Prostate health is not always easy to talk about—but it is crucial. If you are a man over 50 or have symptoms like frequent urination or a weak stream, you might be wondering: What is the best way to check for an enlarged prostate? Two of the most common methods are the PSA blood test and the Digital Rectal Exam (DRE). But which one should you choose?
Let us break down both screening options so you can make an informed decision.
What Is an Enlarged Prostate?
An enlarged prostate, or benign prostatic hyperplasia (BPH), is a non-cancerous increase in the size of the prostate gland. It is extremely common as men age, affecting 50% of men over 50 and up to 90% over 80.
Common Symptoms of an Enlarged Prostate:
- Difficulty starting urination.
- Weak or interrupted flow
- Frequent urge to urinate, especially at night.
- Incomplete bladder emptying
While BPH is not prostate cancer, the symptoms can significantly affect your quality of life—and early screening is key.
What Causes an Enlarged Prostate?
While the exact cause of BPH is not fully understood, several risk factors have been identified:
- Ageing: Risk increases dramatically after age 50.
- Hormonal shifts: Changes in testosterone and dihydrotestosterone (DHT) levels may stimulate prostate growth.
- Genetics: Family history of prostate issues may increase your chances.
- Lifestyle: Obesity, lack of exercise, and poor diet could contribute.
Knowing these triggers can help you assess whether it is time to speak to a urologist in Dubai.
Symptoms That Should Prompt Immediate Prostate Screening
Not all urinary symptoms mean you have an enlarged prostate, but these are signs worth checking immediately:
- Sudden difficulty or pain during urination
- Inability to fully empty the bladder.
- Blood in urine or semen
- Frequent nighttime urination disrupting sleep.
- Pelvic or lower back discomfort
Do not wait for symptoms to escalate. Early detection matters.
PSA Test: What You Need to Know
What Is It?
The Prostate-Specific Antigen (PSA) test is a simple blood test that measures the level of PSA, a protein produced by both normal and cancerous prostate tissue.
Pros:
- Non-invasive – just a blood sample.
- Can detect early signs of prostate cancer before symptoms appear.
- Useful for monitoring prostate health over time.
Cons:
- Not specific to cancer – PSA levels can rise due to an enlarged prostate, infection, or even recent ejaculation.
- May lead to overdiagnosis and unnecessary anxiety if not interpreted correctly.
Digital Rectal Exam (DRE): What It Involves
What Is It?
A Digital Rectal Exam (DRE) is a manual examination where a doctor inserts a gloved, lubricated finger into the rectum to feel the size, shape, and texture of the prostate.
Pros:
- Helps detect abnormal lumps or hard areas.
- Immediate, real-time physical assessment.
- Especially useful when combined with a PSA test.
Cons:
- Some patients find it uncomfortable or embarrassing.
- Can miss abnormalities if they are not near the surface of the gland.
PSA vs DRE: Which One Is Better?
The short answer: neither is perfect on its own—but together, they are powerful
| Feature | PSA Test | DRE |
| Type | Blood test | Physical exam |
| Comfort | Extremely comfortable | Slight discomfort |
| Accuracy | Sensitive, not specific | Specific, not always sensitive |
| Best For | Monitoring PSA trends | Feeling structural changes |
If you have symptoms of an enlarged prostate, most urologists in Dubai recommend using both tests as complementary tools. A raised PSA level with a normal DRE may still warrant further investigation, and vice versa.
How a Urologist in Dubai Assesses Prostate Health
Wondering what happens during a prostate check-up? A urologist in Dubai typically follows this process:
1. Medical history review
Lifestyle, symptoms, and family history
2. Physical examination
including a DRE
3. PSA blood test
If needed, follow-up imaging such as prostate ultrasound or MRI.
4. Discussion of treatment or monitoring plans
The goal is personalised, evidence-based care.
What Happens After a High PSA or Abnormal DRE?
If your results are not within normal range, do not panic. Here is what typically happens:
- Repeat testing: PSA levels may fluctuate due to temporary factors like infection.
- Advanced imaging: MRI or TRUS (transrectal ultrasound) can provide a clearer view.
- Biopsy: If needed, your urologist may take a small sample to rule out or confirm cancer.
- Ongoing monitoring: Not all abnormalities need immediate action—sometimes “watchful waiting” is best.
PSA and DRE in Combination: Why Dual Screening Is Effective
Using PSA and DRE together offers a more accurate assessment of your prostate health:
- PSA detects biochemical changes.
- DRE detects structural abnormalities.
This dual approach increases diagnostic accuracy and reduces the chances of false positives or missed cases.
Are There Any Alternatives to PSA and DRE?
Yes, newer screening methods are available, especially for high-risk patients:
- Prostate Health Index (PHI): Combines multiple PSA markers for higher specificity.
- 4Kscore Test: Helps predict aggressive prostate cancer risk.
- MRI-based imaging: Non-invasive, highly detailed prostate imaging.
- PCA3 urine test: A genetic test used alongside PSA in select cases.
Speak to your urologist about whether these alternatives are right for you.
So, which is better: PSA or DRE?
Honestly, it is not about picking one over the other. They each tell a different part of the story. When used together, they give us the clearest picture of what is going on with your prostate.
If you are dealing with urinary symptoms, concerned about an enlarged prostate, or just want peace of mind, the best thing you can do is speak with someone who really listens and understands.
That is exactly what you will get with Dr. Mahesh K Dhanjee. He is not just up to date with the latest surgical techniques and diagnostic tools he genuinely takes time with each patient. No rushed appointments. No awkward silences. Just clear answers and respectful care.
Whether it is prostatic disease, erectile dysfunction, renal stones, or even paediatric urology, Dr. Mahesh treats these conditions every week with expertise and empathy.
If something feels off, do not wait. You are not alone in this and there is nothing to feel embarrassed about.
Let us get you clarity and comfort—book your consultation today.
Frequently Asked Questions
Is PSA testing better than a DRE?
Not necessarily. PSA tests are more sensitive, but DREs can identify issues that blood tests miss. Using both gives the most accurate picture.
Can an enlarged prostate increase PSA levels?
Yes, an enlarged prostate can raise PSA levels without the presence of cancer. That is why interpretation by a qualified urologist is crucial.
How often should men get screened?
It depends on your age and risk factors. Men over 50 should discuss prostate screening every 1–2 years with their doctor.
Are there risks to PSA testing?
Yes. False positives can lead to unnecessary biopsies or stress. That is why combining it with a DRE and follow-up is recommended.
Can you feel an enlarged prostate during a DRE?
Often yes. A urologist in Dubai can detect irregularities in shape or size during the exam.
