Prostatitis Diagnosis
A digital rectal examination (DRE) is used to determine if the prostate gland is tender or swollen. To perform a DRE, the physician inserts a lubricated, gloved finger into the patient's rectum to feel the surface of the prostate gland through the rectal wall and assess its size, shape, and consistency.
A three-part urinalysis is the standard diagnostic tool. Two urine specimens are collected and analyzed, followed by a prostate massage and a third urine sample is collected that contains prostatic fluid.
During the prostate massage, the physician inserts a lubricated, gloved finger into the rectum to massage the surface of each lobe of the prostate gland, resulting in the release of prostate fluids. Prostate massage should not be used if ABP is suspected because massage may encourage the spread of bacteria.
Urinalysis determines the presence of white blood cells (leukocytes) in the urine. Leukocytes help the body to fight infection; a high number indicates a bacterial infection. A urine culture is performed to identify bacteria.
Nonbacterial prostatitis is diagnosed when tests reveal no bacteria in the urine or prostatic secretions. There is no test to diagnose prostatodynia; it is diagnosed after eliminating other probable causes (e.g., kidney stones, interstitial cystitis, urethral cancer).
Prostatitis may increase the level of Prostate-specific antigen (PSA) in the blood. PSA is a substance naturally produced in the prostate gland, and high levels in the blood may sometimes - but not always - be a sign of prostate cancer. For that reason, if there is an elevation of PSA level and the patient also has acute prostatitis, he should be rechecked after he has been treated with antibiotics.
Videourodynamics: In cases where there is a history of chronic prostatitis, evaluation of potential contributing factors or underlying causes is done. Videourodynamics is a special examination that analyzes bladder function and the flow of the urine in the urinary tract. For instance, in patients with chronic prostatitis, this test can be helpful to find out whether any structure is producing blockage of the urinary tract.