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Your doctor can diagnose BPH through a combination of: Review your personal and family medical history Performing a physical examination, which may include a digital rectal exam (DRE) Running additional medical tests, such as: Cystoscopy to view the inside of the urethra and bladder Post-void residual volume measurement to measure the amount of urine left after urinating Prostate-specific antigen (PSA) blood test to measure markers of prostate cancer Ultrasound of the prostate to look at the size and structure of the prostate Urinalysis to check for signs of infection or other problems Uroflowmetry to measure the speed of urine flow Urodynamic pressure testing to test the bladder pressure during urination Urinary blood test to screen for bladder cancer PSA Blood Test Prostate-specific antigen (PSA) is a protein produced exclusively by the prostate gland