Detecting prostate enlargement: What should be examined?

The article was professionally consulted by Specialist Doctor I Nguyen Hung - Endocrinologist - Department of Medical Examination & Internal Medicine - Vinmec Da Nang International General Hospital. The doctor has 36 years of working experience.

Prostate enlargement is a common problem in middle-aged men. If not detected and treated in time, the disease can cause many impacts on the patient's daily life and activities and can lead to serious complications to health.

Benign prostatic hypertrophy, also known as prostatic hyperplasia, is a benign enlargement of the prostate gland. The disease arises due to the hyperplasia of the parietal cells of the prostate gland, thereby causing urinary disorders.
According to statistics of the World Health Organization, more than 50% of men aged 60 - 70 years have prostate cancer, up to 88% of men over 80 years old have this disease. At the same time, statistics also show that the incidence and severity of the disease often increase with age.
An enlarged prostate usually develops slowly and does not pose any danger over a long period of time. The prostate gland surrounds the urethra, so when it is enlarged, it will prevent urine from flowing from the bladder to the urethra, so there will be urinary disorders. If this condition is prolonged, it can cause chronic urinary retention and lead to complications such as:
Cystitis. Urinary tract infections. CKD. Therefore, when there are symptoms of urinary tract disorder or acute urinary retention, the patient needs to see a doctor immediately.

To be able to definitively diagnose an enlarged prostate, it should be based on the following factors:
Asking the disease: The doctor will exploit the clinical symptoms of the patient's urinary disorder through asking the patient. .
Examination: After asking the patient, the doctor will conduct a rectal exam to assess the prostate condition. Normally, when having benign prostatic hypertrophy, the doctor who examines the prostate gland through the rectum will find the prostate gland has the following characteristics:
Enlarged size. Clear boundaries. Smooth surface. Solid density. When pressed, the patient feels pain.

Subclinical: Laboratory tests will help the doctor accurately diagnose whether the patient has an enlarged prostate gland and the extent of the disease.

Ultrasound is an easy-to-implement and valuable laboratory method. This is a commonly used subclinical method in examining and detecting prostate cancer.
Ultrasound assessment of prostate volume plays an important role in the diagnosis and monitoring of prostate cancer. This method has the advantage of not causing trauma, the process is fast, accurate and highly efficient.

The role of prostate ultrasound:
Helps evaluate prostate volume, thereby orienting in the selection of treatment methods. Helps evaluate prostate parenchyma for differential diagnosis of abscess or prostate cancer. Helps to evaluate some complications caused by prostate fibroids in the bladder and urinary tract such as stones, dilatation of the ureter, dilatation of the renal pelvis,... Helps to assess the stage of the disease and the results of surgery through measurement of residual urine. At the same time, it helps to evaluate other combined diseases of the urinary tract such as kidney stones, bladder tumors,... Helps determine the volume, shape and density of the prostate gland. By convention 1cm3 volume = 1g gland weight. In addition, ultrasound also helps to determine the amount of residual urine in milliliters. Prostate ultrasound methods include:
Ultrasound above the pubic bone. Transrectal ultrasound method. Trans perineal ultrasound method: this method has little results, so it is rarely used. Transurethral transurethral ultrasound: This method carries the risk of urethral rupture and infection, so it is rarely used. Color Doppler ultrasound method: in case of necessity, it can be combined with classical ultrasound methods.

An X-ray image of the urinary system will show:
Abnormal changes in the anatomical structure of the urinary tract caused by an enlarged prostate gland. Determine the degree of protrusion into the bladder lumen of the prostate tumor. Evaluation of bilateral kidney function and urethral status in some associated complications such as malformations, stones,...

Urodynamic testing is a test used to measure bladder pressure and function. This test helps evaluate the pressure inside the bladder and the effectiveness of bladder contractions. This investigation is performed when the patient is suspected of having a bladder problem rather than an enlarged prostate.

Quantification of PSA and PAP is used to differentiate between prostate enlargement and prostate cancer.

This test is to check if the patient has a narrowing of the urethra.

Bacteriological tests can be done, such as a urine culture, and an antibiogram.
In addition to the above tests, there are a number of other tests such as: biopsy, magnetic resonance imaging, scanner,... However, not every patient needs to do all of the above tests. The choice of testing method depends on the patient's medical condition and the physical facilities of the place of medical examination and treatment. In which prostate ultrasound can be considered the most important, indispensable for the diagnosis of prostate cancer.

Patients suspected of having an enlarged prostate can go to public hospitals at the district level or higher, or private hospitals and clinics that specialize in Nephrology - Urology for examination and treatment.
There are many public and private hospitals that can examine and treat this disease, but many patients still wonder which hospital is the best for prostate examination. You should choose Vinmec to examine and treat prostate enlargement for the following reasons:
Vinmec Hospital is equipped with a modern ultrasound system with flat transducers, high frequency, and high resolution. HD produces clear images, helping to accurately detect lesions. There is an advanced laboratory system, meeting international standards. Along with that is a team of leading experts with extensive experience in the field of urology. Patients with prostate cancer after examination will be consulted to choose the appropriate treatment method. To detect prostate enlargement, patients need to be asked about the disease, clinical examination and necessary paraclinical tests, the most important of which is prostate ultrasound.
To register for examination and treatment with experienced urologists at Vinmec, customers please book an appointment directly at the website for service