What tests are done for benign prostatic hyperplasia (BPH)?
Aug 27, 2025
Source: Cainiu Health
Dr. Cao Zhiqiang
Introduction
Under normal circumstances, the severity of benign prostatic hyperplasia (BPH) needs to be determined through professional examinations to provide a basis for subsequent treatment. Common diagnostic procedures include digital rectal examination, urinary system ultrasound, urinalysis, urodynamic studies, and prostate-specific antigen (PSA) testing. In addition, some patients may require urethroscopy or other examinations depending on their specific condition.
Generally, benign prostatic hyperplasia (BPH) requires professional examinations to determine the severity of the condition, providing a basis for subsequent treatment. Common diagnostic procedures include digital rectal examination, urinary system ultrasound, urinalysis, urodynamic studies, and prostate-specific antigen (PSA) testing. Detailed explanations are as follows:
1. Digital Rectal Examination (DRE)
A digital rectal examination is a basic diagnostic test for BPH. During this procedure, the physician inserts a gloved, lubricated finger into the patient's rectum to palpate the prostate area. This examination allows for an initial assessment of the prostate's size, shape, texture, and presence of nodules. An enlarged prostate typically presents with increased volume, firmer texture, and a smooth surface, helping to preliminarily identify BPH and exclude other prostate pathologies.
2. Urinary System Ultrasound
Urinary system ultrasound uses ultrasonic imaging to clearly visualize the prostate's size, structure, and surrounding urinary organs. It accurately measures prostate volume and detects the presence of post-void residual urine. Increased residual urine often indicates urethral obstruction caused by BPH. This examination can also identify complications such as bladder stones and hydronephrosis.
3. Urinalysis
Urinalysis involves collecting a urine sample from the patient to test for red blood cells, white blood cells, glucose, and protein in the urine. The purpose is to exclude other diseases such as urinary tract infections or diabetes that may present with similar voiding symptoms. If white blood cells are elevated in the urine, it may indicate infection, which should be controlled before further evaluation of BPH.
4. Urodynamic Studies
Urodynamic studies use specialized equipment to record parameters such as urinary flow rate, voiding time, and urine volume during micturition. These tests assess the degree of urethral obstruction and bladder function. Patients with BPH often exhibit reduced urinary flow rates and prolonged voiding times. The results of this examination help determine whether surgical intervention is necessary and guide the selection of appropriate surgical methods.
5. Prostate-Specific Antigen (PSA) Testing
Prostate-specific antigen testing involves drawing the patient's blood to measure the level of PSA in the bloodstream. PSA is secreted by prostate tissue and may be mildly elevated in patients with BPH. Significantly elevated levels warrant further investigation to rule out other conditions such as prostate cancer, thereby preventing missed diagnosis of serious pathology.
In addition, some patients may require urethroscopy or other tests based on their specific condition. Patients should follow medical instructions to prepare properly before examinations—for example, providing a first-morning urine sample for urinalysis or drinking an adequate amount of water before urodynamic studies—to ensure accurate results.
