The prostate is a sex gland in men. It
is about the size of a walnut, and surrounds the neck of the bladder and
urethra - the tube that carries urine from the bladder. It is partly
muscular and partly glandular, with ducts opening into the prostatic
portion of the urethra. It is made up of three lobes: a center lobe with
one lobe on each side. The gland's primary function is
to produce most of the fluids in semen, the fluid that nourishes and
Screening and diagnosis
To diagnose prostate enlargement, your doctor will likely begin by
asking you what your symptoms are, when they developed and how often
they occur. Your doctor will also want to know about other health
problems, medications you're taking and whether there's a history of
prostate problems in your family. Over-the-counter (OTC) drugs, such as
aspirin, decongestants and antacids, are considered medications, so tell
your doctor about those too. The history of when you start and stop
medications is also important for your doctor to know about.
In addition, your checkup may include:
To perform this exam, your doctor puts on an examination glove,
applies a lubricant to one finger, and then gently inserts the
lubricated finger into your rectum. Because the prostate gland is
located adjacent to the rectum, your doctor can feel the back wall
of the gland. This allows your doctor to determine whether your
prostate is enlarged and to help rule out prostate cancer.
Having a sample of your urine analyzed in the laboratory can help
your doctor rule out an infection or other conditions that can
produce symptoms similar to those of prostate enlargement, such as
prostatitis, cystitis and kidney disease.
Prostate-specific antigen (PSA) blood test.
Prostate-specific antigen is naturally produced in your prostate
gland to help liquefy semen. A small amount circulates in your
blood. Higher-than-normal levels in your blood can indicate BPH,
prostate cancer or prostatitis.
If the results of these tests suggest prostate enlargement, your doctor
may want to perform additional exams. The following can help confirm the
diagnosis of prostate enlargement and determine its severity:
This test measures the strength and amount of your
urine flow. By charting the results of this test, your doctor can
determine if your urinary flow patterns change over time and at what
rate. Keep in mind that your peak flow rate normally decreases as
you age. Restricted urine flow can also be a sign of other problems,
such as a weakened bladder muscle.
residual volume test.
This test measures
whether you can empty your bladder. The test is done one of two
ways: by inserting a thin, soft tube (catheter) into your urethra
and up into your bladder or by using ultrasound imaging to see
inside your bladder. The ultrasound method is more common and less
uncomfortable, but often less accurate. Because the results of this
test can vary, you may need to have it done more than once to get an
Imaging through ultrasound is used to estimate the size of your
prostate gland. In addition, it can help detect problems such as an
obstruction of your kidney, stones in your kidneys or prostate, or a
tumor in the prostate.
If your doctor suspects that your symptoms may be
related to a bladder problem rather than prostate enlargement, he or
she may recommend a series of tests to measure bladder pressure and
function. These tests are done by threading a small catheter through
the urethra and into your bladder. Water is gently injected into
your bladder to measure internal bladder pressure and to determine
how effectively your bladder contracts. Bladder pressure is measured
during bladder filling and urination.
This procedure involves the use of a thin tube containing a lens
with a light system (cystoscope) that's gently inserted into the
urethra under local anesthesia. It allows your doctor to see inside
the urethra and bladder. The procedure can detect problems including
enlargement of the prostate, compression of the urethra due to
enlarged prostate, obstruction of the urethra or bladder neck, an
anatomical abnormality, and the development of stones in your
bladder. These disorders may cause your bladder to weaken.
An intravenous pyelogram is an X-ray image of the
urinary tract used to help detect an obstruction or abnormality. Dye
is injected into a vein, and an X-ray is taken of your kidneys,
bladder and tubes that attach your kidneys to your bladder (ureters).
The dye makes it possible to identify urinary stones, tumors or a
blockage above your bladder.
If your signs and symptoms are mild and don't bother you, your doctor
may suggest watchful waiting as an appropriate response to an enlarged
prostate. Your doctor will periodically evaluate your condition to see
if it improves, stays the same or worsens.
The risk you take in following this approach is that your condition
could worsen over time and other problems could develop, such as
infection, bleeding and kidney damage. However, these complications are
Prostate enlargement becomes a serious health threat only if it
interferes with your ability to empty your bladder. A bladder that's
continuously full can interfere with your sleep, cause recurrent bladder
infection or result in kidney damage. If you're unable to pass urine at
all, seek immediate medical attention.
Treatments for prostate enlargement don't reduce or increase the risk of
prostate cancer. Even if you're being treated for prostate enlargement,
you still need to continue regular prostate exams to screen for cancer.
Surgical treatment for prostate enlargement can identify cancer in its