Diagnosing & Tests for Prostatitis
Diagnosing and performing tests for prostatitis can be challenging not just because there are many similar conditions to prostatitis but because there are various prostatitis causes. Only about 5 to 10% of prostatitis cases are caused by some type of bacterial infection. When no bacteria can be found, such as with most cases of chronic pelvic pain syndrome (CPPS), doctors usually consider other causes of prostatitis symptoms. The different causes range from a variety of triggers including inflammation, chronic tension disorders, stress, autoimmune disorders, food intolerance, genetics, pelvic floor spasm, and many more.
Because about 90 to 95% of prostatitis cases are CPPS, diagnosing prostatitis is not that easy, and once the type of prostatitis is diagnosed, your prostatitis treatment may involve trying many different therapies. It may take several different treatments in a multimodal approach to eventually cure the problem.
If a healthcare provider has identified bacteria as the reason for your prostatitis symptoms, he or she can prescribe treatment with antibiotics. But even bacterial cases are not that simple. Cases of chronic bacterial prostatitis may require two to four (sometimes even six) weeks of antibiotics and may require some natural prostatitis treatments in addition to the antibiotics. Keep in mind that if you feel better while taking antibiotics but then feel worse after you stop taking antibiotics, it does not necessarily mean that you have a bacterial infection. Antibiotics such as quinolones, macrolides, and tetracyclines are also powerful anti-inflammatory drugs that directly block cytokines, which are substances secreted by immune system cells involved in cell communication and generating an immune response. If your prostatitis is caused by, say, pelvic muscle dysfunction, antibiotics are not going to relieve the problem (even if you felt slightly better while on them).
There are general tests for prostatitis that your doctor will perform when diagnosing prostatitis. Your physician will take your complete medical history at the time of the evaluation including having you answer questions from the Chronic Prostatitis Symptoms Index (CPSI), a test that looks at the scale of your symptoms. Share with your doctor any past medical problems, surgeries (especially urologic), trauma, medications, and allergies. Your doctor should ask about the location of your pain and its severity, location, and duration. He or she will ask you about lower urinary tract symptoms and other symptoms such as fever or other pain syndromes such as sexual pain and health. Be prepared to talk about the impact your symptoms have had on your quality of life including your sex life.
You will undergo a complete examination of your abdomen, external genitalia, perineum, and prostate. You will be asked to provide a urine culture. Your doctor may order various tests and imaging to help diagnose your prostatitis. You can learn more about the specific tests for prostatitis in General Tests for Prostatitis—What to Expect.