Prostatitis Diagnosis

Prostatitis is a common male urinary system disease, particularly prevalent among men aged 20 to 50. Failure to achieve accurate early diagnosis and timely intervention may lead to chronic pain, sexual dysfunction, and even infertility. Diagnosis mainly relies on medical history collection, physical examination, prostatic fluid analysis, and imaging studies to determine the cause and type, providing guidance for treatment.

Diagnostic Criteria for Prostatitis

1. Medical History Collection

Doctors ask about urinary symptoms, including frequency, urgency, dysuria, and lower abdominal discomfort, as well as perineal dull pain or painful intercourse. This helps in the preliminary determination of prostate-related disease and exclusion of other urinary tract conditions.

2. Digital Rectal Examination (DRE)

Through rectal examination, the prostate is palpated to detect tenderness, swelling, or nodules. In chronic prostatitis, the prostate may feel soft or mildly tender, while in acute cases, it often appears enlarged with significant tenderness.

3. Prostatic Fluid Analysis

After prostate massage, fluid is collected for microscopic examination to assess white blood cell count and lecithin body density. Increased white blood cells indicate inflammation, while reduced lecithin bodies may reflect impaired prostate function.

4. Urinalysis

Routine urinalysis may reveal white blood cells and bacteria, suggesting infection. The three-glass test helps distinguish prostatitis from urethritis or cystitis.

5. Bacterial Culture and Sensitivity Testing

Bacterial cultures of prostatic fluid or urine identify pathogens and guide antibiotic selection, especially important in chronic bacterial prostatitis.

6. PSA Testing

Prostate-specific antigen (PSA) is an important indicator of prostate health. PSA levels may rise slightly in prostatitis but are less pronounced compared to prostate cancer, aiding differential diagnosis.

7. Imaging Studies

Ultrasound or MRI helps evaluate prostate size, shape, and surrounding structures, ruling out nodules, calcifications, or other abnormalities for more comprehensive diagnosis.

8. Chronic Pelvic Pain Index (NIH-CPSI)

The NIH-CPSI scoring system evaluates symptom severity and quality-of-life impact in chronic prostatitis patients, aiding disease classification and treatment assessment.

Conclusion

Accurate diagnosis of prostatitis is crucial for symptom improvement and individualized treatment planning. Experts at United Life International Medical Center emphasize that early detection of inflammation, combined with systematic evaluation and classification, helps prevent recurrence, improves treatment efficacy, and enhances quality of life.