Prostatitis Diagnosis   

The first step your doctor will take to examine your prostate is a digital rectal examination (DRE). During the exam, your physician will use a gloved, lubricated finger to check for abnormalities in your prostate gland: enlarged prostate , swelling and tenderness of the scrotum, etc. However, the digital rectal exam is not enough to confirm the diagnosis; other tests such as urine and semen test , vesicoprostatic ultrasound, cystoscopy and biopsy of the prostate will be performed to accurately diagnose the prostatitis. 

Digital rectal exam (DRE) - during this proctologic exam, your doctor introduces a gloved, lubricated finger into your rectum through the anus to detect any sign that indicates prostatitis. In case of prostatitis, the prostate is enlarged and painful. Although painless, this exam, however, can be uncomfortable for some patients. DRE can only reveal if the prostate is tender or inflamed; it cannot determine the causative factor of the disorder. 

Urine and semen test – to do this test, a lab specialist will take sample of your urine and semen to look for bacteria and white blood cells. This exam will detect the germs responsible for the infection, and pus in the urine if there is any. The prostatitis is most often caused by Chlamydia trachomatis in patients under 35 years, and Escherichia coli (E.coli) in older patients.  

Vesicoprostatic ultrasound – this imaging technique is a noninvasive medical test that helps your physician to diagnose prostatitis and other medical conditions. It allows your health care provider to examine your bladder and prostate gland and their surrounding tissue. During the procedure, the specialist inserts an ultrasound probe into your rectum, which allows him/her to detect abnormal change in your prostate and bladder.  

Cystoscopy - your doctor may recommend a cystoscopy of your urethra and bladder. Under local anaesthesia, a tube with a small camera on the end called cystoscope is inserted through your urethra and into the bladder. It allows your doctor to take picture of the inside of your bladder and urethra. Cystoscopy is performed in case of recurrent prostatitis to rule out other disorders of the prostate gland. 

Prostate biopsy - to rule out prostate cancer, your doctor may recommend a biopsy of prostate. During the procedure, small samples of your prostate gland are taken to be examined under microscope to look for the presence of cancer cells. After the biopsy, for several days or even several weeks, you will tend to have: 

·         Bleeding in the urine  

·         Bleeding in the stool 

·         Blood in the ejaculate. 

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