Medically reviewed by Dr. Paul Song M.D
Article at a Glance
- Bacterial prostatitis is a serious condition that can cause fever, intense pain, and at times can require hospitalization.
- Treatment usually involves antibiotics.
- Even though acute bacterial prostatitis can be serious, it is usually easily treated.
The process of testing for bacterial prostatitis is much easier than testing for non-bacterial prostatitis and chronic pelvic pain syndrome (CPPS). Bacterial prostatitis is still a serious condition that can cause fever, intense pain, and at times can require hospitalization. But because bacterial prostatitis is caused by bacteria, if the doctor finds bacteria then voila—mystery solved. Bacterial prostatitis is generally treated with antibiotics. Acute bacterial prostatitis is treated much faster than chronic bacterial prostatitis, which can recur and last at least three months. Chronic bacterial prostatitis treatment takes longer and involves antibiotics along with natural and alternative therapies.
Testing for Bacterial Prostatitis
When you undergo testing for acute bacterial prostatitis it usually involves the following:
- physical examination (abdomen, external genitalia, perineum, and prostate)
- medical history
- simple tests
- medical and surgical history
- discussion of location, severity, frequency, and duration of pain
- questions about lower urinary tract symptoms
- digital rectal exam (DRE)—but not a prostate massage during the DRE
- urinalysis and culture
Doctors usually order the urinalysis and culture to check for the presence and type of bacteria that may be causing symptoms. Your doctor will most likely not recommend a PSA test because an infection could temporarily elevate your PSA level and cause unnecessary worry.
The doctor may perform additional tests if the symptoms have been occurring on and off for several months and there is concern about chronic bacterial prostatitis. When diagnosing a potential case of chronic bacterial prostatitis, the physician will also take some cultures of the lower urinary tract via the Meares-Stanley “Four Glass Test” or even a 2-glass pre- and post-massage test (PPMT). Semen cultures are not considered helpful in diagnosing bacterial prostatitis. A transrectal prostatic ultrasound is generally unnecessary, but certain indications may cause your doctor to suggest this test. If you or your doctor suspect there is a urinary obstruction, undergoing urodynamics can help provide more information about that.