Benign prostatic hyperplasia is the medical name for a swollen or enlarged prostate which will affect half of all men by the time they reach the age of 60 and ninety percent of men by the age of 80.
As its name suggests benign prostatic hyperplasia is a benign or non-cancerous enlargement of the prostate gland and can often be treated with medication or with minor minimally invasive surgery. The first step however is to confirm that the problem is indeed benign prostatic hyperplasia and that your symptoms are not being caused by something else, such as a urinary tract infection or problems with the bladder or kidneys.
It is also important to check for the presence of prostate cancer as, although benign prostatic hyperplasia does not cause prostate cancer, it is possible for both benign prostatic hyperplasia and prostate cancer to be found together.
Initial testing will normally involve a physical examination known as a digital rectal examination (DRE) together with an evaluation of the symptoms reported by the patient and his medical history. As the prostate gland is situated between the bladder and the rectum it is a simple matter for the doctor to insert a gloved and lubricated finger into the rectum while the patient lies on his side and to feel the prostate gland for signs of enlargement or abnormality. This is not perhaps the most pleasant of procedures but is more uncomfortable than painful.
It is also common at this stage for the doctor to order a series of laboratory tests. These may include a blood test to check PSA levels, blood urea nitrogen and creatinine and a urine test (urinalysis and urine culture).
PSA, which stands for prostate specific antigen, is present in the blood and is specific to the prostate with levels being raised slightly in the case of benign prostatic hyperplasia and markedly in response to prostate cancer.
The remaining tests are designed to look for the presence of a urinary tract infection or for problems with the kidneys, both of which can produce symptoms similar to those seen in cases of benign prostatic hyperplasia.
In certain cases a doctor may also order additional tests such as an ultrasound examination, to determine the size of the prostate and to measure the volume of urine in the bladder, or a cystoscopy (an examination using a thin flexible scope) to check the condition of the urethra and bladder.
If none of these tests produce conclusive results the doctor may order a prostate biopsy in which one or more small samples of tissue are taken from the prostate for microscopic evaluation.
