Tests for Non-Bacterial Prostatitis
Undergoing tests for non-bacterial prostatitis is more involved than testing for bacterial prostatitis simply because there can be many different causes of non-bacterial prostatitis. Many of the causes of non-bacterial prostatitis actually originate outside of the prostate. Also called chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), this category of prostatitis makes up 90 to 95% of all the cases of prostatitis, and yet it is the hardest and most frustrating type of prostatitis to treat. Because bacteria are not a cause of CP/CPPS, antibiotics are not recommended and will not work. That is why it is important for your doctor your correctly diagnose CP/CPPS when conducting tests for non-bacterial prostatitis.
When you visit your doctor for testing for non-bacterial prostatitis, it is recommended to fill out a symptom scoring questionnaire to evaluate the severity of your current symptoms. The National Institutes of Health Chronic Prostatitis Symptoms Index (NIH-CPSI) is an established international standard for symptoms evaluation.
Your doctor will conduct a physical examination of your abdomen, external genitalia, prostate, and perineum. When your doctor performs a digital rectal exam (DRE), he or she may apply pressure. It is normal to feel your pelvic pain get worse during the DRE, and this increase in pain can help identify the location of your pelvic pain and any myofascial trigger points. You doctor may also find any possible musculoskeletal dysfunction of your pelvic floor or pelvis during this exam, and this may help guide treatment as well.
It is recommended to use a Meares-Stanley “Four Glass Test” or even a 2-glass pre- and post-massage test (PPMT) when testing for non-bacterial prostatitis. If you have any urinary voiding problems, your doctor may recommend a urodynamic evaluation to check your urine flow rates, post-void residual volume, and pressure flow. The following tests are not recommended because they have not been found helpful in diagnosing CP/CPPS: semen culture, cystoscopy, transrectal ultrasound, CT scan or MRI, and PSA test.
There is increasing evidence that some cases of CP/CPPS are associated with psychological causes like depression, problems with coping, and poor social support. You physician may screen for these types of problems.