Diagnosis of Chronic Prostatitis

When doctors diagnose prostatitis, they often use the NIH-CPSI (National Institutes of Health Chronic Prostatitis Symptom Scale), which will be described in detail later in this manual. The scoring system lists a series of questions about the symptoms of prostatitis and the degree to which the patient is bothered.

After carefully filling in the form according to your condition, discuss the scoring results with your doctor. This is a way for you to participate in the diagnosis process. During the treatment, the doctor will ask you to answer the questions listed in the table again and judge the treatment effect by comparing the symptom scores before and after treatment.

In the outpatient department, besides asking you to fill in the scoring form, the doctor will also ask about your medical history and check your body.

The physical examination items include the digital rectal examination (DRE), that is, the doctor will wear gloves, apply paraffin oil to the index finger to lubricate, and then slowly extend the lubricated index finger into your rectum to check the size, texture, and sensitivity of the prostate, which will provide important information for the doctor.

During the examination, doctors may massage your prostate to obtain a sample of prostatic fluid. After the prostate massage, the expressed prostatic secretions(EPS) is discharged through the external orifice of the urethra, and then collected for examination under the microscope. Urine can also be examined and cultured under a microscope.

Some doctors also check your blood or semen samples. Doctors use these tests to find out if there is evidence of microbes, white blood cells, or other infections.

When there is no acute infection, cystoscopy will be used to exclude other diseases similar to prostatitis symptoms. The cystoscope has a light source and a magnifying lens, which is inserted into the urethra and slowly enters the bladder under direct vision. The bladder and prostate can be observed.

If necessary, the doctor may also carry out other tests, such as uroflowmetry (the rate of urine flow during urination), residual urine measurement (the amount of urine left in the bladder after urination), etc.

How to choose the right doctor?

Patients usually go to the community doctor first, then the community doctor gives the patient a physical examination, evaluates the patient's symptoms, and eliminates the possibility of urinary tract infection or other diseases. After the initial diagnosis, the patients were introduced by the community doctors and transferred to the urologists or andrologists for further diagnosis and treatment.

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