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How is Prostatitis Diagnosed?

Digital Rectal Exam (DRE)

If your health care provider suspects a problem with your prostate or nearby tissues, he/she may send you to a urologist. A urologist is a doctor who treats problems of the urinary tract and male reproductive systems.

Each type of prostatitis calls for a different treatment. Your doctor will want to know exactly what is causing your symptoms. To find the answers, more than one type of test may be used.

Questionnaire

Your health care provider may ask you to fill out a questionnaire to understand your pain. One kind is the NIH Chronic Prostatitis Symptom Checklist. This questionnaire asks about your symptoms and how they feel to you.

Male Cytoscopy
Digital Rectal Exam of the Prostate

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 doctor will press and feel the prostate to see if it is enlarged or tender. Lumps or firmness can suggest prostate cancer. He/she will ask you how much pain you feel during this test. If you have prostatitis, this exam may 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. An ultrasound uses sound waves to show a picture of the prostate. To "see" the prostate, the ultrasound probe is placed in the rectum.

Urine and prostate fluid tests

Your doctor may test your urine and fluid from your prostate gland. 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 tell the doctor if the 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, this can change the 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.