- 1. PSA - Blood test
- 2. Digital rectal examination
- 3. Transrectal ultrasound
- 4. Measurement of the urine stream
- 5. Examination of laboratory urine
- 6. Biopsy
- Prostate exam age
- What can be the altered prostate exam
The most suitable tests to assess prostate health are rectal examination and PSA blood analysis, which must be performed every year by all men over 50 years of age.
When changes are found in these 2 exams, the doctor may request others, such as urine jet measurement, transrectal ultrasound, PCA3 urine test, and biopsy, which are requested according to the needs of each person.
Here are the tests that evaluate the prostate:
1. PSA - Blood test
It is done from a common blood test that evaluates the tumor marker PSA, which results in normal values lower than 4 ng / ml. Thus, when this value is increased, it can indicate problems such as inflammation of the prostate or cancer. However, this value also increases with age and, therefore, it is important to take into account the laboratory reference value. Learn How to understand the PSA exam result.
Preparation for blood test: to carry out the blood test, the patient is instructed to avoid sexual intercourse in the 72 hours prior to collection, avoid cycling, riding or motorcycling and do not perform a rectal exam, as it may change the dosage value of the PSA.
2. Digital rectal examination
Another essential test to evaluate the prostate is digital rectal examination, performed by the doctor in the office, during a consultation with a urologist or proctologist. This exam is very quick, takes about 1 minute and does not hurt, although it can be uncomfortable. In this examination the doctor can assess whether the prostate gland looks bigger or harder than it should. Understand how the digital rectal exam is done.
Preparation for digital rectal examination: normally you do not need to do any type of preparation to perform this exam.
3. Transrectal ultrasound
Transrectal ultrasound or ultrasound of the prostate is done to assess the size of this gland and to identify changes in its structure, which is very useful in the diagnosis of prostate cancer early in its development. But as it is an invasive test, it does not need to be performed every year, being indicated only when there are changes in PSA and digital rectal examination, and normally the doctor takes advantage of this test to collect the sample to perform a prostate biopsy.
Preparation for ultrasound: it may be indicated to use laxative before the exam to empty the intestine.
4. Measurement of the urine stream
Urinary flowmetry is an exam ordered by the doctor to evaluate the force of the jet and the amount of urine in each urination, because when changes in the prostate occur, the jet becomes slower and weaker, indicating changes. This test is not performed as a specific diagnosis of prostate cancer, but it is useful in case of prostate cancer already detected for your follow-up because it helps to understand its impact on the bladder and urethra.
Preparation for flowmetry: you must have a full bladder and feel like urinating, it is important to drink at least 1 L of water before the exam, which is done with the individual urinating in a specific container connected to a computer, which records the time and urine volume.
5. Examination of laboratory urine
The urologist may also order a urine test, called PCA3, which is specific to assess whether there is prostate cancer, because the test does not show other changes, such as prostatic hyperplasia. This urine test also shows the aggressiveness of the tumor, being useful to choose the appropriate treatment.
Preparation for urinalysis: urine collection should be done immediately after digital rectal examination in specialized clinics.
6. Biopsy
A prostate biopsy is done to confirm diagnoses of changes in this gland, such as cancer or benign tumors, and it is necessary to remove a small piece of this gland to send to the laboratory for analysis. This examination is always done in conjunction with prostate ultrasound, for a better visualization of the structures. See How the prostate biopsy is done.
Preparation for prostate biopsy: it is usually necessary to take the antibiotic prescribed by the doctor, for about 3 days, fast for 6 hours and take laxative to clean the intestine.
Watch the following video and understand how these exams are performed:
Prostate exam age
Diagnostic tests, such as PSA and digital rectal examination, are recommended after 50 years of age, but when the man has first-degree relatives, with prostate cancer, it is recommended to perform them after 45 years of age.
These 2 exams are basic and must be repeated once a year.
But when a man has benign prostatic hyperplasia, these tests must be repeated annually, regardless of age.
When the doctor finds changes in these 2 basic exams, he requests the others as needed.
What can be the altered prostate exam
Examinations can have altered results when problems such as:
- Inflammation of the prostate, known as benign prostate tumor; Presence of bacteria in the prostate, also known as prostatitis; Taking medications such as diuretics, steroids or aspirin; Carrying out medical procedures on the bladder, such as biopsy or cystoscopy, may slightly raise levels of PSA.
In addition, with aging, PSA blood test levels may increase and not mean illness. See other causes of an enlarged prostate at: Enlarged prostate, the most common prostate disorder.
