From the Guidelines
Prostatitis lab results typically include a combination of urine analysis, cultures, and inflammatory marker tests to diagnose and differentiate between acute and chronic forms. According to the guidelines for the prevention, diagnosis, and management of urinary tract infections in pediatrics and adults: a wikiguidelines group consensus statement 1, the diagnosis of acute bacterial prostatitis (ABP) relies on clinical presentation and laboratory tests, while chronic bacterial prostatitis (CBP) diagnosis involves comparing bacteria levels in prostatic fluid and urinary cultures. Some key lab results for prostatitis include:
- Elevated white blood cell counts in urine, expressed prostatic secretions (EPS), or post-massage urine samples, indicating inflammation or infection
- Cultures that identify specific pathogens like E. coli, Klebsiella, or Proteus species in bacterial prostatitis
- Mildly elevated PSA levels during active inflammation
- Pyuria (white blood cells in urine) and bacteriuria in acute cases, as shown by urinalysis
- Inflammatory markers, such as increased leukocytes in semen analysis, which may be present in chronic pelvic pain syndrome (non-bacterial prostatitis) without identifiable pathogens. It is essential to note that the optimal durations of treatment for ABP or CBP are unknown and have not been established by high-quality studies, as stated in the guidelines 1.
From the Research
Prostatitis Lab Results
Prostatitis lab results typically include:
- Urine culture to determine the presence of bacteria and antibiotic sensitivity pattern 2, 3, 4
- Urinalysis to check for signs of infection, such as blood or white blood cells in the urine 2, 3, 4
- Urine specimen testing pre- and post-prostatic massage to help diagnose acute and chronic bacterial prostatitis 2
- Digital rectal examination to assess the prostate for tenderness, enlargement, or nodules 5, 4
- Midstream urine (MSU) sample for urine dipstick, microscopy, and culture 5
Diagnostic Evaluation
The diagnostic evaluation of prostatitis may also include:
- History and physical examination to assess for symptoms and signs of prostatitis 2, 3, 5, 4
- Lower urinary tract localization tests to help diagnose chronic bacterial prostatitis 3
- Symptom index, flow rate, and residual urine determination to evaluate chronic pelvic pain syndrome 3
- Optional evaluations, such as semen analysis and culture, urethral swab, urodynamics, cystoscopy, imaging, and prostate-specific antigen determination 3
Laboratory Investigations
The laboratory investigations required for prostatitis diagnosis vary depending on the type of prostatitis: