A urologist is a medical doctor who specializes in the urinary tract and male reproductive system. These specialists complete years of surgical and medical training after medical school. The prostate sits below the bladder, and it often changes in size and function with age. A urologist evaluates these changes and recommends next steps based on your symptoms and test results.
Diagnosing Enlarged Prostates
Doctors call an enlarged prostate benign prostatic hyperplasia (BPH). This condition affects many men over 50 because prostate tissue tends to grow with age. BPH is not cancer, but it may press on the urethra and slow urine flow. Symptoms typically develop slowly over several years.
You may notice a weak stream, or you may feel the urge to urinate often at night. Some men also have trouble starting or stopping urination. When these symptoms appear, a urologist reviews your medical history and asks about your daily habits.
To confirm a diagnosis, the urologist may order tests that measure urine flow and leftover urine in the bladder. An ultrasound shows the size of the prostate, and a urinalysis checks for infection or blood. These results help rule out other causes of your symptoms.
Screening for Prostate Cancer
Prostate cancer typically n causes no symptoms in its early stages. Many men feel fine during this time, so a urologist relies on screening tests for clues. The most common test is the prostate-specific antigen (PSA) blood test, which measures a protein from the prostate. Your urologist may also review several risk factors:
- Age, especially after 50
- Family history of prostate cancer
- Black or African American ancestry
- Results from past PSA tests
If your PSA level is high, the urologist may repeat the test or order an MRI. A biopsy gives the most definite answer about cancer. Screening guidelines differ by age and risk, so talk with your urologist about the right schedule for you.
Performing Digital Rectal Exams
A digital rectal exam (DRE) is typically short, and it requires no special preparation. During the exam, the urologist inserts a gloved, lubricated finger into the rectum. This position lets the doctor feel the back of the prostate, which lies just in front of the rectum. Most urologists perform it in a regular exam room.
The doctor checks the prostate for size, shape, and texture. Hard spots or lumps may lead to more testing, while a smooth, enlarged gland may point to BPH. The exam may feel uncomfortable, but it rarely causes pain. Many urologists pair a DRE with a PSA test for a fuller picture.
Providing Conservative and Surgical Treatments
Treatment depends on your diagnosis, and your urologist will explain each option in plain terms. For mild BPH, the doctor may suggest watchful waiting, which means regular checkups without immediate treatment. Other conservative options include the following:
- Prescribed medications that relax prostate muscles or shrink the gland
- Less fluid intake in the evening
- Less caffeine and alcohol
- Active surveillance for low-risk prostate cancer
Visit a Urologist Near You
Prostate changes are common with age. Some changes cause clear symptoms, but others stay silent for years. If you notice urinary changes or have a family history of prostate cancer, schedule an appointment with a urologist. Bring a list of your symptoms, medications, and questions to your first visit.
