Which Tests Should Be Performed In The Diagnosis Of Prostatitis
In acute bacterial prostatitis, most patients have pyuria and bacteruria, allowing the infecting organism to be isolated by midstream urine collection. Blood cultures, a complete blood count , and a basic metabolic panel should be obtained.
In chronic bacterial prostatitis, bacteria and leukocytes may or may not be observed in prostate-specific secretions . More than 15 leukocytes/HPF is abnormal.
Symptoms Of Chronic Bacterial Prostatitis
Bacterial infections in the prostate can be very painful.
The symptoms begin slowly and last 3 months or longer. Seek medical attention if you have any of the following symptoms:
Serious complications can arise if an infection isnt properly treated. Complications include:
- urinary retention, which is an inability to urinate
- , which occurs when bacteria spread into the bloodstream
- a prostate abscess, which is a collection of pus that causes inflammation
A bacterial infection causes chronic bacterial prostatitis. Even when the primary symptoms of infection have been treated, bacteria may continue to thrive in the prostate.
Causes of infection include:
- sexually transmitted infections , such as chlamydia and gonorrhea
- E. coli after having an infection of the testicles, urethritis , or a UTI
Certain factors put people at risk for developing this condition, such as:
The Sperling Prostate Center Solution
New hope: A 3T multiparametric MRI before a biopsy helps correct diagnosis.
Thanks to our pioneering use of 3T mpMRI BlueLaser, the Sperling Prostate Center is a recognized leader in identifying prostate diseases. Our 3T mpMRI BlueLaser is superior to CT and ultrasound in defining abnormal tissue in the prostate and its surroundings. When interpreted by our expert readers, it reveals prostate abnormalities that distinguish prostatitis from benign prostatic hyperplasia or prostate cancer.
The type of imaging we offer using our powerful, state-of-the-art MRI uses specialized sequences, or parameters, that reveal distinctive characteristics of prostatitis such as cellular differences, and blood flow that distinguishes inflammation vs. prostate cancer.
During a scan for prostatitis, if an area is detected that is suspicious for prostate cancer, a targeted in-bore mpMRI-guided biopsy using minimal needles can be done to rule out prostate cancer.
How Is The Psa Test Used In Men Who Have Been Treated For Prostate Cancer
The PSA test is often used to monitor patients who have a history of prostate cancer to see if their cancer has recurred . If a mans PSA level begins to rise after prostate cancer treatment, it may be the first sign of a recurrence. Such a biochemical relapse typically appears months or years before other clinical signs and symptoms of prostate cancer recurrence.
However, a single elevated PSA measurement in a patient who has a history of prostate cancer does not always mean that the cancer has come back. A man who has been treated for prostate cancer should discuss an elevated PSA level with his doctor. The doctor may recommend repeating the PSA test or performing other tests to check for evidence of a recurrence. The doctor may look for a trend of rising PSA level over time rather than a single elevated PSA level.
How Is Prostatitis Diagnosed
Your urologist will ask you questions about the symptoms you have and are currently experiencing and about your medical history. Please click here to complete a chronic prostatitis symptom score
You will then be examined, and this will include an examination of your tummy , testicles and a digital rectal examination to feel the prostate gland. A urine dipstick will be performed to see if there is any evidence of blood in the urine or of a urinary infection, and the specimen may then be sent off for a urine culture.
Your PSA blood test may be taken, although the value of this is uncertain.Your urologist may ask you to perform a flow test to see how fast you pass urine. You will need to have a comfortably full bladder to do this. It involves passing urine as usual, but into a funneled tube which collects the urine and can measure how much you pass per second. Following this you will have a bladder scan, which takes just a minute and involves passing an ultrasound probe over the lower part of your tummy to see how much urine you leave in your bladder.You may also need to undergo a cystoscopy to examine the prostate and bladder further. This test is completed in the hospital, and takes about ten minutes. A small telescope is inserted into the urethra after an anaesthetic gel is applied. This telescope allows the specialist to see your prostate and bladder, and see if there are any abnormalities or inflammation. to read our information leaflet about flexible cystoscopy
Use In Men Who Might Have Prostate Cancer
The PSA blood test is used mainly to screen for prostate cancer in men without symptoms. Its also one of the first tests done in men who have symptoms that might be caused by prostate cancer.
PSA in the blood is measured in units called nanograms per milliliter . The chance of having prostate cancer goes up as the PSA level goes up, but there is no set cutoff point that can tell for sure if a man does or doesnt have prostate cancer. Many doctors use a PSA cutoff point of 4 ng/mL or higher when deciding if a man might need further testing, while others might recommend it starting at a lower level, such as 2.5 or 3.
- Most men without prostate cancer have PSA levels under 4 ng/mL of blood. Still, a level below 4 is not a guarantee that a man doesnt have cancer.
- Men with a PSA level between 4 and 10 have about a 1 in 4 chance of having prostate cancer.
- If the PSA is more than 10, the chance of having prostate cancer is over 50%.
If your PSA level is high, you might need further tests to look for prostate cancer.
To learn more about how the PSA test is used to look for cancer, including factors that can affect PSA levels, special types of PSA tests, and what the next steps might be if you have an abnormal PSA level, see Screening Tests for Prostate Cancer.
When To Get Medical Advice
See a GP if you have symptoms of prostatitis, such as pelvic pain, difficulty or pain when peeing, or painful ejaculation.
They’ll ask about the problems you’re having and examine your tummy.
You may also have a rectal examination. This is where a doctor inserts a gloved finger into your bottom to feel for anything unusual. You may have some discomfort during this examination if your prostate is swollen or tender.
Your urine will usually be tested for signs of infection, and you may be referred to a specialist for further tests to rule out other conditions.
See a GP straight away if you get sudden and severe symptoms of prostatitis.
You may have acute prostatitis, which needs to be assessed and treated quickly because it can cause serious problems, such as suddenly being unable to pee.
If you have persistent symptoms , you may be referred to a doctor who specialises in urinary problems .
Read Also: Can Enlarged Prostate Cause Blood In Urine
Biopsy During Surgery To Treat Prostate Cancer
If there is more than a very small chance that the cancer might have spread , the surgeon may remove lymph nodes in the pelvis during the same operation as the removal of the prostate, which is known as a radical prostatectomy .
The lymph nodes and the prostate are then sent to the lab to be looked at. The lab results are usually available several days after surgery.
What Is The Prognosis For Prostatitis Does It Increase The Risk Of Developing Prostate Cancer
Prostatitis caused by bacterial illness often can be treated with antibiotics, or the condition can be chronic that recurs and requires long-term medical attention.
- Acute bacterial prostatitis can often be treated very successfully and has a very good prognosis.
- Chronic prostatitis, and especially chronic nonbacterial prostatitis, can often lead to long-term symptoms and discomfort if treatment is unsuccessful. It is important to have close follow-up and continued care by either your primary care doctor or a urologist.
- Prostatitis does not increase your risk of developing prostate cancer.
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What Are Some Of The Limitations And Potential Harms Of The Psa Test For Prostate Cancer Screening
Detecting prostate cancer early may not reduce the chance of dying from prostate cancer. When used in screening, the PSA test can help detect small tumors that do not cause symptoms. Finding a small tumor, however, may not necessarily reduce a mans chance of dying from prostate cancer. Many tumors found through PSA testing grow so slowly that they are unlikely to threaten a mans life. Detecting tumors that are not life-threatening
that requires treatment.
What Research Is Being Done
Researchers are trying to find out more about prostatitis so that they can develop better treatments.
Theyre looking into the causes of CPPS and why it affects men differently. This includes looking at the genes involved. A better understanding of the causes will mean that, in the future, treatments can be tailored to suit each man.
Theyre also looking into different treatments. These include a number of medicines, botox, surgery, and using small electrical currents to reduce pain.
Another area of research is looking at ways to help men live with CPPS, such as cognitive behavioural therapy , and ways men can take more control themselves such as with diet and supplements.
At the moment, most of the research is happening in other countries, but if youre interested in taking part in a clinical trial, mention this to your doctor. There might be trials you can join in the future.
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What Is The Prostate Gland What Does It Look Like
The prostate gland is part of the male reproductive system, and it is a walnut-sized gland found in men that is located below the bladder and in front of the rectum. It surrounds the urethra, the tube through which urine and semen exit the body. Its main function is to produce seminal fluid in order to transport sperm through the urethra.
Tests To Diagnose And Stage Prostate Cancer
Most prostate cancers are first found as a result of screening. Early prostate cancers usually dont cause symptoms, but more advanced cancers are sometimes first found because of symptoms they cause.
If prostate cancer is suspected based on results of screening tests or symptoms, tests will be needed to be sure. If youre seeing your primary care doctor, you might be referred to a urologist, a doctor who treats cancers of the genital and urinary tract, including the prostate.
The actual diagnosis of prostate cancer can only be made with a prostate biopsy .
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Tests For Chronic Bacterial Prostatitis
Your doctor will ask about your symptoms and any similar problems youve had before. This is because chronic bacterial prostatitis tends to affect people whove had infections in the past. They will then try to rule out other problems that could be causing your symptoms. For example, theyll ask you to have a urine test to make sure you dont have a urine infection. They may also do some further tests ask your doctor for more information about these.
How To Check Your Prostate
This article was co-authored by Robert Dhir, MD. Dr. Robert Dhir is a board certified Urologist, Urological Surgeon, and the Founder of HTX Urology in Houston, Texas. With over 10 years of experience, Dr. Dhirs expertise includes minimally-invasive treatments for enlarged prostate , kidney stone disease, surgical management of urological cancers, and mens health . His practice has been named a Center of Excellence for the UroLift procedure, and is a pioneer in non-surgical procedures for ED using his patented Wave Therapy. He earned his undergraduate and medical degrees from Georgetown University and was awarded honors in pre-medical studies, urology, orthopedics, and ophthalmology. Dr. Dhir served as chief resident during his urological surgical residency at University of Texas at Houston / MD Anderson Cancer Center in addition to completing his internship in general surgery. Dr. Dhir was voted Top Doctor in Urology for 2018 to 2019, one of the top three Best Rated Urologists in 2019 & 2020 for Houston Texas, and Texas Monthly has named him to the 2019 & 2020 Texas Super Doctors Rising Stars list.wikiHow marks an article as reader-approved once it receives enough positive feedback. This article has 11 testimonials from our readers, earning it our reader-approved status. This article has been viewed 1,025,150 times.
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Psa Screening Blood Test
A Prostate-specific antigen is made by the cells of the prostate gland. PSA testing is a common method to test for prostate cancer. PSA is found in semen, with a small amount in the blood. Men without prostate cancer often have PSA levels under 4 nanograms per milliliter of blood. Elevated PSA level increases the likelihood of having prostate cancer .
The American Cancer Society reports that men with a total PSA level of between 4 and 10 have roughly a 1 in 4 chance of having prostate cancer. With a total PSA of over 10, the chance of having prostate cancer rises to over 50%. Following the PSA test, if the levels are high, a doctor may suggest a repeat screening test or a prostate biopsy.
In addition to prostate cancer, there are many other factors that can affect a mans PSA levels.
Reasons for a High PSA:
Reasons for a Low PSA:
What Natural Or Home Remedies Relieve Pain Symptoms And Treat Prostatitis
In addition to medical treatment, natural home remedies for prostatitis include:
- Warm sitz baths
- Avoid alcohol, caffeine, and spicy foods.
- Prostate massage: In a few studies, prostate massage has been shown to decrease symptoms in some patients with chronic nonbacterial prostatitis.
- Lifestyle changes: If you cycle or ride horses, it is recommended to suspend this activity until you improve.
- Although there are many herbal preparations available, there is no current evidence that herbal remedies are definitely helpful with prostatitis.
- Acupuncture has shown a decrease in symptoms for some people who suffer from prostatitis.
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What Is The Prostate
The prostate is a walnut-shaped gland that is part of the male reproductive system. It has two or more lobes, or sections, enclosed by an outer layer of tissue. The prostate is located in front of the rectum and just below the bladder, where urine is stored. It surrounds the urethra at the neck of the bladder and supplies fluid that goes into semen.
Postvoid Residual Urine Volume Measurement
Measurement of the postvoid residual urine volume may be helpful in the older patient for whom prostatism is suspected. Although this measurement is traditionally performed via catheterization, some institutions are now using ultrasonography for this measurement. If the postvoid residual urine volume is elevated, then a urinary catheter must be placed and urologic consultation obtained.
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Getting The Results Of The Biopsy
Your biopsy samples will be sent to a lab, where they will be looked at with a microscope to see if they contain cancer cells. Getting the results usually takes at least 1 to 3 days, but it can sometimes take longer. The results might be reported as:
- Positive for cancer: Cancer cells were seen in the biopsy samples.
- Negative for cancer: No cancer cells were seen in the biopsy samples.
- Suspicious: Something abnormal was seen, but it might not be cancer.
If the biopsy is negative
If the prostate biopsy results are negative , and the chance that you have prostate cancer isnt very high based on your PSA level and other tests, you might not need any more tests, other than repeat PSA tests sometime later.
But even if many samples are taken, biopsies can still sometimes miss a cancer if none of the biopsy needles pass through it. This is known as a false-negative result. If your doctor still strongly suspects you have prostate cancer , your doctor might suggest:
- Getting other lab tests to help get a better idea of whether or not you might have prostate cancer. Examples of such tests include the Prostate Health Index , 4Kscore test, PCA3 tests , and ConfirmMDx. These tests are discussed in Whats New in Prostate Cancer Research?
- Getting a repeat prostate biopsy. This might include getting additional samples of parts of the prostate not biopsied the first time, or using imaging tests such as MRI to look more closely for abnormal areas to target.
Prostate cancer grade
How Is Prostatitis Treated
Treatment depends on the type of prostatitis.
Chronic prostatitis/chronic pelvic pain syndrome. Treatment for chronic prostatitis/chronic pelvic pain syndrome aims to decrease pain, discomfort, and inflammation. A wide range of symptoms exists and no single treatment works for every man. Although antibiotics will not help treat nonbacterial prostatitis, a urologist may prescribe them, at least initially, until the urologist can rule out a bacterial infection. A urologist may prescribe other medications:
- 5-alpha reductase inhibitors such as finasteride and dutasteride
- nonsteroidal anti-inflammatory drugsalso called NSAIDssuch as aspirin, ibuprofen, and naproxen sodium
- cans such as chondroitin sulfate
- muscle relaxants such as cyclobenzaprine and clonazepam
- neuromodulators such as amitriptyline, nortriptyline , and pregabalin
Alternative treatments may include
- warm baths, called sitz baths
- local heat therapy with hot water bottles or heating pads
- physical therapy, such as
- Kegel exercisestightening and relaxing the muscles that hold urine in the bladder and hold the bladder in its proper position. Also called pelvic muscle exercises.
- myofascial releasepressing and stretching, sometimes with cooling and warming, of the muscles and soft tissues in the lower back, pelvic region, and upper legs. Also known as myofascial trigger point release.
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