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Prostate Tests
Prostate Health Testing; Prostate Check-Up; Prostate Exam
Prostate tests can find out whether you might have prostate cancer or another prostate problem, such as an enlarged prostate or prostatitis. Learn more about prostate problems, commonly performed tests, and key points to discuss with your doctor.
Prostate Specific Antigen (PSA), Core Biopsy
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Prostate Anatomy by Zones with insets
Image by TheVisualMD
The prostate is a walnut-shaped gland that is part of the male reproductive system. It has two or more lobes, or sections, enclosed by an outer layer of tissue. The prostate is located in front of the rectum and just below the bladder, where urine is stored. It surrounds the urethra at the neck of the bladder and supplies fluid that goes into semen.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Male Reproductive System / Male Reproductive Organ
Healthy Prostate / Enlarged Prostate
Healthy Prostate vs Enlarged Prostate
Interactive by TheVisualMD
Healthy Prostate / Enlarged Prostate
The most common prostate problem in men younger than age 50 is inflammation, called prostatitis. Prostate enlargement, or benign prostatic hyperplasia (BPH), is another common problem. Because the prostate continues to grow as a man ages, BPH is the most common prostate problem for men older than age 50. Older men are at risk for prostate cancer as well, but it is much less common than BPH.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Male Pelvis Showing Erect Penis / 3D Visualization of Ejaculation through the cross section of the male reproductive system
Two bladders showing normal versus restricted urine flow as caused by an enlarged prostate and urethra constriction.
Image by National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
The symptoms of prostate problems may include
Different prostate problems may have similar symptoms. For example, one man with prostatitis and another with BPH may both experience urinary urgency. Sometimes symptoms for the same prostate problem differ among individuals. For example, one man with BPH may have trouble beginning a urine stream, while another may experience nocturia. A man in the early stages of prostate cancer may have no symptoms at all. Because of this confusing array of symptoms, a thorough medical exam and testing are vital.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Prostate Cancer Screening and Detection
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To diagnose prostate problems, the health care provider will perform a digital rectal exam (DRE). The health care provider will also ask the patient
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.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Exam, Digital Rectal
Image by National Cancer Institute / National Cancer Institute
A DRE is a physical exam of the prostate. The health care provider will ask the patient to bend over a table or lie on his side while holding his knees close to his chest. The health care provider slides a gloved, lubricated finger into the rectum and feels the part of the prostate that lies next to it. The DRE may be slightly uncomfortable, but it is brief. This exam reveals whether the prostate has any abnormalities that require more testing. If an infection is suspected, the health care provider might massage the prostate during the DRE to obtain fluid to examine with a microscope. This exam is usually done first. Many health care providers perform a DRE as part of a routine physical exam for men age 50 or older, some even at age 40, whether or not the man has urinary problems.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Digital Rectal Examination
Also called: DRE, Digital Rectal Exam
A digital rectal examination (DRE) is a test in which a doctor inserts a lubricated, gloved finger into your rectum to assess your pelvic organs. It is commonly used to check the prostate gland in men, but it can also be used to evaluate the uterus and ovaries in women.
Risks of Prostate Cancer Screening
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The first test for detecting prostate problems is a blood test to measure prostate-specific antigen (PSA), a protein made only by the prostate gland. This test is often included in routine physical exams for men older than age 50. Because African American men have higher rates of getting, and dying from, prostate cancer than men of other racial or ethnic groups in the United States, medical organizations recommend a PSA blood test be given starting at age 40 for African American men. Medical organizations also recommend a PSA blood test be given starting at age 40 for men with a family history of prostate cancer. Some medical organizations even recommend a PSA blood test be given to all men starting at age 40.
If urination problems are present or if a PSA blood test indicates a problem, additional tests may be ordered. These tests may require a patient to change his diet or fluid intake or to stop taking medications. If the tests involve inserting instruments into the urethra or rectum, antibiotics may be given before and after the test to prevent infection.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Prostate-Specific Antigen (PSA) Test
Also called: PSA, Prostate-Specific Antigen, Total PSA
Prostate-specific antigen (PSA) test is a blood test that checks the level of PSA in the blood. PSA is a protein made by the prostate gland. The amount of PSA may be higher in men who have prostate cancer, benign prostatic hyperplasia (BPH), or infection or inflammation of the prostate.
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Protein Specific Antigen Levels
Image by TheVisualMD
A PSA blood test is performed to detect or rule out prostate cancer. The amount of PSA in the blood is often higher in men who have prostate cancer. However, an elevated PSA level does not necessarily indicate prostate cancer. The U.S. Food and Drug Administration has approved the PSA blood test for use in conjunction with a DRE to help detect prostate cancer in men age 50 or older and for monitoring men with prostate cancer after treatment. However, much remains unknown about how to interpret a PSA blood test, its ability to discriminate between cancer and problems such as BPH and prostatitis, and the best course of action if the PSA level is high.
When done in addition to a DRE, a PSA blood test enhances detection of prostate cancer. However, the test is known to have relatively high false-positive rates. A PSA blood test also may identify a greater number of medically insignificant lumps or growths, called tumors, in the prostate. Health care providers and patients should weigh the benefits of PSA blood testing against the risks of follow-up diagnostic tests. The procedures used to diagnose prostate cancer may cause significant side effects, including bleeding and infection.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Diagnosis of Prostate Cancer
Image by Tonry, C., Finn, S., Armstrong, J. et al./Wikimedia
If the DRE or the PSA blood test indicates a problem may exist, the health care provider may order additional tests, including urinalysis, urodynamic tests, cystoscopy, abdominal ultrasound, transrectal ultrasound with prostate biopsy, and imaging studies such as magnetic resonance imaging (MRI) or computerized tomography (CT) scan.
Urinalysis is the testing of a urine sample for abnormal substances or signs of infection. The urine sample is collected in a special container in a health care provider’s office or commercial facility and can be tested in the same location or sent to a lab for analysis.
If an infection is suspected, the health care provider may ask that the urine sample be collected in two or three containers during a single urination to help locate the infection site. After the first collection, the health care provider will have the patient stop the urine stream for a prostate massage before collecting more urine. If signs of infection appear in the first container but not in the others, the infection is likely to be in the urethra. If the urine contains significantly more bacteria after the prostate massage or bacteria are in the prostate fluid itself, the infection is likely to be in the prostate.
Urodynamic testing is any procedure that looks at how well the bladder, sphincters, and urethra are storing and releasing urine. Most urodynamic tests focus on the bladder’s ability to hold urine and empty steadily and completely. If the prostate problem appears to be related to urine blockage, the health care provider may recommend tests that measure bladder pressure and urine flow rate. One test involves urinating into a special device that measures how quickly the urine is flowing and records how many seconds it takes for the peak flow rate to be reached. Another test measures postvoid residual, the amount of urine left in the bladder when urination stops. A weak urine stream and urinary retention may be signs of urine blockage caused by an enlarged prostate that is squeezing the urethra. Some urodynamic tests are performed in a health care provider’s office without anesthesia. Other urodynamic tests are performed in a health care provider’s office, outpatient center, or hospital with local anesthesia.
Cystoscopy is a procedure that allows the health care provider to look for blockage in the lower urinary tract. A cystoscope is a tubelike instrument used to look inside the urethra and bladder. After a solution numbs the inside of the penis, the health care provider inserts the cystoscope through the opening at the tip of the penis and into the lower urinary tract. By looking through the cystoscope, the health care provider can determine the location and degree of the urine blockage. A cystoscopy is performed in a health care provider’s office, outpatient center, or hospital with local anesthesia. The procedure is usually performed by a urologist, a doctor who specializes in treating problems of the urinary tract and the male reproductive system.
Ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure. The transducer can be moved to different angles to make it possible to examine different organs. In abdominal ultrasound, the health care provider applies a gel to the patient’s abdomen and moves a handheld transducer over the skin. The gel allows the transducer to glide easily, and it improves the transmission of the signals. The procedure is performed in a health care provider’s office, outpatient center, or hospital by a specially trained technician and interpreted by a doctor, usually a radiologist—a doctor who specializes in medical imaging. Anesthesia is not needed. An abdominal ultrasound can create images of the entire urinary tract. The images can show damage or abnormalities in the urinary tract resulting from urine blockage at the prostate.
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 man’s 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 provider’s office, outpatient center, or hospital with light sedation and local anesthesia. The biopsied prostate tissue is examined in a laboratory by a pathologist—a doctor who specializes in diagnosing diseases.
An MRI is a test that takes pictures of the body’s internal organs and soft tissues without using x-rays. The MRI machines use radio waves and magnets to produce detailed pictures. An MRI may also involve the injection of dye. A CT scan uses a combination of x-rays and computer technology to create three-dimensional (3-D) images. A CT scan may also involve the injection of a dye. MRI and CT scan images can help identify abnormal structures in the urinary tract, but they cannot distinguish between cancerous tumors and noncancerous prostate enlargement. Once a biopsy has confirmed cancer, these imaging techniques will show how far the cancer has spread. MRIs and CT scans are usually performed at an outpatient center or hospital by a specially trained technician and interpreted by a radiologist; anesthesia is not needed. For an MRI, light sedation may be used for people with a fear of confined spaces.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Prostate Cancer Antigen 3 Test
Also called: PCA3, PCA3 mRNA, Prostate Cancer Gene 3, Differential Display Code 3, DD3
The prostate cancer antigen 3 (PCA3) is a test that is used to determine the need of repeat biopsy in men who remain under suspicion of having prostate cancer, even though previous biopsies have come back negative. This test measures the amount of PCA3 in the urine after a digital rectal exam (DRE).
Prostate Biopsy
Also called: Biopsy of the Prostate
A prostate biopsy is a procedure in which a small sample of the prostate tissue is taken and then sent to a specialist to see if there are any cancerous cells present in it.
Pelvic Ultrasound - Male
Also called: Male Pelvic Scan, Male Pelvic Sonography, Transabdominal Male Pelvic Ultrasound, Transrectal Ultrasound, Endorectal Ultrasound, TRUS, Ultrasound - Pelvic (Male)
A male pelvic ultrasound is a test that uses an ultrasound machine to assess the size, shape, and location of the organs and tissues inside a man’s pelvis, including the seminal vesicles, ejaculatory ducts, prostate, and bladder.
Acid Phosphatase Test
Acid phosphatase is an enzyme that is highly concentrated in the prostate, but it can also be found in several other tissues such as bone, kidney, liver, and semen, among others. An acid phosphatase test can be used to diagnose prostate disorders and bone disorders, as well as aid in rape investigations.
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Cystoscopy
Also called: Bladder Endoscopy
A cystoscopy is a procedure to look inside the urethra and bladder using a thin camera called a cystoscope. The test can help find problems with the urinary tract, including early signs of cancer, infection, narrowing, blockage, or bleeding.
Urinalysis Test
Also called: Urine Test
A urine test is used to help diagnose a wide range of conditions such as urinary tract infections, kidney disease, and diabetes. It evaluates many characteristics, macroscopic (that can be seen with the naked eye) and microscopic (invisible to the naked eye). It is a routine exam for your health check-up, before surgery, or when pregnant.
Glucose in Urine Test
Also called: Urine sugar test, Urine glucose test, Glucosuria test, Glucose urine dipstick
A glucose in urine test measures the amount of glucose (sugar) in your urine. The test is used to monitor both type 1 and type 2 diabetes.
Bilirubin in Urine Test
Also called: Total Urine Bilirubin, Bilirubin
Bilirubin is a yellowish pigment found in bile, a fluid produced by the liver. When the liver is damaged, bilirubin can leak into your urine. A bilirubin in urine test can help detect liver disease.
Ketones in Urine Test
Also called: Urine Ketones, Ketone Bodies (Urine), Ketones Urine Test
Ketones in urine may indicate a problem with the body's ability to burn energy. Diabetics are at a higher risk for developing urine ketones. A ketones in urine test can prompt you to get treatment before a medical emergency occurs.
Urine Specific Gravity Test
Also called: Urine SG, Specific Gravity of Urine, Urine Density
A urine specific gravity test measures the concentration of solutes in your urine, which shows if your kidneys are properly diluting urine. This test is a partial analysis used in case of suspected kidney disorder.
Blood in Urine Test
Also called: Hematuria, Bloody urine
A blood in urine test is part of a urinalysis, a test that measures different cells, chemicals, and other substances in urine. Most causes of blood in your urine are not serious, but sometimes red or white blood cells in your urine can mean that you have a medical condition that needs treatment, such as a kidney disease, urinary tract infection,
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PH of Urine Test
Also called: Acid Loading Test, Urine pH, Alkaline Urine Test, Acidic Urine Test
A urine pH test is used to detect a wide range of conditions such as urinary tract infections, kidney disease, and diabetes. Any pH higher than 8 is basic or alkaline, and any under 6 is acidic. A urine pH test is carried out as a part of a urinalysis.
Protein in Urine Test
Also called: Urine Protein
A protein in urine test measures how much protein is in your urine. A large amount of protein can indicate a problem with your kidneys.
Urobilinogen Test
Also called: Urinary Urobilinogen
A urobilinogen in urine test looks for liver disease or damage. It may be included in a routine exam or if a liver problem is suspected.
Nitrites in Urine Test
Also called: Urine Nitrite
A nitrites in urine test is part of a urinalysis, a test that measures different substances in urine. If nitrites are present, it may indicate an infection.
Red Blood Cells in Urine Test
Also called: RBC urine
Red blood cells (RBCs), also known as erythrocytes, may also be found in a urinalysis, or a urine test. High levels of RBCs in your urine indicates that you have hematuria.
White Blood Cells, Urine Test
Also called: Leukocytes in Urine
White blood cells (WBCs), also known as leukocytes, may also be found in a urinalysis, or a urine test. High levels of WBCs in your urine suggest that you have a urinary tract infection (UTI).
Epithelial Cells in Urine Test
The test measures the amount of epithelial cells in urine. A large amount may indicate an infection, kidney disease, or other serious medical condition. This test is part of a urinalysis, a test that measures different substances in your urine.
Urinary Casts Test
Also called: Urine Casts
Urinary casts are tiny structures that can be seen in a urine test (urinalysis) when certain kidney diseases or conditions are present.
Warm Bath
Image by islandworks/Pixabay
Urodynamic tests and cystoscopy may cause mild discomfort for a few hours after the procedures. Drinking an 8-ounce glass of water every half-hour for 2 hours may help reduce discomfort. The health care provider may recommend taking a warm bath or holding a warm, damp washcloth over the urethral opening to relieve discomfort. A prostate biopsy may produce pain in the area of the rectum and the perineum, which is between the rectum and the scrotum. A prostate biopsy may also produce blood in urine and semen.
An antibiotic may be prescribed for 1 or 2 days to prevent infection.
Patients with signs of infection—including pain, chills, or fever—should call their health care provider immediately.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Prostate Cancer Grading with Gleason Scale
Image by TheVisualMD
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.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
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