What are the tests to diagnose prostatitis?

Excluding urethral orifice stenosis or other diseases that may affect urination (such as phimosis, penile tumors, etc.).

Digital rectal examination is a simple but important diagnostic method that needs to be performed after the bladder is empty. Attention should be paid to the boundaries, size, and texture of the prostate. In prostatic hyperplasia, the gland may increase in length, width, or both. Clinically, different methods are used to describe the degree of prostate enlargement.

Digital rectal examination has certain errors in estimating prostate size. If the middle lobe protrudes toward the bladder, enlargement of the prostate gland will not be obvious during digital rectal examination. At the same time, if suspicious induration is found on the prostate during digital rectal examination, a needle biopsy should be performed to rule out the possibility of prostate cancer. The proportion of patients with abnormal DRE who are finally diagnosed with prostate cancer is 26% to 34%, and the positive rate increases with age. At the same time, attention should be paid to the contraction function of the anal sphincter to rule out neurogenic bladder dysfunction.

Examination of the perianal and perineal peripheral nervous system to indicate the presence of neurogenic bladder dysfunction due to neurogenic disease.

To determine whether patients with lower urinary tract symptoms (LUTS) have hematuria, proteinuria, pyuria, and urine glucose.

Observe the size, shape and structure of the prostate, whether there are abnormal echoes, the degree of protrusion into the bladder, and the residual urine volume (Postvoidresidual volume). Commonly used methods include transrectal and transabdominal ultrasonography. The former is more accurate but requires high equipment, while the latter is simple and can be popularized.

During transrectal B-ultrasound examination, the prostate volume can also be measured, and the deformation and displacement of the urethra, the dynamic changes of lower urinary tract obstruction, and the status after treatment can be determined from the sonogram during urination. Transabdominal B-ultrasound examination is more commonly used in China, and it is not as good as transrectal B-ultrasound examination to observe the internal structure of glands.