Diagnosis of BPH

Palpation
The finger is a very fine instrument of investigation.
To determine a diagnosis of benign prostatic hyperplasia (BPH), are available to the physician a variety of study options. If you suspect a prostate problem is to always start the rectal examination, ie palpation with the finger through the anus. Judge in this simple and can usually painless examination, the size, shape and texture of the prostate. Here you can make an initial distinction between a proliferation of the prostate in BPH and a prostate tumor. Also, prostate stones may werden.Ist detected at palpation palpation painful for the patient, usually there is associated urinary tract infection.

Diagnostic imaging and uroflow
Ultrasound can be used very differently.
Then closes usually on an ultrasound. It is superior to a CT scan, the transducer because the prostate is easily accessible. Again may be different between the benign and malignant tumors, as you can also get references to an inflammation of the prostate (prostatitis).

If it is suspected further investigations.
Suspected of having BPH, is followed by further studies to assess the extent of disease and to select appropriate therapy. These include an IVU, Micturition cysto urethrografie and Urethrografie.

The bladder emptying is closely monitored and recorded.
By means of uroflow-metry, a dynamic analysis of voiding is checked, for how long and how strong is the urine. In a healthy person, the duration of bladder emptying is dependent on the filling of the bladder. The urinary flow rate is always the same: The urine stream is weak at the beginning, rises to a maximum value and becomes weaker towards the end again. At a victim with BPH, however, is unreasonably prolonged the emptying time and the rate remains about constant over the time of discharge, or has several smaller peak. Then, after a voiding residual urine assessed by ultrasound in the bubble and to see if there is a urinary obstruction.

Laboratory tests
Blood tests are routine.
In the laboratory, urine and blood tested. The blood test will determine the blood count to rule out anemia or leukocytosis. Leukocytosis is, if there are too many white blood cells in blood. This points to an infectious process, such as through a urinary tract infection. In anemia, the number of red blood cells is reduced. This may indicate, for example, to a loss of blood. Moreover, in the blood also searched for substances that are normally excreted in the urine, such as urea and creatinine. A presence may indicate kidney damage. The electrolytes potassium and sodium are also determined.

Every man should know his PSA from 45 value.
Very important is the PSA level. Elevated levels may indicate BPH. They are also early signs of prostate inflammation and prostate cancer.

The urine gives further guidance.
The investigation includes the determination of urine pH, urine culture and the examination of urine sediment. The focus here in particular the identification of leukocytes, erythrocytes and bacteria.

Endoscopic diagnosis and punctures
A cystoscopy is often needed for clarification.
Excluded in certain cases, such as heavy bleeding or a bladder tumor, a cystoscopy (cystoscopy) may be required. So even while the bladder mucosa and bladder wall is judged to be impaired in urinary obstruction and reflux. Since mirroring is performed through the urethra, this is also investigating the same time.

The removal of a tissue sample from the prostate secures the findings.
If the digital rectal examination and ultrasound is inconclusive, and the PSA level increases, so this is an indication for prostate biopsy. The extracted sample is then examined for cancer out. Often does, with unclear results, a second biopsy should be performed.