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How is Prostatitis Diagnosed?

If your health care provider suspects you have a problem with your prostate or nearby tissues, he or she may send you to a urologist.  A urologist is a doctor who treats problems of the urinary system and male reproductive system. Your urologist or other health care provider may run tests to figure out what is going on and how to help.

Each type of prostatitis calls for a different treatment. Your doctor will want to know which type you have and make sure other health problems aren't causing your symptoms. To find the answers, many types of tests are used.

Questionnaire

Your health care provider may ask you to fill out a questionnaire called the NIH Chronic Prostatitis Symptom Index. This questionnaire asks about your symptoms and how they affect you. You may be asked to fill this out many times during treatment to find out how well your treatment is working.

Digital Rectal Exam of the Prostate
Digital Rectal Exam of the Prostate
Alan Hoofring (Illustrator), National Cancer Institute

Transrectal Ultrasound
Transrectal Ultrasound
© 2010 Terese Winslow, U.S. Govt. has certain rights

Male Cytoscopy
Male Cytoscopy
Cancer Research UK

Uroflowmetry Equipment
Uroflowmetry Equipment
National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health

Cystometric test
Cystometric test
National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health

Physical Exam

Your health care provider may do a digital rectal exam (DRE). This is done by putting a lubricated, gloved finger into your rectum.

Your health care provider will press and feel the prostate to see if it is enlarged or tender. Lumps or firmness can suggest prostate cancer. Your health care provider will ask you how much pain or discomfort you feel when areas around the prostate are pressed. If you have prostatitis, this exam may be uncomfortable and hurt a bit. But it doesn't cause any harm or lasting pain.

Tests

Ultrasound

To get a closer look at the prostate gland, your health care provider may order a transrectal ultrasound. Ultrasound uses sound waves bouncing off an organ to show a picture of the organ. To "see" the prostate, the ultrasound probe is placed in the rectum.

Specimens

Your health care provider may test your urine and fluid from your prostate gland to find out what is causing your problems. When the prostate is massaged during the DRE, a fluid called expressed prostatic excretion (EPS) comes out of the penis. Urine and EPS are checked for signs of inflammation and infection. The test results may also show whether your problem is in your urethra, bladder, or prostate.

Your blood and semen may also be tested for bacteria, white blood cells, or other signs of infection. Because it can be hard to get good samples, health care providers can sometimes have trouble telling if prostatitis is caused by bacteria. Also, if you have been treated with antibiotics in the recent past, that can change the test results.

If you are at risk for cancer, your health care provider may order a blood test to check your prostate specific antigen (PSA) level. But if you have a prostate infection, your PSA can be falsely raised. Because of this, doctors are careful about how they read your PSA test results.

Cystoscopy

Your urologist may look inside your urethra, prostate, and bladder with a cystoscope. A cystoscope is a long, thin telescope with a light at the end. First, your urologist will numb your urethra. Then, he or she will gently guide the cystoscope through your urethra into the bladder.

Urine Flow Studies (Urodynamics)

Your urologist may also order urine flow studies or urodynamics. These help measure the strength of your urine flow. These tests also spot any blockage caused by the prostate, urethra, or pelvic muscles.