Diagnosing Prostatitis

What is prostatitis?

Prostatitis is a condition that occurs when the prostate gland becomes inflamed. The prostate gland is approximately the size of a walnut and is located just below a man's bladder. Inflammation can spread to other areas surrounding the prostate.

The prostate gland surrounds the upper portion of the urethra, which is the tube that carries urine from the bladder. The prostate, along with other glands, produce fluid (semen) to protect sperm as they travel.

Diagnosis

Diagnosis consists of a medical history evaluation, physical examination, and other testing deemed necessary. Additional testing can rule out other conditions or determine the cause of prostatitis. Testing for prostatitis may include the following:

Digital rectal exam (DRE)

A digital rectal exam (DRE) detects pain and inflammation of the prostate gland. A health care professional inserts a gloved, lubricated finger into the rectum to feel the prostate. They may also massage the prostate to collect a sample of seminal fluid to test for bacteria.

Urinalysis

A urine sample determines if bacteria is present in the urine. It can also recognize the presence of a urinary tract infection (UTI).

Urodynamic tests

If no signs of infection are present, an urodynamic test identifies the source of urinary issues by measuring how well the bladder and urethra hold and release urine. Urodynamic tests may include the following:

• Cystometry measures pressure inside the bladder to identify how much it can hold and its elasticity.
• Uroflowmetry measures quantity and quickness of urination.
• Postvoid residual measurement determines the amount of fluid remaining in the bladder following urination.
• Video urodynamic tests include a combination of cystometry, uroflowmetry, and X-ray cystography.
• Electromyography measures electrical activity of the muscles and nerves around the bladder.

Blood test

A blood test inspects PSA (prostate-specific antigen) levels. PSA is a protein that is produced by the prostate. High PSA levels may indicate BPH (benign prostatic hyperplasia) or prostate cancer. A blood test can also discover an infection.

Prostatic specimen test

During a digital rectal exam, a health care professional gently massages the prostate to release fluid into the urethra. A urine sample expels the fluid to check for the presence of bacteria.

Imaging tests

Possible imaging tests include the following:

• A CT scan or MRI of the prostate looks for prostate irregularities, growths, or other issues causing pain. An MRI provides a more detailed image if the rectal exam was atypical.
• Transrectal ultrasound consists of inserting a slender wand into the rectum to gather prostate images. This is typically completed when antibiotics do not help acute or chronic bacterial prostatitis.
• Cystoscopy is a procedure that involves insertion of a small tube into the urethra to view the bladder. It determines if an enlarged prostate is causing the urethra to constrict.