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RN Nursing · Renal and Urinary Assessment · Practice question

An NP is assessing an older adult with incomplete bladder emptying and suspects benign prostatic hyperplasia (BPH). Which of the following diagnostic studies is recommended to confirm this condition?

Answer & explanation

Correct: Ultrasound of the prostate.

Transrectal or abdominal ultrasound of the prostate is the recommended imaging study to confirm benign prostatic hyperplasia. Ultrasound allows direct visualization of prostate size, shape, and structure, and can also assess post-void residual urine volume — a key finding in BPH with incomplete bladder emptying. It provides objective evidence of prostatic enlargement and helps rule out other structural pathology such as prostate cancer or bladder abnormalities. A urinalysis and renal panel are useful adjuncts to assess for urinary tract infection or renal impairment caused by chronic obstruction, but they do not confirm BPH itself. Urine culture and sensitivity is ordered when infection is suspected and identifies the causative organism and antibiotic sensitivities — it does not diagnose BPH. Prostate-specific antigen is a tumor marker primarily used in the screening and monitoring of prostate cancer; while it may be mildly elevated in BPH, it is not diagnostic of the condition and lacks specificity. Therefore, ultrasound remains the most direct and confirmatory imaging modality for suspected BPH, particularly when incomplete bladder emptying is already documented clinically.

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