What examinations are necessary?
In addition to a detailed record of the medical history, especially the symptoms, a digital rectal examination of the prostate is always part of the standard diagnostic procedure.
Laboratory tests include kidney values, urine tests to exclude urinary tract infections, and the PSA value, which can be helpful in differentiating between prostate enlargement, prostate inflammation and the presence of malignant prostate disease (see chapter on prostate cancer).
In order to determine the exact degree of any obstruction of urinary flow, urine flow measurement (uroflowmetry), which measures the amount of urine per second achieved when urinating, is recommended.
Urosonography, i.e. ultrasound examination of the kidneys, bladder and prostate, not only reveals the actual size of the prostate, but can also detect stones and tumours in the urogenital tract.
A cystoscopy is recommended when there is blood in the urine in order to rule out a bladder tumour, and in the case of urethral narrowing.
If the urge symptoms are predominant, function measurement of the bladder, a so-called urodynamic test, should be carried out.
The International Prostate Symptoms Score (IPSS) has been developed to assess the severity of the symptoms of benign prostate enlargement. It is a questionnaire that makes the extent of the flow disorder measurable and comparable. The altogether seven questions result in scores that help to identify the need for therapeutic action.