A single negative prostate microscopy cannot rule out chronic prostatitis, because the symptoms of chronic prostatitis can fluctuate in severity over time. Moreover, the one or two drops of prostate fluid that are expressed during examination may not necessarily be from the inflamed area. Therefore, when patients present with a chronic prostatitis syndrome, it is best to seek specialized care from a urologist. If a single prostate fluid test is negative, it might be worth retesting after some time, preferably during periods when symptoms are more severe, which could aid diagnosis.
The symptoms of chronic prostatitis are varied. Some symptoms, such as lower back pain, can easily be confused with orthopedic diseases; others, like rectal fullness, can be mistaken for anal and intestinal diseases; and discomfort in the groin or testicles can be confused with lesions within the scrotum. So, how do we diagnose chronic prostatitis and distinguish it from other easily confused diseases?
For the diagnosis of chronic prostatitis, the following two points should be noted:
1. Non-specialist doctors often fail to perform a digital rectal examination due to various reasons, and rashly diagnose chronic prostatitis based solely on the patient's subjective symptoms. This is very harmful, not only causing unnecessary long-term medication for many patients who do not have this condition, leading to significant trouble and waste, but also subjecting them to the harm of drug side effects and mental suffering.
2. A single negative prostate microscopy cannot rule out chronic prostatitis, because its symptoms can vary in intensity at different times, and the one or two drops of prostate fluid expressed during examination may not be from the inflamed area. Therefore, when patients present with a chronic prostatitis syndrome, it is best to consult a urologist. If a single prostate fluid test is negative, it might be worth retesting after some time, preferably during periods when symptoms are more severe, which could aid diagnosis.
Additionally, bacterial culture of prostate fluid is recommended, and ideally, segmental localization culture of both urine and prostate fluid should be performed. The growth of pathogenic bacteria has diagnostic significance. Simultaneous antibiotic sensitivity testing helps in selecting appropriate antibiotics. When necessary, other examinations such as urography, urethroscopy, ultrasound, zinc content determination, and serum antibody tests can be conducted to assist in diagnosing chronic prostatitis and identifying potential triggers such as obstruction or stones.
In summary, if the patient does not have urinary tract infection or systemic symptoms; presents with symptoms of chronic prostatitis; has more than 15 white blood cells per high-power field in the prostate fluid examination; and if the prostate fluid culture shows the growth of pathogenic bacteria, then a diagnosis of chronic prostatitis can be made. If all these criteria are met except for the absence of symptoms, it is referred to as latent prostatitis.
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