Prostate problems are common in men, particularly in men over 50 years of age.

• Do you have difficulty starting to urinate (pass urine, pee)?
• Does it take a long time to urinate?
• Does your urine flow stop and start?
• Do you dribble urine after you’ve finished urinating (peeing)?
• Do you feel like your bladder isn’t completely empty after urinating?
• Do you have to get up more than twice a night to pass urine, but only pass small amounts?

If you answered “yes” to any of these questions, it’s important to speak with your health care provider. Your doctor will usually ask about your symptoms, perform a physical examination and may recommend additional tests.

Digital Rectal Examination (DRE)

As part of the evaluation, your doctor or health care provider may perform a digital rectal examination (DRE). This involves the doctor gently inserting a gloved, lubricated finger into your back passage (rectum) while you lie on your side or bend over. The exam only takes a few minutes and may be slightly uncomfortable but it should not be painful.

Blood Test

A blood test may be performed to evaluate kidney function and to measure the level of prostate-specific antigen (PSA). PSA is a protein produced by the prostate gland and its level in the blood tends to increase as the prostate enlarges.

• Mildly elevated PSA levels are often associated with benign prostatic hyperplasia (BPH), a non-cancerous enlargement of the prostate.
• Higher PSA levels may indicate a greater risk of prostate cancer, although additional testing is usually required to confirm the diagnosis.

Urine Flow Test

This test may be performed in a medical office or hospital setting to evaluate the strength and pattern  of your urine stream. During the procedure, you will be asked to urinate into a special device called a urinary flowmeter, which measures the speed and volume of urine flow. This helps assess whether there is any obstruction (blockage) or abnormality in the urinary tract.

Ultrasound Scan

An ultrasound scan may be performed to find out how efficiently you empty your bladder. A scanning probe is placed on your lower abdomen before and after you urinate to measure the amount of urine left in your bladder. This test is simple and not uncomfortable, but can only be performed when your bladder is reasonably full.

Prostate Biopsy

To determine whether prostate cancer is present, small samples of prostate tissue are removed for examination – a procedure called a ‘biopsy’. You will be given antibiotics to reduce the risk of infection, and a local anaesthetic to numb the area. Up to 12 tiny tissue samples are collected using a fine needle inserted into the prostate through the rectum. These samples are examined under a microscope to look for cancer cells. Antibiotics are usually continued for several days after the procedure.

Ultrasound guidance is often used during the biopsy. A finger-sized probe is inserted in the rectum to send sound waves through the prostate, producing a live image on a computer screen. While the procedure may be uncomfortable, it is not usually painful. You may feel a slight prick as each tissue sample is taken, even with the local anaesthetic.

After a prostate biopsy, it is common to see some blood in your urine, semen or bowel (stool) movements for several weeks, or longer. There is a risk of infection.  If you develop a fever, feel shaky or feel generally unwell, contact your health care provider immediately, as you may require additional antibiotics or even hospitalization for intravenous antibiotics.

MRI Scan

If prostate cancer is suspected or has been diagnosed, you doctor may recommend an MRI scan (magnetic resonance imaging). The scan captures cross-sectional images of the body – similar to slices through a loaf of bread – providing a clear view of the prostate and surrounding tissues. MRI can help determine the size and extent of any cancer and detect whether it has spread to other parts of the body. While some people may feel slightly claustrophobic during the scan, the procedure is completely painless.

First published on embarrassingproblems.com
Reviewed and edited by Dr Diane K. Newman
Last updated: July 2025 by Dr Diane K. Newman