Prostatic enlargement

The possibility of prostatic carcinoma should always be considered.

Prostate specific antigen (PSA) is the test of choice, but results must be interpreted in conjunction with other clinical findings, particularly the findings on rectal examination.

A normal PSA level does not exclude the diagnosis of carcinoma; increased levels are not specific for prostatic carcinoma. Acid phosphatase is less sensitive and less specific than PSA and should not be used.

Prostate biopsy under ultrasound guidance if clinical assessment and PSA are suggestive of malignancy.