Prostatitis

Diagnosis

Your physician will ask about your symptoms, and will conduct a prostate exam and urine test to confirm a diagnosis. Gently palpating the prostate gland will help your physician to determine whether you have prostatitis. In acute prostatitis, the gland will be tense or boggy, and will feel extremely tender. Fever is also very common. A urine sample and bacterial stain and culture may be sufficient to confirm the diagnosis.

Symptoms of chronic prostatitis are less defined, and are more difficult to diagnose. To diagnose chronic prostatitis, your physician will usually compare levels of bacteria in a series of urine tests, which will identify the cause and location of your urinary tract infection. The physician will ask for a specimen from the morning's first urination (called first-void), and a midstream specimen. The amount of bacteria in these samples will be compared with a urine sample taken after the physician massages your prostate. Your doctor will also culture secretions expressed from the prostate. He or she will do this in the office by inserting a gloved finger into your rectum, and gently pushing on your prostate. If high level of bacteria are found in the sample that comes from a prostate massage, and again in a urine sample following the massage, then you will likely be diagnosed with prostatitis. The same series of tests may identify an increased number of white blood cells in the expressate and postmassage urine in nonbacterial prostatitis, which suggests inflammation and infection.

Prostate massage is generally not recommended for acute prostatitis, as it could injure the gland and cause the bacteria to spread to the circulatory system.