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

• Do you have difficulty in starting to pass urine?
• Do you think it takes you too long to pass urine?
• Do you pass urine in stops and starts?
• Do you dribble urine after you stopped urinating (peeing)?
• Do you have a sensation of not having emptied your bladder completely?
• Do you have to get up more than twice a night to pass urine, but only pass small amounts?

If you are experiencing any of these problems, then you should arrange to see your health care provider. Your doctor will usually ask about your symptoms, perform a physical examination and discuss other tests with you.

Digital Rectal Examination (DRE)

Your doctor will feel your prostate with his finger through the back passage (rectum) while you either lie on your side or bend over. It only takes a few minutes. The examination may be mildly uncomfortable but not painful.

Blood Test

This may include a test for kidney function and a test for prostate specific antigen (PSA), a protein that appears at increasing levels in the blood as a man’s prostate enlarges.

PSA levels that are only slightly higher than normal are often due to benign prostatic hyperplasia (prostate enlargement). A high PSA level can be a sign of prostate cancer; the higher the PSA level, the greater the risk of prostate cancer.

Urine Flow Test

This may be performed at a medical office or at a local hospital to assess the flow of your urine stream. You will be asked to pass urine into a special device called a urinary flowmeter.

Ultrasound Scan

An ultrasound scan may be performed to find out how efficiently you can empty your bladder. A scanner probe is placed on your lower abdomen before and after you pass urine to find out how much urine is left behind. This test is not at all unpleasant but can only be done when the bladder is reasonably full.

Biopsy

To check whether cancer is present, some tiny pieces of prostate tissue are removed for examination. This procedure is called a ‘biopsy’. You will be given antibiotics to reduce the risk of infection, and a local anaesthetic, then several (up to 12) samples of prostate tissue are removed using a very fine needle inserted into the prostate via the rectum. The tissue is then examined under a microscope to look for cancer cells. Antibiotics are continued for several days.

Ultrasound is often used to ‘guide’ the biopsy needle. A finger-sized probe is inserted in the back passage (rectum). The probe passes inaudible sound waves through the prostate that produce an image of the gland on a computer screen. The test is uncomfortable but not very painful, though you may feel a needle prick as each piece of tissue is pierced, even with the local anaesthetic.

After a prostate biopsy, you may see blood in your urine, semen or stool movements for several weeks, or even longer. An infection may occur, in which case you should consult your health care provider as further antibiotics may be necessary. If you start to feel shaky and develop a temperature, you may need to go to hospital. You may need a course of intravenous antibiotics.

MRI Scan

If prostate cancer is suspected or has been diagnosed, you may need to have an MRI scan (magnetic resonance imaging). The machine takes several pictures at different points throughout the body, rather like slices through a loaf of bread. This produces detailed images of the prostate, which may show the extent of any cancer, if it is present.

Scans can also show whether secondary tumours have formed in other tissues. Some people find these tests a little claustrophobic, but they are not at all painful.

First published on: embarrassingproblems.com
Reviewed and edited by: Dr Diane Newman
Last updated: October 2020