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2023 Author: Alfred Shackley | [email protected]. Last modified: 2023-05-21 13:14
With prostatitis in men, an inflammatory process develops in the prostate gland, which is located under the bladder around its neck and is part of the reproductive system. The disease develops frequently, especially in sexually mature men between 20 and 40 years of age.
The risk of complications will be minimal if prostatitis treatment is started on time. Therefore, every man should know what allows him to suspect the development of the disease and how to diagnose prostatitis.
Diagnosis of prostatitis
An accurate diagnosis can only be made by a specialist urologist based on the results of the collected anamnesis and research.
Diagnostics includes the collection of laboratory tests, instrumental and physical (finger) methods.
As a rule, signs of prostatitis are detected already by finger feeling and questioning the patient. But to confirm the diagnosis, the doctor directs it to other studies.
The doctor selects diagnostic measures for each patient individually and only then prescribes adequate and effective treatment, taking into account the stage of the disease, its form, and the individual characteristics of the patient's body.
Methods for diagnosing prostatitis
Taking anamnesis
One of the important methods of examining this pathology is the collection of anamnesis, which is carried out by interviewing the patient with a doctor.
The following information is taken into account by polling:
- the duration of the course of the disease;
- the sequence of the onset of pronounced symptoms;
- factors provoking the appearance of exacerbations;
- previously transferred genital infections;
- information about the patient's sex life;
- information about previous treatment, its results;
- information about previous systemic diseases, operations on the pelvic organs.
It is the collection of anamnesis that allows a qualified doctor to obtain information for drawing up a plan for the further diagnosis of the patient and making him the correct diagnosis.
Physical (digital rectal)
The physical examination is a digital rectal examination (DRE) of the prostate and scrotum.
Despite its antiquity, the method is still one of the most effective. Even modern examination methods such as MRI, CT, TRUS cannot replace it. This is because this method allows you to obtain specific information about the state of the gland, which is not possible to obtain by using other examination methods.
The procedure is performed by feeling the gland with the index finger. Previously, the doctor puts on latex gloves treated with petroleum jelly and inserts a finger into the patient's rectum through the anus.
In this case, the position of the patient can change (knee-elbow position, standing position with a tilted torso; lying on its side with legs pulled up to the stomach, on the back with legs spread apart).
Before examining the prostate, the doctor receives information about the condition of the anus, the tone of the rectal sphincter, the presence of hemorrhoids, cracks in the anus, and rectal neoplasms.
Next, he examines the gland itself, which is located at a distance of 3-4 cm from the anus and is shaped like a chestnut. A furrow runs longitudinally in the middle, which divides it into 2 lobules - left and right. Normally, the consistency of the gland is tight-elastic, uniform. Its boundaries are clear, the rectal mucosa is mobile.
In addition to the gland, the doctor must examine the scrotum, assess its size and shape, the condition of the skin, the mobility and consistency of the testicles. When palpating the spermatic cord, its parts are determined, the presence of inflammation and varicose veins.
Examination is not carried out with exacerbation of inflammatory diseases.
Instrumental method
The main instrumental method is ultrasound. This method has many advantages, including high information content and its availability. An ultrasound examination is prescribed in the course of acute and chronic forms of prostatitis. The technique allows you to identify the presence of an abscess or stones in the gland, the degree of compression of the urethra.
When conducting an ultrasound, the doctor can use several methods:
- external through the anterior wall of the peritoneum;
- external through the perineum;
- transrectally through the rectum;
- transurethral (intracavitary). The sensor is inserted through the urethra.
More informative is the third method, in which a transrectal sensor is inserted through the rectum.
Another available method of instrumental diagnostics is uroflowmetry, in which direct graphical registration of the urine flow rate is performed. Based on the results, the doctor assesses the patency of the urethra and the contractility of the detrusor.
An ultrasound is not done if there are hemorrhoids, cracks in the anus, rashes on the skin in the anus, if there have been recent operations in this area, as well as in case of urinary incontinence.
Laboratory research
To collect additional information about the condition of the gland, a laboratory test is performed.
It includes the delivery of the following tests:
- urine analysis (general, bacteriological, cytological);
- blood test (general, biochemical);
- urethral smear;
- secret of the gland;
- sperm culture (spermogram);
- PCR method (polymerase chain reaction). Latent genital infections are revealed.
For patients over 50 years of age, if there is a suspicion of prostate cancer, a PSA (prostate specific antigen) test is performed.
The test requires three portions of urine. The first portion shows the state of the urethra. An excess of the norm of leukocytes indicates inflammation (urethritis). The second portion shows the state of the bladder and kidneys themselves. An increase in leukocytes here indicates the presence of inflammation in the bladder or kidneys (cystitis, pyelonephritis). After receiving the results of urine analysis, the urologist massage the patient's prostate to release her secret, which is also sent for examination.
Additional research methods
If there are certain indications for examining the disease, additional diagnostic methods are carried out in the conditions of a medical institution. This is a cystoscopy method. It is carried out with trauma to the organs of the genitourinary system, hematuria (the presence of blood in the urine).
The doctor can give a referral for a computed tomography of the pelvic organs, biopsy.
Computed tomography is used when there is a suspicion of prostate cancer. Tomography shows the image in several planes, creates a three-dimensional image of the organ.
If you suspect an abscess of the gland (a complication of the acute form) and an adenoma, the method of nuclear magnetic resonance imaging is used.
During a biopsy, a piece of gland tissue is taken to conduct a histological examination for cancer cells. But it cannot be carried out in the presence of infectious diseases, poor blood clotting, inflammation of the rectum, hemorrhoids, acute form of prostatitis.
Based on all the results in the aggregate, the doctor develops a treatment regimen for each patient individually, which must be strictly observed in order to achieve the desired effect. Otherwise, the result will be unsatisfactory.
Diagnosis of prostatitis at home
At home, you can do the following research. Take three glass jars and put some urine in the first jar.
Then pour almost the entire volume into the second and a teaspoon into the third. If the urine is cloudy only in the first can, it is urethritis. If there is turbidity in the third bank, these are signs of prostatitis. Thus, at home, you can first conduct a study of urine analysis at home, but this method does not exclude contacting a specialist.
In general, doctors do not recommend examining prostatitis at home, because there is no way to use tools, and even this method gives inaccurate data. Many of the symptoms of the disease are similar to those of other diseases. The results in this case are based only on the patient's feelings and assumptions.
After the diagnosis has been carried out, the patient needs rest. An irritated posterior opening can be lubricated with vegetable oil or cream. Physical activity is limited.
A timely and correct diagnosis is the first and very important step towards recovery. But only a qualified doctor should put it. Home conditions are not suitable for making an accurate diagnosis.
It is impossible to differentiate the results without special medical education and without additional medical methods for examining prostatitis.