Dr. Francisco Manuel Antuña
Dr. Francisco Manuel Antuña

Diagnostic investigations

The basis for effective treatment is an accurate diagnosis. Diagnostic tests help to determine the pathology present and its extent, enabling specialist doctors to approach effective treatment more precisely, according to each patient’s individual needs.
At HC Marbella we provide personalized care, starting with a consultation with the urologist who will evaluate the tests required to deliver an accurate diagnosis and plan the best treatment for each patient.

The PSA test measures the level of prostate-specific antigen in the blood. This antigen is produced by both benign tissue and malignant tumours of the prostate gland.
Normal PSA values are ≤ 4 ng/mL. An increase in these values may be indicative of the presence of prostate cancer or benign prostatic hyperplasia.
This test is usually accompanied by a rectal examination, depending on the results, other imaging tests may be considered.

Urological ultrasound is a common diagnostic test performed by urologists during a consultation, it provides an initial assessment of the urinary tract and the male reproductive system.
Depending on its location it may be:

  • Of the bladder: this is for observation of the bladder and analysis of the thickness of the bladder wall, it checks for any obstruction that could make urination difficult.
    Bladder ultrasound enables the specialist to detect calculi or stones in the bladder and bladder tumours. It also helps to identify any signs of benign prostatic hyperplasia.

  • Of the prostate: this is performed abdominally and is used to assess the state of the prostate, its size and shape. It helps to detect or rule out possible tumours.

  • Of the kidneys: this is to visualize the structures of the kidney, checking for kidney cysts, solid tumours or kidney stones.

Transrectal ultrasound is performed using a probe introduced into the rectum. It allows imaging at different angles and estimation of the size and weight of the prostate, determining whether cancer or other pathologies are suspected.
Sometimes if suspicious tissue is detected during the investigation, a needle biopsy may be performed at that time.
This procedure is indicated for the diagnosis of prostate cancer, benign prostatic hyperplasia, and acute/chronic prostatitis.

This is an endoscopic procedure performed by inserting a flexible tube with a built-in camera (cystoscope) through the urethra. It enables observation, evaluation, and diagnosis of diseases of the urethra, prostate, and particularly the bladder.
Although it may be a little uncomfortable, it is a minimally invasive and safe procedure which is not painful and does not usually require anaesthesia.
It is indicated for the assessment of haematuria (blood in the urine) and monitoring of bladder tumours.

Uroflowmetry is a common diagnostic technique performed in urology outpatients and is indicated in patients who have some type of difficulty urinating.
It is a non-invasive test that aims to assess the volume of urine voided, the rate at which it is passed, and the time it takes to do this.
Abnormal flow when voiding may be a symptom of diseases such as urinary tract infection, calculi or stones, urethral stricture, prostatic hypertrophy or urinary tract tumour.

This is a diagnostic technique that is performed by administering intravenous contrast when obtaining images of the urinary tract (kidneys, ureters and bladder).
CT Urogram is indicated for:

  • Patients with haematuria (blood in the urine)
  • Lithiasis (kidney or bladder stones)
  • Cancer of the urinary tract
  • Kidney infection (pyelonephritis)

Our 3 Tesla MRI scanner provides high quality images which are essential to determine an accurate diagnosis.
It enables the prostate to be analysed in detail to show:

  • Whether the prostate is healthy.
  • Whether it is enlarged (Benign Prostatic Hyperplasia).
  • Whether there is any suspicious tissue, such as a malignant tumour.

If there is suspected tumour tissue, a biopsy is necessary to determine whether the tumour is malignant. Multiparametric magnetic resonance imaging is a critical investigation when undertaking fusion biopsy. During this procedure, the high-resolution image of the MRI is merged with the ultrasound image, serving as a map to identify the affected area and enabling an effective sample of the affected tissue to be obtained.

A biopsy is a procedure in which a sample of tissue is obtained to determine whether it is benign or malignant.
Fusion biopsy is a technique in which two images are fused, the image from the previous MRI and the real-time ultrasound image, the two together providing a detailed, three-dimensional image of the prostate.
MRI provides the map, telling us where the lesion is, ultrasound allows us to guide the biopsy needle into the suspicious tissue to obtain a much more accurate specimen.
This specimen is then tested using microscopy to check for cancer cells.
Thanks to this minimally invasive procedure, we can detect early-stage cancers and improve treatment planning.
Using fusion biopsy we can detect the presence of prostate cancers in 70% of cases, this is much more reliable than other more conventional techniques and significantly decreases the need for second or third biopsies.

PET-CT is a fundamental test in cancer diagnosis. It provides information on the location of the tumour (anatomical) and information about its behaviour (metabolic).
For Prostate Cancer, a prostate-specific radiopharmaceutical called F18-Choline is administered, this is a radiotracer that preferentially attaches to prostate tumour cells.
It is indicated in patients with high-risk prostate cancer or patients being monitored when recurrence is suspected. It provides information about spread of the disease, whether it is localized, or whether prostate cancer cells can be detected elsewhere in the body.


Dr. Arrazola, Tomás
Especialista en Farmacia Hospitalaria
Especializado en terapia contra el cáncer, certificado por la Sociedad Americana de Farmacéuticos de Hospital

Tel.: +34 952 908 628

952908898 Oncology
951829978 Diagnosis by imaging
951829947 Gynecology
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