Exams and Tests
Your doctor will first want to make sure that your urination problem is caused by benign prostatic hyperplasia (BPH) and not by something else. This can usually be determined from your medical history, a physical exam that focuses on the urinary tract, a urinalysis, and a blood test. A neurological exam should also be done to determine whether your symptoms are related to a problem with the nerves to the bladder. A questionnaire such as the American Urological Association (AUA) symptom index may be used to evaluate how bothersome your symptoms are. It is not used to diagnose BPH.
Tests that are often done
Tests that are used as needed
If your symptoms are moderate to severe, additional tests, called urodynamic studies, may be done.
- A blood creatinine test checks how well your kidneys are working.
Post-void residual urine test (PVR) measures the amount of urine left in the bladder after urination. This test is done using ultrasound or a small tube (catheter) put into the bladder through the urethra.
- Pressure flow studies measure pressure in the bladder while urinating. They may help distinguish between urinary symptoms caused by obstruction, such as BPH, and those caused by a problem affecting the bladder muscles or nerves.
Cystometrogram measures the bladder's pressure, compliance, and capacity during urinary storage. This may include a uroflowmetry test, which measures how fast the urine flows out of the bladder.
Tests that may be done
The following tests may be done if you have complications of BPH or if there is a need to look for other causes of the symptoms.
Ultrasound uses sound waves to check the size and structure of the kidneys, bladder, and prostate. A small device called a transducer is inserted into the rectum (transrectal ultrasound) to evaluate the prostate.
Cystoscopy allows the doctor to look inside the urethra and bladder. This may allow the doctor to find out how much an enlarged prostate is blocking the urethra.
Intravenous pyelogram (IVP) uses X-rays to show the function of the kidneys and the flow of urine from the kidneys to the bladder.
- Spiral (helical) computed tomography (CT) scan uses X-rays to make detailed pictures of structures inside the body. These scanners can check for an enlarged prostate gland , blockage, and urine flow from the kidneys.