How To Test For Enlarged Prostate

Prostate Cancer Diagnoses And Treatment

All cancer is complex, but prostate cancer testing and treatment is particularly complicated.

In some men with prostate cancer, the cancer will grow very slowly, and wont significantly affect them during their lifetime. Other mens prostate cancer can grow and spread very quickly. At the moment, there is no test that can tell what type of prostate cancer a man has when he is diagnosed.

Because some treatments for prostate cancer can cause side effects which might impact on quality of life, its important for men to discuss with their doctor all their options for testing and treatment, and to discuss these with their partners and families. These might include watchful waiting, which means waiting to see what the cancer does over time, radiation, surgery or taking medications.

You can read more about what kinds of questions to ask your doctors about prostate cancer testing and treatment on theCancer Council website.

When Should You Call A Doctor For Bph

Urinary symptoms related to enlarging prostate initially affect the quality of life, and if no complications exist, as mentioned above , the decision to treat is optional and is left to the patient. This means that if you dont feel bothered enough to take a medicine or undergo a procedure for it, youll need to follow up with your doctor to ensure the symptoms are stable, and the bladder empties well. This can be assessed by prostate symptom questionnaires and a measure of the strength of the urinary stream and residual urine in the bladder. If complications develop, however, or if the bladder starts holding increasing amounts of residual urine after urination, treatment should be started.

If you experience bladder pain or burning with urination, blood in the urine associated with fever/chills or nausea/vomiting, or if the prostate enlargement condition worsens and symptoms such as blood in the urine or lower back pain are present, consult a doctor immediately. If you cannot reach your doctor when these symptoms are present, seek evaluation at a hospitals emergency department.

For acute symptoms such as acute urinary retention , you should immediately go to the closest emergency medical facility for bladder drainage, usually with a catheter, which is a tube inserted into the bladder.

Men over 50 years of age should have their prostate checked annually by their physician even if they have no symptoms.

What Are Enlarged Prostate Treatments

There are a wide variety of strategies for getting that prostate gland back to normal, according to Dr. Ramin. In less severe cases, he notes, it may be enough to limit coffee, tea, and sodacaffeine can stimulate the bladder and increase urinary frequency, which might be putting stress on the prostate.

In slightly more advanced situations, medications like alpha blockerswhich relax muscles in your bladder and prostate to make peeing easier, and alpha reductase inhibitors, which can shrink prostate growth, may be needed.

There are also minimally invasive treatment options like microwave therapy, Dr. Ramin says. In other cases, you may need to undergo resection of the prostate through laser therapy.

For markedly enlarged prostates, patients may need a robotic subtotal prostatectomy procedure.

The best treatment option really depends on a particular patients symptoms and results of testing, says Dr. Ramin. Not every patient with enlarged prostate is created equal, and not every treatment option is a good option for all patients.

So talk to your doctor about whats right for you. Just dont ignore the issue: Untreated enlarged prostate can lead to issues like incontinence, blood in your urinedue to inflammation from straining to peeand eventually, youre at risk for kidney damage, says Dr. Ramin.

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The Test Is Often Not Needed

Most men with high PSAs dont have prostate cancer. Their high PSAs might be due to:

• An enlarged prostate gland.
• Recent sexual activity.
• A recent, long bike ride.

Up to 25% of men with high PSAs may have prostate cancer, depending on age and PSA level. But most of these cancers do not cause problems. It is common for older men to have some cancer cells in their prostate glands. These cancers are usually slow to grow. They are not likely to spread beyond the prostate. They usually dont cause symptoms, or death.

Studies show that routine PSA tests of 1,000 men ages 55 to 69 prevent one prostate cancer death. But the PSA also has risks.

Sign : Frequent Urge To Urinate

You feel sudden urges to go anytime, even if you have little or no urine in your bladder. The urge may be so strong that you feel like you cant hold it until youre in the bathroom.

These urges can significantly impact your life. If you wake up to go 2-3 times or more per night because of them, you could suffer from fatigue, loss of focus, moodiness, and lack of energy.

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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.

How Might An Enlarged Prostate Affect My Life

Having an enlarged prostate affects men in different ways. Some men can manage mild symptoms and dont need treatment. Other men find they need to stay near a toilet. This can make it difficult to work, drive, be outdoors and attend social events. If you need the toilet a lot during the night, this can affect your sleep and make you feel more tired during the day.

Some men with an enlarged prostate find their symptoms improve over time without treatment. But for most, the symptoms will stay the same or slowly start to cause more problems over time unless they have treatment.

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How Soon Will Prostate Test Results Be Available

Results for simple medical tests such as some urodynamic tests, cystoscopy, and abdominal ultrasound are often available soon after the test. The results of other medical tests such as PSA blood test and prostate tissue biopsy may take several days to come back. A health care provider will talk with the patient about the results and possible treatments for the problem.

Diagnosis Of An Enlarged Prostate

In order to establish the possible underlying causes for an enlarged prostate, doctors will perform a variety of tests.

Tests which are commonly used to find the cause of an enlarged prostate include:

• A digital rectal exam. A physician or nurse will insert a gloved finger into the patientâs rectum to digitally examine the prostate for swelling and/or enlargement.
• Swab tests for urethral discharge or urine. To determine underlying conditions such as STIs/STDs and urinary tract infections. A swab of discharge or urine is taken and sent to a medical laboratory for culturing, so that any microorganisms are identified.
• Urinalysis. A urine sample is sent to a medical laboratory for analysis and may be tested for urea nitrogen or creatinine, among other things.
• Blood tests. A sample of blood is sent to a medical laboratory for analysis, which may include tests for creatinine or blood urea nitrogen, as well as antibodies and infectious agents.
• Prostate-specific antigen test. A blood sample is sent to a medical laboratory to be tested for prostate-specific antigen , an enzyme produced by cells in the prostate. A change in PSA levels can indicate that there is a problem with the prostate.

If patients are referred to a urologist, they may have further tests, including:

Before referring the patient for tests, the physician may also ask questions in order to determine the possible causes of the discomfort, their severity, and their duration. Such questions may cover:

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What Does The Psa Test Involve

The PSA test involves taking a blood sample and sending it to a laboratory for analysis. The results indicate:

• Normal levels: Most healthy adult males have PSA levels below 4 nanograms per milliliter .
• Borderline levels: PSA levels of 410 ng/ml are borderline. There is a 25% chance that cancer is present, and the person will usually need additional tests.
• High levels: If PSA levels are over 10 ng/ml, there is a 50% chance that the person has prostate cancer. The specialist will likely recommend more testing, including a prostate biopsy.

It is important to note that PSA levels can naturally vary from person to person. A person with high levels may not have prostate cancer. On the other hand, about 15% of people who test positive for prostate cancer after a biopsy have PSA levels below 4 ng/ml.

Prostate cancer is not the only cause of high PSA levels. Find out more about the other causes here.

How Are Prostate Problems Diagnosed

To diagnose prostate problems, the health care provider will perform a digital rectal exam . The health care provider will also ask the patient

• when the problem began and how often it occurs
• what symptoms are present
• whether he has a history of recurrent urinary tract infections
• what medications he takes, both prescription and those bought over the counter
• the amount of fluid he typically drinks each day
• whether he consumes caffeine and alcohol
• about his general medical history, including any major illnesses or surgeries

Answers to these questions will help the health care provider identify the problem or determine what medical tests are needed. Diagnosing BPH may require a series of medical exams and tests.

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Symptoms Of Prostate Cancer

• Frequent urge to pass urine, especially at night
• Weak or interrupted urine stream
• Pain or burning when passing urine
• Nagging pain in the back, hips, or pelvis

Prostate cancer can spread to the lymph nodes of the pelvis. Or it may spread throughout the body. It tends to spread to the bones. So bone pain, especially in the back, can be a symptom of advanced prostate cancer.

Prostate Specific Antigen Test

A blood test called a prostate specific antigen test measures the level of PSA in the blood. PSA is a substance made by the prostate. The levels of PSA in the blood can be higher in men who have prostate cancer. The PSA level may also be elevated in other conditions that affect the prostate.

As a rule, the higher the PSA level in the blood, the more likely a prostate problem is present. But many factors, such as age and race, can affect PSA levels. Some prostate glands make more PSA than others.

PSA levels also can be affected by

• Certain medical procedures.

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Watchful Waiting With An Enlarged Prostate

When the symptoms of an enlarged prostate gland are mild, with low scores on the BPH Impact Index , it may be best to wait before starting any treatment whats known as watchful waiting.

With regular checkups once a year or more often, doctors can watch for early problems and signs that the condition is posing a health risk or a major inconvenience. Thats where the BPH Index is especially helpful, Westney tells WebMD. It lets us know how high the symptom score is ⦠when to start treatment.

The driving force in treatment, she explains, is whether the symptoms are affecting your quality of life and whether a blockage is causing serious complications, such as inability to urinate, blood in the urine, bladder stones, kidney failure, or other bladder problems.

A few questions to ask yourself:

• How severe are your symptoms?
• Do symptoms prevent you from doing things you enjoy?
• Do they seriously affect your quality of life?
• Are they getting worse?

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How Do I Empty My Bladder With An Enlarged Prostate

Enlarged Prostate: Bathroom Tips

Practice “double voiding” by urinating as much as possible, relaxing for a few moments, and then urinating again.

Try to relax before you urinate. …

Take plenty of time to urinate.

Try sitting on the toilet instead of standing. …

Think of other things or read while you are waiting.

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How Does An Enlarged Prostate Affect Your Sex Life

An enlarged prostate, along with its treatment, results in many side effects that can affect your sex life. Because drugs are harmful, you may want to look for a natural solution to support your prostate health and improve your urination problems.

What to do if you have an enlarged prostate gland?

If your prostate is causing symptoms, your doctor will likely offer you medication to improve and manage them. Two main classes of drugs are used: alpha blockers and 5-alpha-reductase inhibitors . Your doctor may prescribe one or both types, depending on your symptoms and the size of your prostate gland.

Using Medication To Reduce Symptoms

1Recognize the symptoms of an enlarged prostate. Look for a weak stream of urine, dribbling at the end of urination, or an increased need to urinate at night. You may also have difficulty starting urination or need to strain to empty your bladder. If you notice these symptoms, make an appointment with your doctor for an official diagnosis.XTrustworthy SourceMayo ClinicEducational website from one of the worldâs leading hospitalsGo to source

2Try alpha-blockers if you have trouble urinating. Talk to your doctor about alpha-blockers, which can relax muscles around the bladder and prostate. These drugs help increase the flow of urine when you use the bathroom and keep you from needing to urinate too frequently.XResearch source

While adverse side effects are infrequent, alpha-blockers can cause dizziness. The good news is, they typically help relieve symptoms within a few weeks.

Take alpha-blockers, like tamsulosin, as directed by your doctor.

Most alpha-blockers are safe to take with other medications. Consult your pharmacist for any potential drug interactions with your current medication regimen.

3Explore enzyme-inhibitors if you have a very enlarged prostate. Ask your doctor if enzyme-inhibitors, like finasteride and dutasteride, would be a good fit for your symptoms. These drugs shrink prostate tissue to reduce urinary problems and are often most effective on severely enlarged prostates.XResearch source

Like alpha-blockers, dizziness is the most common side effect.

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Risk Factors For Prostate Cancer

Some risk factors have been linked to prostate cancer. A risk factor is something that can raise your chance of developing a disease. Having one or more risk factors doesnât mean that you will get prostate cancer. It just means that your risk of the disease is greater.

• Age. Men who are 50 or older have a higher risk of prostate cancer.
• Race. African-American men have the highest risk of prostate cancerâthe disease tends to start at younger ages and grows faster than in men of other races. After African-American men, prostate cancer is most common among white men, followed by Hispanic and Native American men. Asian-American men have the lowest rates of prostate cancer.
• Family history. Men whose fathers or brothers have had prostate cancer have a 2 to 3 times higher risk of prostate cancer than men who do not have a family history of the disease. A man who has 3 immediate family members with prostate cancer has about 10 times the risk of a man who does not have a family history of prostate cancer. The younger a manâs relatives are when they have prostate cancer, the greater his risk for developing the disease. Prostate cancer risk also appears to be slightly higher for men from families with a history of breast cancer.
• Diet. The risk of prostate cancer may be higher for men who eat high-fat diets.

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How Is Bph Treated

In some cases, in particular where symptoms are mild, BPH requires no treatment. At the opposite extreme, some men require immediate intervention if they cannot urinate at all or if kidney/bladder damage has occurred. When treatment is necessary, many men will simply require daily medication. If this fails to completely treat the symptoms, or if there are signs of damage from BPH, the doctor may recommend minimally invasive endoscopic surgery . Or, in some cases, traditional surgery may be recommended.

• Drug treatment: The FDA has approved several drugs to relieve common symptoms associated with an enlarged prostate, including drugs that inhibit the production of the hormone DHT and drugs that relax the smooth muscle of the prostate and bladder neck to improve urine flow.

For surgery, there are many procedures to choose from, and the choice depends largely on your specific prostate anatomy, and surgeon preference and training. These procedures all have a common goal of widening the urethral channel as it passes through the prostate. Procedures include the following:

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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.