Benign Prostatic Hyperplaisa (BPH ) 
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Diagnosis of Benign Prostatic HyperplasiaThis examination is usually the first test done. The doctor inserts a gloved finger into the rectum and feels the part of the prostate next to the rectum. This examination gives the doctor a general idea of the size and condition of the gland.
Healthy prostate tissue is soft, like the fleshy tissue of the hand where the thumb joins the palm.
Malignant tissue is firm, hard, and often asymmetrical or stony, like the bridge of the nose.
If the examination reveals the presence of unhealthy tissue, additional tests are performed to determine the nature of the abnormality.
Prostate-specific antigen (PSA) is a specific antigen produced by the cells of the prostate capsule (membrane covering the prostate) and periurethral glands. Patients with benign prostatic hyperplasia (BPH) or prostatitis produce larger amounts of PSA. The PSA level also is determined in part by the size and weight of the prostate.
The test measures the amount of PSA in the blood in nanograms per milliliter (ng/mL).
A PSA of 4 ng/mL or lower is normal; 4–10 ng/mL is slightly elevated; 10–20 is moderately elevated; and 20–35 is highly elevated.
Most men with slightly elevated PSA levels do not have prostate cancer, and many men with prostate cancer have normal PSA levels. However, a highly elevated level may indicate the presence of cancer.
The PSA test can produce false results. A false positive result occurs when the PSA level is elevated and there is no cancer. A false negative result occurs when the PSA level is normal and there is cancer.
Because of this, a biopsy imay be performed to confirm or rule out cancer when the PSA level is high. Urologists recommend that men over age 50 check their PSA level once every year.
If there is a suspicion of prostate cancer, your doctor may recommend a test with rectal ultrasound. In this procedure, a probe inserted in the rectum directs sound waves at the prostate. The echo patterns of the sound waves form an image of the prostate gland on a display screen. To determine whether an abnormal-looking area is indeed a tumor, the doctor can use the probe and the ultrasound images to guide a biopsy needle to the suspected tumor. The needle collects a few pieces of prostate tissue for examination with a microscope.
Urodynamic tests, usually performed in a physician's office, are used to measure the volume and pressure of urine in the bladder and to evaluate the flow of urine.
They are particularly useful for the diagnosis of Intrinsic sphincter deficiency and uncertain cases of mixed, overflow, urgency, or total incontinence. Additional tests may be conducted if symptoms indicate that blockage is caused by a condition other than BPH.
In this examination, the doctor inserts a small tube through the opening of the urethra in the penis. This procedure is done after a solution numbs the inside of the penis so all sensation is lost. The tube, called a cystoscope, contains a lens and a light system that help the doctor see the inside of the urethra and the bladder. This test allows the doctor to determine the size of the gland and identify the location and degree of the obstruction.
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