Diagnosis of Prostatitis
A digital rectal exam (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 prostate massage, with the collection and culture of any secretions produced, and a third urine sample that contains prostatic fluid.
During 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).