How To Detect Enlarged Prostate

Transrectal Ultrasound With Prostate Biopsy

Transrectal ultrasound is most often used to examine the prostate. In a transrectal ultrasound, the health care provider inserts a transducer slightly larger than a pen into the mans rectum next to the prostate. The ultrasound image shows the size of the prostate and any abnormal-looking areas, such as tumors. Transrectal ultrasound cannot definitively identify prostate cancer.

To determine whether a tumor is cancerous, the health care provider uses the transducer and ultrasound images to guide a needle to the tumor. The needle is then used to remove a few pieces of prostate tissue for examination with a microscope. This process, called biopsy, can reveal whether prostate cancer is present. A transrectal ultrasound with prostate biopsy is usually performed by a doctor in a health care providers office, outpatient center, or hospital with light sedation and local anesthesia. The biopsied prostate tissue is examined in a laboratory by a pathologista doctor who specializes in diagnosing diseases.

What Are Some Common Uses Of The Procedure

A transrectal ultrasound of the prostate gland is performed to:

• detect disorders within the prostate.
• determine whether the prostate is enlarged, also known as benign prostatic hyperplasia , with measurements acquired as needed for any treatment planning.
• detect an abnormal growth within the prostate.
• help diagnose the cause of a man’s infertility.

A transrectal ultrasound of the prostate gland is typically used to help diagnose symptoms such as:

• a nodule felt by a physician during a routine physical exam or prostate cancer screening exam.
• an elevated blood test result.
• difficulty urinating.

Because ultrasound provides real-time images, it also can be used to guide procedures such as needle biopsies, in which a needle is used to sample cells from an abnormal area in the prostate gland for later laboratory testing.

What Questions Should I Ask My Healthcare Provider

• How can you tell that I have BPH?
• If I dont have BPH, what other condition might I have?
• What can I do to help reduce the size of my prostate?
• Do I need treatment?
• Whats the best treatment for me?
• What supplements do you recommend?
• Will these supplements affect any other medications or supplements that Im taking?
• Should I see a urologist?

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How Can I Reduce My Risk Of Developing Benign Prostatic Hyperplasia

The best ways to reduce your risk of developing BPH are to make lifestyle changes that improve your prostate and heart health and take supplements.

Exercising at least 30 minutes each day may help prevent BPH or slow prostate growth. Maintaining normal cholesterol, blood pressure and blood sugar levels is also important.

The following herbal supplements may also help reduce your risk of developing BPH:

• Beta-sitosterol. Beta-sitosterol is a micronutrient in plants that may help keep your heart healthy.
• Pygeum africanum. Pygeum africanum is an herbal extract from African cherry tree bark that may help shrink your prostate.
• Flaxseed. Flax is a good source of dietary fiber and omega-3 fatty acids that may help lower your cholesterol.
• Pumpkin seed oil. Pumpkin seed oil comes from pumpkin seeds. It may help shrink your prostate.

Talk to your healthcare provider before taking any new supplements. They may adversely react to other supplements or medications youre currently taking.

What Tests Might I Have At The Hospital

If youre given an appointment with a hospital specialist, they may do some of the tests you had at the GP surgery again. You may also have other tests, including the tests described below.

Symptom questionnaire

You might be asked to fill in a short questionnaire about your symptoms. This is called the International Prostate Symptom Score and is used to see how bad your symptoms are and how much they are bothering you.

Urine flow test

Youll be asked to urinate into a machine that measures the speed of your urine flow. Men with an enlarged prostate usually have a slower flow than other men. You’ll need a full bladder for the test. The doctor or nurse will tell you how much to drink before you have the test. They may also ask you not to urinate for two to three hours before the test.

Pelvic ultrasound scan

This shows how much urine your bladder can hold, and if it is emptying properly. You may have the scan straight after the urine flow test to see how much urine is left in your bladder after you urinate. You may also have an ultrasound scan to look at your kidneys.

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How Do I Know If My Prostate Is Enlarged

If your prostate is enlarged, it may not be a sign of cancer, but it is something that you should discuss with your doctor. Many of the symptoms of an enlarged prostate tend to relate to urination. If you are concerned about an enlarged prostate, here are 7 symptoms to look for:

Difficulty starting urination. The enlarged prostate alters the pressure of your bladder to pass urine. This can have damaging effects on your kidneys.

Weak urine stream. As the urethra becomes constrained, urine passes at a much slower rate.

Urgent need to urinate. You may go from not needing to urinate to suddenly needing to go because of how the bladder gets constrained.

Issues with sleeping. Pressure from the enlarged prostate can interfere with nerve signaling in the middle of the night. This leads to you thinking you have to urinate when you dont.

Feeling unable to completely empty your bladder. You may not be able to completely empty your bladder, which can lead to Urinary Tract Infections and stone issues.

Urinary tract infection. A UTI is caused by the urine that sits in your bladder which you cant fully empty, creating an environment for bacteria to thrive.

Bladder stones. The leftover urine in your bladder can also crystallize to create bladder stones.

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Causes Of Benign Prostate Enlargement

The exact cause of benign prostate enlargement is unknown, but research suggests that hormones probably play an important role in the condition’s development.

Hormones are powerful chemicals that can have a wide range of effects on the cells of the body.

One theory is that as some men and anyone with a prostate gets older, the levels of a type of hormone called dihydrotestosterone increases, which may stimulate the growth of the prostate.

Another theory suggests that two hormones, testosterone and oestrogen, play a role. Younger men and anyone with a prostate produce high levels of testosterone and much smaller levels of oestrogen. But as they get older, levels of testosterone decrease, which means they then have a higher proportion of oestrogen in their body. It’s been suggested that the relative increase in oestrogen may stimulate prostate growth.

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What Tests Might I Have At The Gp Surgery

Symptom check

Your GP will ask about your symptoms, how long youve had them, whether they are getting worse over time, and how they are affecting your life.

Before you visit your GP, you might want to think about how often youve had symptoms over the last month. This may help you explain your symptoms to your GP. You might also want to keep a diary of how much you drink and how often you urinate.

Your GP will check whether your symptoms might be caused by another health problem, such as diabetes, or by any medicines you are taking, such as blood pressure medicines, anti-depressants or herbal medicines.

They will also check whether your symptoms could be caused by your lifestyle for example, if you often drink large amounts of fluid, alcohol, or drinks containing caffeine .

Bladder diary

Your GP may ask you to keep a diary for a few days to check how much you are drinking, what type of drinks you have, how much urine you pass, and how often and at what times you urinate. A diary can help your doctor to work out what may be causing your symptoms and how to treat them.

Urine test

Your GP may ask you for a urine sample to check for blood or any infection that could be causing your symptoms. You may need to give more than one sample. If you have an infection your GP will give you a course of antibiotics.

Blood tests

Physical examination

How Can A Doctor Tell If You Have Prostate Cancer

What Is BPH? Benign prostatic hyperplasia, or BPH, is an enlarged prostate gland. Its symptoms can look like prostate cancer, but its not. BPH symptoms can also be hard to tell apart from urinary tract infections and bladder or kidney problems. Your doctor can do tests like a digital rectal exam and a biopsy to know for sure whether you have BPH.

Can a BPH test be used to check for prostate cancer?

This checks for levels of whats called prostate specific antigen, or PSA, in your blood. PSA is a protein your prostate makes. Both BPH and prostate cancer can raise your PSA level. This test alone cant confirm that you have BPH. You will need other tests, too.

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An enlarged prostate can also be the cause of other problems. If the enlarged prostate is causing symptoms, the best treatment would be a natural remedy. In the meantime, there are treatments for a wide range of conditions that cause a man to experience pain. A common surgical procedure involves an electric loop, laser, or electro-stimulation. The procedure is a safe and effective option for treating enlarged or symptomatic BPH.

How Does The Procedure Work

Ultrasound imaging uses the same principles as the sonar that bats, ships, and fishermen use. When a sound wave strikes an object, it bounces back or echoes. By measuring these echo waves, it is possible to determine how far away the object is as well as its size, shape, and consistency. This includes whether the object is solid or filled with fluid.

Doctors use ultrasound to detect changes in the appearance of organs, tissues, and vessels and to detect abnormal masses, such as tumors.

In an ultrasound exam, a transducer both sends the sound waves and records the echoing waves. When the transducer is pressed against the skin, it sends small pulses of inaudible, high-frequency sound waves into the body. As the sound waves bounce off internal organs, fluids and tissues, the sensitive receiver in the transducer records tiny changes in the sound’s pitch and direction. A computer instantly measures these signature waves and displays them as real-time pictures on a monitor. The technologist typically captures one or more frames of the moving pictures as still images. They may also save short video loops of the images.

The same principles apply to ultrasound procedures such as transrectal ultrasound which require insertion of a special imaging probe or transducer into the body.

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There Are Risks To Getting Prostate Cancer Tests And Treatments

If your PSA is not normal, you will probably have a biopsy. The doctor puts a needle through the wall of the rectum and into the prostate to take a few samples. Biopsies can be painful and cause bleeding. Men can get serious infections from biopsies, and they may need hospital care.

Surgery or radiation are the usual treatments for prostate cancer. They can do more harm than good. Treatment can cause serious complications, such as heart attacks, blood clots in the legs or lungs, or even death. In addition, 40 men out of 1,000 will become impotent or incontinent from treatment.

Getting A Prostate Biopsy

For some men, getting a prostate biopsy might be the best option, especially if the initial PSA level is high. A biopsy is a procedure in which small samples of the prostate are removed and then looked at under a microscope. This test is the only way to know for sure if a man has prostate cancer. If prostate cancer is found on a biopsy, this test can also help tell how likely it is that the cancer will grow and spread quickly.

For more details on the prostate biopsy and how it is done, see Tests to Diagnose and Stage Prostate Cancer.

For more information about the possible results of a prostate biopsy, see the Prostate Pathology section of our website.

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What Are The Limitations Of Prostate Ultrasound Imaging

Men who have had the end of their bowel removed during prior surgery are not good candidates for ultrasound of the prostate gland because this type of ultrasound typically requires placing a probe into the rectum.

However, the radiologist may attempt to examine the prostate gland by placing a regular ultrasound imaging probe on the perineal skin of the patient .

Sometimes the gland can be examined by ultrasound this way, but the images may not be as detailed as with the transrectal probe. An MRI of the prostate gland is another alternative imaging option and may be done instead of or in-addition to an ultrasound.

Prostate MRI can sometimes be done without requiring anything to be placed into the rectum. It may be a good option for men who have had their rectum removed.

Can I Check For Prostate Cancer At Home

It is strongly advised under any circumstances not to self-examine for prostate cancer at home either by yourself or with a partner. Not only does it take a skilled professional to assess how the prostate feels to make an accurate determination of overall prostate health, self-examinations have the potential to cause injury.

âSince the prostate is an internal gland, itâs extremely important that only licensed medical professionals conduct the exam. At-home self-exams should not be administered in order to avoid injury or self-harm. Regular screening is important for prostate cancer, as the disease often does not present symptoms until it is too late. Talk to your doctor about making sure you receive a regular DRE check-up at each visit.â

While actually screening yourself for prostate cancer at home is ill advised, you can still monitor your risk factors for prostate cancer between yearly check-ups, like practicing a healthy diet and exercising regularly.

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Medications For Enlarged Prostate

There are two main classes of pharmaceuticals that work to alleviate enlarged prostate symptoms: alpha blockers and alpha reductase inhibitors

• Alpha Blockers. Alpha blockers relax the smooth muscle around the bladder neck and within the urethra.
• Inhibitors. Inhibitors stop the conversion of the male hormone testosterone to DHT to reduce the prostates size, eliminating blockage.

Dont be surprised if your physician prescribes a combination of the two medications, as they have been shown to work more effectively together than alone. The downside is that combination therapy may increase the likelihood of experiencing side effects from the medications. Be sure to work with your doctor to assess the benefits and costs before starting on combination therapy.

Transrectal Ultrasound Scan Guided Biopsy

Your doctor takes a series of small tissue samples from the prostate to examine under a microscope. You have the biopsy through the back passage using a transrectal ultrasound scanner.

A TRUS guided biopsy can be uncomfortable. You usually have a local anaesthetic to numb the area and reduce any pain.

• Find out more about having a TRUS guided biopsy

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Further Tests For An Enlarged Prostate

Depending on your test results, you may have further tests to find out what is causing your symptoms.

Bladder pressure test

You may have this test if youre thinking about having surgery to treat an enlarged prostate, or if youve had surgery but your symptoms havent improved or are getting worse.

Flexible cystoscopy

You may have this test if you have severe urinary symptoms, blood in your urine or pain, or if you often get urine infections. You may also have this test if your doctor thinks your urethra or the opening of your bladder may be too narrow this is called a stricture.

What Causes Benign Prostatic Hyperplasia

Healthcare providers and medical researchers arent sure what causes BPH.

One theory is that, as you age, the amount of testosterone in your body decreases . At the same time, your estrogen levels remain the same. These hormone changes may cause your prostate cells to grow. However, people who take supplemental testosterone may develop or worsen BPH.

Older men and people AMAB also have higher levels of dihydrotestosterone . DHT is a more potent form of testosterone that increases the size of your prostate.

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How Is Benign Prostate Enlargement Diagnosed

If your GP suspects that you have an enlarged prostate, you’ll be asked to complete a questionnaire to assess your symptoms.

Each question has five possible answers that carry a score, and your overall score indicates the severity of your symptoms.

Your GP will also want to rule out other conditions that cause similar symptoms to prostate enlargement.

You may have a number of standard tests, such as urine tests, plus some more specific tests, such as a blood test that measures PSA.

How Is Bph Diagnosed

To find out if you have BPH, your provider will:

• Ask about your medical history. Be sure to tell your provider about all the medicines you take, because certain medicines can make BPH symptoms worse.
• Ask about your family health history.
• Examine you. The exam may include a digital rectal exam of your prostate. In a DRE, your provider inserts a gloved finger into your rectum to check if your prostate is large, tender, or irregular in any other way.
• Order medical tests, if needed, such as:
• A PSA blood test .
• Urodynamic testing to see how well you can hold and release urine.
• Cystoscopy to look inside your urethra and bladder.
• Ultrasound pictures of your prostate and urinary tract.
• A prostate biopsy to diagnose or rule out prostate cancer.

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