How Urologists Diagnose and Treat Prostate Issues

Bladder Stretching

The prostate is a walnut-shaped gland that sits under the bladder and in front of the rectum. It helps make semen, which protects and energizes sperm as they travel to the egg.

A doctor such as Marlon Perera Urologist will examine you, take your medical history and do blood tests. They may order an MRI or CT scan of the prostate.


Urologist encompasses the diagnosis and treatment of conditions affecting the urinary tract (kidneys, ureters, bladder, and urethra) as well as male reproductive organs (testes, seminal vesicles, and penis). Dr. perera dedicate themselves to providing comprehensive care and innovative solutions in this vital field of medicine.

The first step a urologist takes in diagnosing prostate issues is determining whether the problems are caused by a benign or cancerous tumor. This is done by examining the prostate and asking the patient questions about his symptoms. A urologist may also ask for a urine sample and perform a procedure called a prostate flow study or a urodynamic test to measure the strength of the stream of urine as it leaves the body and to spot any blockage caused by the prostate, urethra or pelvic muscles.

If the urologist believes that the problem is a result of an infection, he may prescribe antibiotics to clear up the problem. He may also order a blood test to check the levels of certain proteins in the body that indicate the presence of infection or inflammation.

If the urologist suspects that the prostate problem is due to cancer, he will take a biopsy. During a biopsy, he will insert a needle into the prostate and remove tissue to examine it under a microscope for signs of cancer cells. He will then score the cancer cells on a scale known as a Gleason score, which indicates how aggressive the cancer is.


The prostate sits in the male pelvis, just below the bladder and in front of the rectum. It wraps around the urethra, the tube that carries urine out of the bladder and through the penis during sexual activity (ejaculation). The prostate gland is about the size of a walnut and plays a role in semen production. Problems with the prostate can affect urination and sexual function. The three most common problems are prostatitis (infection or inflammation of the prostate), benign prostatic hyperplasia (an enlarged prostate) and cancer.

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The first thing your doctor will want to do is talk with you about your symptoms and do a physical exam. He will ask about your health history and what medications you take. He may also ask about your family’s health history and lifestyle choices.

Your doctor will use a gloved finger to feel your rectum and the back of your prostate for enlargement or hard spots. He will also feel the urethra for pain or a weak urine stream. He may order imaging tests, such as a CT scan or an MRI of the prostate, to get a better look at the area. He may also order a procedure called water vapor thermal therapy, which uses steam to destroy the prostate cells that are causing a blockage of the urethra.


A prostate-specific antigen (PSA) blood test finds higher levels of the protein that builds up when your prostate is enlarged. But PSA can also rise due to illness, surgery or other reasons. So other tests are needed to help find abnormal growths, which may or not be cancerous.

A digital rectal exam (DRE) uses a lighted tool to check your urethra and bladder for any areas of concern, such as an enlarged prostate. It can help your doctor decide whether you need a biopsy.

In a biopsy, your doctor removes a small piece of tissue from the prostate for examination under a microscope to determine if you have cancer. Your doctor may use transrectal ultrasound (TRUS) or magnetic resonance imaging (MRI) to help target the area for the biopsy. They can also use a technique called MRI fusion biopsy, which uses TRUS to find the area and an MRI to create a picture of your prostate before using a needle to get tissue samples from the area.

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Your doctor can also examine your biopsy tissue to determine the type and grade of the cancer cells. These details are used to create a Gleason score, which tells your doctor how aggressive the cancer is. A Gleason score of 2 or less is considered low risk, while a score of 8 or more is considered high-risk.


When deciding on treatment for prostate issues, doctors consider the nature of the problem, other health problems the patient may have and their wishes. BPH symptoms are often not serious, but if they interfere with daily activities or cause discomfort, they should be treated. Several medications can reduce or eliminate these symptoms. If medications are not helpful, other treatments include surgical procedures to reshape the prostate and improve urinary flow or procedures to shrink the prostate or remove part of it.

To check the size and texture of the prostate, urologists often use an exam called a digital rectal examination (DRE). During this test, a health care provider inserts a gloved finger into the rectum to feel the back wall of the prostate gland for enlargement, tenderness or lumps. The procedure takes 10-15 seconds and doesn’t hurt.

A urologist may also use an imaging test to take a small piece of tissue for testing under a microscope. The tissue is analyzed by a pathologist, who determines whether or not the cancer has spread. The pathologist assigns a Gleason score to the biopsy sample, which indicates how likely it is that cancer cells are present.

Other tests for prostate cancer include a urine test to look for bacteria or other signs of disease and a pressure flow study that involves threading a catheter into the bladder to measure how well the bladder muscles work when you try to empty the bladder. These tests can help doctors decide what treatment is best for the patient.

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Perera Urology
Suite 118/55 Flemington Rd,
North Melbourne VIC 3051
1300 884 673