Prostate Diagnostics

What Is the Prostate?

The prostate belongs to the male sexual organs and plays a role in reproduction. The organ is the size of a chestnut and surrounds the urethra in ring-shaped. The urinary bladder is on its upper side, while its backside is adjacent to the rectum. The prostate's primary function is to produce prostatic secretion, which is a component of the sperm fluid and acts as a transport fluid for the sperm. In addition, sperm motility depends on prostatic secretion.

Furthermore, the prostate closes the seminal ducts during urination and the urethra towards the urinary bladder during ejaculation, preventing urine from entering the seminal ducts and sperm from entering the urinary bladder. The prostate is also involved in hormone metabolism, in which it converts the precursor of the hormone testosterone into its active form.

What Are the Prostate Diseases?

The three most common diseases of the prostate are prostatitis, benign prostatic hyperplasia, and prostate cancer. Prostatitis describes the inflammation of the organ, which is manifested by lower abdominal pain and discomfort during urination. Benign prostatic hyperplasia is a benign alteration in the inner layer of the organ. It occurs at an older age. The proliferation of tissue around the urethra can cause it to be narrow, which in turn leads to micturition disorders. Finally, prostate cancer is a malignant tumor of the prostate and is one of the most common cancers in men.

What Are the Different Prostate Examinations?

Palpation Examination

The digital rectal examination describes the palpation of the prostate via the rectum. The word digital comes from the Latin term digitus for finger. The examiner inserts a finger moistened with lubricant into the rectum and palpates the prostate through the thin intestinal wall. The sphincter and rectum are also palpated during this examination. The examination takes a few minutes and is painless. The size, displaceability, and surface area of the prostate can be examined.

PSA Test

Prostate-specific antigen (PSA) is a protein produced almost exclusively by the prostate gland and is released into the blood in small amounts. Prostate cancer cells have more of this protein, so a higher amount is released into the bloodstream. The PSA concentration can be measured in the laboratory using a blood sample. The level of the PSA concentration can be used to conclude the possible presence of prostate cancer. However, an elevated PSA level is not a definite indication of cancer, so further examinations are required to clarify the suspicion.

Ultrasound

An ultrasound examination works via sound waves and is a quick and straightforward way to examine various organs in the form of cross-sectional images. However, the quality of the images depends on the distance of the organs to be examined from the transducer that emits the sound waves. Therefore, there should be as little distance and tissue as possible between the transducer and the target organ. One way to improve the examination situation for deep-located organs such as the prostate is the transrectal ultrasound examination. For this purpose, a special transducer is inserted into the rectum. As a result, the sound waves only have to pass through the thin intestinal wall so that the prostate can be seen clearly.

The size, shape, and internal structure of the prostate can be examined in the ultrasound. In addition, the seminal vesicles and the tissue around the prostate can be examined. Changes in the prostate, calcifications as well as secretion congestion are visible.

Biopsy

In a biopsy, a small sample of tissue is taken to be examined under a microscope. The prostate biopsy is performed if there is a suspicion of prostate carcinoma, which has arisen, for example, after a screening examination. The prostate biopsy is performed on an outpatient basis under local anesthesia. During this procedure, 10 to 12 tissue samples are taken with fine needles under ultrasound guidance.

Fusion Biopsy

A magnetic resonance imaging (MRI) scan is performed before tissue sampling to improve visualization in fusion biopsy. The images produced by this procedure can better visualize tumors in the prostate than ultrasound. The MRI images can be superimposed on the live ultrasound images so that biopsy samples can be explicitly taken from the suspicious organ regions. A fusion biopsy increases the accuracy of puncture needles into small areas of tissue suspected of cancer.

Prostate MRI

Magnetic resonance imaging (MRI) offers the possibility of good quality imaging of the prostate. For this purpose, various particular examination sequences are combined to form the so-called multiparametric MRI (mpMRI). This, among others, offers the possibility of excluding prostate carcinoma with certainty in the case of elevated PSA levels.

Which Doctor Is a Specialist for Prostate Examinations?

The urologist is a specialist for the prostate. The general practitioner can also perform a palpation examination and the PSA test for early prostate cancer detection. MRI scans are performed in radiology departments or doctor’s offices and reviewed by a radiology specialist.

Every patient who needs a doctor wants the best medical care. Therefore, the patient is wondering where to find the best clinic. As this question cannot be answered objectively and a reliable doctor would never claim to be the best one, we can only rely on the doctor’s experience.

We will help you find an expert for your condition. All listed doctors and clinics have been reviewed by us for their outstanding specialization in prostate diagnostics and are awaiting your inquiry or request for treatment.

Sources:

• Michel et al.: Die Urologie. Springer 2016, ISBN: 978-3-642-39939-8.
• Jocham, Miller: Praxis der Urologie: Band 1. 3. Auflage Thieme 2007, ISBN: 978-3-131-11903-2
• Aumüller et al.: Duale Reihe Anatomie. 3. Auflage Thieme 2014, ISBN: 978-3-13-136043-4