Which examination best assesses benign prostatic hyperplasia?

• A. Digital Rectal Examination
• B. Transrectal Examination
• C. Pelvic Ultrasound
• D. Cystoscopy

Answer: (B)

Transrectal examination shines here because the prostate sits directly in front of the rectum, giving direct access to assess its size, contour, and internal architecture. This approach often pairs with ultrasound (transrectal ultrasound) to quantify prostate volume precisely, which is key in evaluating benign prostatic hyperplasia. By measuring how large the gland is and examining its internal zones, you can distinguish the smooth, symmetrical enlargement typical of BPH from other conditions that might mimic it, and you can gauge how much the urethra is being compressed.

Digital rectal examination alone can hint at enlargement but isn’t as reliable for sizing. Pelvic ultrasound can show size but doesn’t directly assess the gland’s relation to urinary flow or provide the same detailed internal assessment. Cystoscopy reveals the urethra and bladder neck but does not measure overall gland size or quantify obstruction.