A urine ‘dipstick’ test can show whether there are any indications of infection or inflammation in the urine. Should it show any abnormalities, the urine can be sent to the laboratory to be tested for infection. A urine infection can affect the result of the PSA test.
Prostate Specific Antigen (PSA) test
A small sample of blood is taken from a vein in your arm and sent to the laboratory to measure the level of PSA. PSA is a protein made in the prostate that leaks into your bloodstream. The PSA level rises as men get older.
There are various reasons for a raised PSA level – it does not necessarily mean cancer is present, nor does a lower level always mean it is absent. It is generally felt that the PSA test is not accurate enough to be used as a definitive guide to whether a man has prostate cancer.
Other blood tests
Blood tests are also used to check your kidney function as some prostate problems affect the way the kidneys work. A blood test to check your white cell count may be used if infection is suspected.
Digital Rectal Examination (DRE)
A DRE requires the patient to lie on their left side on the examination couch with knees drawn up towards the chin. The doctor or nurse will then use a lubricated and gloved finger to feel the prostate via the rectum (back passage). The prostate can be felt through the rectal wall and will be examined for approximate size and consistency. A DRE should not be painful but may be uncomfortable and embarrassing.
There is some controversy over whether a DRE will affect the PSA reading and therefore your blood tests may be taken prior to the examination.
Urine Flow Rate and Bladder Ultrasound
For this test you will be asked to fill your bladder and then pass urine into a special machine which measures the strength of your flow. If your flow is slow it may mean that your prostate is pressing on the urethra and causing an obstruction.
A bladder ultrasound is used following the flow test to check whether you have emptied your bladder completely.
Transrectal Ultrasound (TRUS)
A TRUS is an ultrasound scan of the prostate performed via the rectum. The prostate can be seen clearly through the rectal wall. TRUS images are useful in that they show the shape and consistency of the prostate. Measurements can be taken to calculate the size of the prostate.
You will be asked to lie on a couch on your left side with your knees drawn up towards your chin. The ultrasound probe is lubricated prior to insertion to prevent discomfort. The results of the ultrasound can be explained to you immediately following the test.
If any of the above tests suggest you may be at risk of having prostate cancer, the following tests may also be performed.