A Better Path to Diagnosing Prostatitis

What is Prostatitis?

Diagnosing Prostatitis at Sperling Prostate Center

Prostatitis is an inflammation or swelling of the prostate gland. It may be caused by an infection, but sometimes the usual diagnostic tests are unable to identify a specific organism. This is a problem looking for a solution, especially if the condition is chronic (repeatedly comes back).

Prostatitis symptoms include:

Pain in the pelvic region (genitals or deeper in the groin) or lower back
Difficult or painful urination
Sexual dysfunction or painful orgasm
General health problems (flu-like feelings, fatigue, depression)
An elevated or rising PSA

Diagnosis is Problematic

Prostatitis can defy accurate diagnosis. It overlaps with other prostate conditions. One of the most common tests, a basic urinalysis, fails to detect 85% of bacteria strains that can cause prostatitis.

In standard practice, a doctor takes a detailed description of symptoms and any other problems going on at the same time. Lab analysis includes urine, blood, and prostate fluid. A digital rectal exam is performed, though this only examines one surface of the gland. A physical urological exam may also be done. If results are inconclusive, a diagnosis of Chronic Pelvic Pain Syndrome (CPPS) is often assigned, especially if pain or urinary symptoms have been present for 3 of the previous 6 months. Finally, if PSA is elevated, a biopsy may be ordered to rule out prostate cancer.

▾ Click to learn about the four types of prostatitis

Acute bacterial prostatitis comes on gradually or suddenly. It is caused by a bacterial infection. A complete course of appropriate antibiotics generally clears it up.
Chronic bacterial prostatitis either lingers on or comes and goes in cycles because antibiotics did not get rid of all the bacteria. It may be difficult to treat because of drug-resistant bacterial strains.
Chronic prostatitis with no sign of infection has the same characteristics as chronic bacterial prostatitis but no infection is found. It is the most difficult to diagnose accurately. Antibiotic treatment is not effective. In some cases, the problem may actually be Chronic Pelvic Pain Syndrome, or CPPS, a condition caused by tense pelvic floor muscles.
Asymptomatic prostatitis does not have any symptoms, but is detected while diagnosing other health issues in the pelvic area. A doctor can determine if treatment is necessary.

The Sperling Prostate Center Solution

New hope: A 3T multiparametric MRI before a biopsy helps correct diagnosis.

Thanks to our pioneering use of 3T mpMRI – BlueLaser™, the Sperling Prostate Center is a recognized leader in identifying prostate diseases. Our 3T mpMRI – BlueLaser™ is superior to CT and ultrasound in defining abnormal tissue in the prostate and its surroundings. When interpreted by our expert readers, it reveals prostate abnormalities that distinguish prostatitis from benign prostatic hyperplasia (BPH) or prostate cancer.

The type of imaging we offer using our powerful, state-of-the-art MRI uses specialized sequences, or parameters, that reveal distinctive characteristics of prostatitis such as cellular differences, and blood flow that distinguishes inflammation vs. prostate cancer.

During a scan for prostatitis, if an area is detected that is suspicious for prostate cancer, a targeted in-bore mpMRI-guided biopsy using minimal needles can be done to rule out prostate cancer.

Daily Choices That Make a Difference

Nutrition DOs and DON’Ts

Note: Discomfort can be linked with bowel problems, so if you’re prone to bowel irritation, avoid foods that cause it.

DO’s	DON’T’s
Mediterranean diet is best since it’s non-inflammatory Veggies – focus on cruciferous ones like cauliflower, broccoli, and kale to reduce inflammation Fruits – avoid acidic fruit if discomfort increases Opt for plant protein over animal protein Seek out high-fiber foods Aim for organic, if possible, to reduce toxicity	Trigger foods can include: Hot peppers and other spicy foods Wheat or gluten Acidic foods and drinks Caffeine Alcohol Any food allergy that irritates the bowel

Supplements

Note: There is nearly universal agreement on the information below, though research into supplements produces sometimes conflicting results. Always discuss supplements with your doctor before using.

Okay to Consider	Should be Avoided
Quercetin Graminex pollen extract Phytotherapy (Quercetin + pollen extract) Turmeric/curcumin Stinging nettle Pygeum (to help with urinary symptoms) Remember: Always buy supplements from reputable companies and discuss with your doctor before trying any	Supplements with a mixture of herbs or active ingredients. It’s best to try a single ingredient at a time to see if it works for you. Don’t fall for advertising claims without checking the credibility of the source

Lifestyle Tips

Exercise	Stress Management
Strengthen core muscles Stretch frequently to release tension Regular aerobic exercise (to decrease inflammation, reduce blood sugar, and balance hormones) Yoga or tai chi	Breath work (may also help manage discomfort) Relaxation and down time Constructive ways to vent/talk out negative feelings with someone you trust Get adequate sleep Massage Join a support group

Mind & Heart	Environment
Embrace a positive attitude Meditation or mindfulness exercises Do something creative Follow your bliss Deepen intimacy with those you love	Replace personal care products that contain chemicals (soap, deodorant, etc.) with natural products Replace toxic household cleaners with natural products Eat organic

Questions Patients Ask Us

▾ What causes prostatitis?

▾ I've had intermittent lower pelvic pain, which my doctor diagnosed as prostatitis, but antibiotics didn't work. Now he says I might have CPPS. What is that?

CPPS is short for Chronic Pelvic Pain Syndrome. Prostatitis is often associated with CPPS, even though prostatitis may not be the culprit. CPPS is harder to get a handle on than prostatitis. In fact, the patient may be experiencing nerve pain resulting from tension in the pelvic floor—but the source of nerve pain can be elusive since the pain may be referred (arises in a different place from where it is felt). Only a doctor can diagnose your unique situation. Consider finding someone in your area who specializes in CPPS for a second opinion.

▾ Is there a better way to tell whether it's prostatitis or CPPS?

Symptoms for both prostatitis and CPPS vary widely among patients. In an effort to arrive at better diagnostic precision, researchers have developed a 6-category system that covers all possible bases. It is called the UPOINT system, a word made up of the first letter from each category:

Urinary symptoms
Psychological dysfunction
Organ-specific symptoms
Infectious causes
Neurologic (nerve) dysfunction
Tenderness of the pelvic floor muscles

This system guides the diagnostic process and allows treatment to be tailored to the individual. In addition, we strongly recommend a baseline multiparametric MRI (mpMRI) as soon as possible to visually identify and characterize the prostate and surrounding tissues. We are proud to offer 3T mpMRI – BlueLaser™ at the Sperling Prostate Center to help screen for a variety of prostate conditions. Our unparalleled imaging and expert readers can detect even subtle tissue changes that indicate prostatitis-related inflammation, making it a superior diagnostic tool for those who may be suffering from prostatitis.

Are you worried about prostatitis?

Schedule a free consultation with Dr. Sperling to map out a diagnosis and treatment plan all personalized for your unique circumstances.

request a consultation

Please fill out this form and a member of our team will contact you to schedule a consultation.
*
First
Email (required)*
Telephone
Best time to contact you
Comments
CAPTCHA
Phone
This field is for validation purposes and should be left unchanged.

Helpful Resources for Patients

Prostate Cancer Overview Prostate Cancer Questions to Ask Your Doctor mpMRI vs. TRUS Biopsy: What to Know About Your Options Aspirin Use and Cancer
From Our Blog