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Your doctor diagnose BPH on the basis of following:
• Physical examination
• Lab tests
Your doctor would take your personal and family history.
He may ask the following details:
• What are your symptoms?
• How long you have been facing such issues?
• How your symptoms started and has it worsen over a period of time?
• If you have any history of UTI?
• How much water or liquid you consume, especially at night?
• If you have any other medical condition or disease?
• If you are taking any medicine or supplements?
• If you have any family history urinary tract disease or prostate cancer?
Digital rectal examination: Your doctor would do this test to check for the size, consistency or any other abnormality of the prostate. He would ask you to lie on one side on a table and hold your knees close to your chest. Following this he would insert his gloved, lubricated finger into your rectum to feel for the prostate. He might ask you to take deep breathes in and out to reduce your discomfort. Apart from the size of the prostate it can inform the doctor about the development of any obvious mass in the prostate. Many doctors recommend this test for all men 40 years and above.
Other physical tests:
To check for any abnormality in the scrotum such as swelling and pain.
To check for any abnormally in the groin such as enlarged or tender lymph nodes.
To check for any abnormal discharge from urethra or abnormality of penis.
Following this your doctor may ask you to do the following tests:
• Urinalysis (urine test): here the test is done on the urine sample to check if the symptoms are because of urine infection or BPH.
• Prostate-specific antigen (PSA): is a blood test which is done to screen for the prostate cancer. This is done to rule out possibility of cancer which might be causing the enlargement of the prostate.
• Urodynamic tests: these tests check the functioning of the bladder by, assessing the rate of the flow of urine, the quantity of the urine left in the bladder after voiding and pressure that develops in the bladder while urinating.
• Cystoscopy: here the doctor would pass a special tube called cystoscope into the bladder. The tube is fitted with a camera which is passed through the urethra into the bladder to check for any abnormality of the bladder.
• Transrectal ultrasound: is a special type of ultrasound which is done to check the abnormalities of prostate. Here the radiologist would insert a long and thin stick like instrument into your rectum to take pictures of the closely lying prostate. It is able to measure the accurate size of the prostate, visualize its internal structure and check for obvious mass arising from the prostate.
• Biopsy: here your doctor would pass a needle into the prostate to take a sample of tissue to evaluate it under a microscope. This is especially done to rule out the presence of cancer cells in your prostate gland. This test is done under anesthesia (usually local) and imaging study guidance such as ultrasound, CT or MRI scan.
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