How is it Diagnosed?
Benign Prostatic Hyperplasia (BPH) is diagnosed through a combination of clinical
assessment, symptom scoring, physical examination, and diagnostic tests. The
diagnostic process begins with a detailed medical history focusing on lower urinary
tract symptoms (LUTS) such as frequency, urgency, nocturia, weak stream, or
incomplete bladder emptying.
The International Prostate Symptom Score (IPSS) questionnaire is commonly used to
assess symptom severity and impact on quality of life.
A digital rectal examination (DRE) allows the physician to evaluate prostate size and
consistency. A smooth, enlarged, non-tender prostate typically indicates BPH, whereas
hard or irregular findings may suggest malignancy.
Urinalysis is done to exclude urinary tract infection or hematuria. Serum ProstateSpecific Antigen (PSA) levels may be tested to screen for prostate cancer, although
elevated PSA can also occur in BPH.
Ultrasound, particularly transrectal ultrasound (TRUS), can provide detailed prostate
volume measurements. Post-void residual (PVR) urine measurement is done via
ultrasound to evaluate bladder emptying efficiency.
In selected cases, urodynamic studies are used to assess bladder function. Cystoscopy
may be performed to visualize the urethra and bladder, especially when hematuria or
recurrent infections are present.
These assessments help confirm the diagnosis of BPH, rule out other causes like
prostate cancer or bladder stones, and guide treatment options, which may include
medication or surgical intervention based on symptom severity and patient preference.