Diagnosis

Diagnosing prostatitis involves ruling out other conditions as the cause of your symptoms and determining what kind of prostatitis you have. Your doctor will ask about your medical history and your symptoms. He or she will also do a physical exam, which will likely include a digital rectal examination.

Initial diagnostic tests might include:

• Urine tests. Your doctor might have a sample of your urine analyzed to look for signs of infection in your urine (urinalysis). Your doctor might also send a sample of your urine to a lab to determine if you have an infection.
• Blood tests. Your doctor might examine samples of your blood for signs of infection and other prostate problems.
• Post-prostatic massage. In rare cases, your doctor might massage your prostate and test the secretions.
• Imaging tests. In some cases, your doctor might order a CT scan of your urinary tract and prostate or a sonogram of your prostate. CT scan images provide more detailed information than plain X-rays do. A sonogram is the visual image produced by an ultrasound.

Based on your symptoms and test results, your doctor might conclude that you have one of the following types of prostatitis:

• Acute bacterial prostatitis. Often caused by common strains of bacteria, this type of prostatitis generally starts suddenly and causes flu-like signs and symptoms, such as fever, chills, nausea and vomiting.
• Chronic bacterial prostatitis. When antibiotics don't eliminate the bacteria causing prostatitis, you can develop recurring or difficult-to-treat infections. Between bouts of chronic bacterial prostatitis, you might have no symptoms or only minor ones.
• Chronic prostatitis/chronic pelvic pain syndrome. This type of prostatitis — the most common — isn't caused by bacteria. Often an exact cause can't be identified. For some men, symptoms stay about the same over time. For others, the symptoms go through cycles of being more and less severe.
• Asymptomatic inflammatory prostatitis. This type of prostatitis doesn't cause symptoms and is usually found only by chance when you're undergoing tests for other conditions. It doesn't require treatment.