Radical Cure Article

How is Prostatitis Diagnosed?

Prostatitis is a frequently painful condition that affects mostly young and middle-aged men. Researchers estimate that 10 to 12 percent of men experience prostatitis-like symptoms. Doctors may have difficulty diagnosing prostatitis because the symptoms are not the same for every patient, and many of the symptoms—such as painful or burning urination and incomplete emptying of the bladder—could be signs of another disease.


But how is prostatitis diagnosed?


A doctor performs a digital rectal exam (DRE) by inserting a gloved and lubricated finger into the patient’s rectum, just behind the prostate. The doctor can feel the prostate to see if it is swollen or tender in spots.


The doctor can diagnose the bacterial forms of prostatitis by examining a urine sample with a microscope. The sample may also be sent to a laboratory to perform a culture. In a urine culture, the bacteria are allowed to grow so they can be identified and tested for their resistance to different types of antimicrobials.


To confirm the prostate infection, the doctor may obtain two urine samples—before and after prostate massage. To perform a prostate massage, the doctor will insert a gloved and lubricated finger into the rectum, as in a DRE, and stroke the prostate to release fluids from the gland. The post-massage urine sample will contain prostate fluid. If that second urine sample contains bacteria or infection-fighting cells that were not present in the premassage urine sample, this suggests the prostate contains infection.


The need for other blood tests or imaging studies like ultrasound, X-ray, and computerized tomography (CT) will depend upon the clinical situation and presentation.


To diagnose chronic prostatitis/chronic pelvic pain syndrome, the doctor must rule out all other possible causes of urinary symptoms, such as kidney stones, bladder disorders, and infections. Since many different conditions must be considered, the doctor may order a full range of tests, including ultrasound or magnetic resonance imaging (MRI), biopsy, blood tests, and tests of bladder function.


If all other possible causes of a patient’s symptoms are ruled out, the doctor may then diagnose chronic prostatitis/chronic pelvic pain syndrome. To aid in understanding the symptoms and measuring the effects of treatment, the doctor may ask a series of questions from a standard questionnaire, the NIH-Chronic Prostatitis Symptom Index.

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