Urinalysis is typically performed when LUTS are present and BPH is suspected to evaluate for signs of a urinary tract infection, glucose in the urine (suggestive of diabetes), or protein in the urine (suggestive of kidney disease).  Bloodwork including kidney function tests and prostate specific antigen (PSA) are often ordered to evaluate for kidney damage and prostate cancer, respectively.  However, checking blood PSA levels for prostate cancer screening is controversial and not necessarily indicated in every evaluation for BPH.  Benign prostatic hyperplasia and prostate cancer are both capable of increasing blood PSA levels and PSA elevation is unable to differentiate these two conditions well.  If PSA levels are checked and are high, then further investigation is warranted. Measures including PSA density, free PSA, rectal examination, and transrectal ultrasonography may be helpful in determining whether a PSA increase is due to BPH or prostate cancer.  Ultrasound examination of the testes , prostate, and kidneys is often performed, again to rule out cancer and hydronephrosis .
Also being studied is a procedure called water-induced thermotherapy (WIT), an experimental procedure that involves destroying excess prostate tissue utilizing heated water and an air-filled balloon, which protects normal prostate tissue. The procedure is performed with only local anesthesia. Results may not be fully apparent for three to four months. However, preliminary studies examining WIT have shown positive results, with a near doubling in urine flow. However, the American Urological Association has not thus far endorsed WIT as a viable treatment option for symptoms of BPH.