery). In cystoscopy, a small tube is inserted into the penis, through the urethra, and into the bladder. Some men may have discomfort during and after the test. A few may get urinary infections or blood in the urine; a few may not be able to urinate for a short time after the test.

    An x-ray called a urogram lets the doctor see blockage in the urinary tract. A dye injected into a vein makes the urine show up on the x-ray. Some men are allergic to the dye.

    Ultrasound lets the doctor see the prostate, kidneys, and bladder without a catheter or x-rays. A probe put on the skin sends sound waves (ultrasound) into the body. The echoes result in pictures of the prostate, kidneys, or bladder on a TV screen. This test is not harmful or painful. A special probe put in the rectum can give a better view of the prostate when the doctor wants to check for prostate cancer.

When Should BPH Be Treated?

BPH needs to be treated only if:

  • The symptoms are severe enough tobother you.
  • Your urinary tract is seriously affected.

An enlarged prostate alone is not reason enough to get treatment. Your prostate may not get bigger than it is now, and your symptoms may not get worse.

Ask yourself how much your symptoms really bother you:

  • Do they keep you from doing the things you enjoy, such as fishing or going to sports events?
  • Would you be a lot happier or do more if the symptoms went away?
  • Do you want treatment now?
  • Are you willing to accept some risks to try to get rid of your symptoms?
  • Do you understand the risks?

Your answers to these questions can help you choose a treatment that is right for you.

Tags: Surgery, risks, residual urine, problems, Residual urine measurement

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