Post Date April, 15 2023
"The diagnosis of chronic prostatitis is not difficult based on medical history, symptoms, digital rectal examination, and prostate fluid examination. However, those with complex symptoms and atypical physical signs should be distinguished from the following diseases.".
1. Prostatic abscess
Most of them are complications of acute bacterial prostatitis, most of which occur at the age of 50~60 years. Half of the patients have acute urinary retention, frequency of urination, dysuria, rectal discomfort, purulent urethra, and some are accompanied by epididymitis. On digital rectal examination, the diseased side of the prostate is enlarged, soft to touch, and has a wavelike sensation. Occasionally, prostate abscesses can naturally rupture into the urethra or rectum, and are mistaken for perirectal abscesses.
2. Prostatodynia
These patients are characterized by persistent frequent urination, pain in urination, difficulty urinating, pain and discomfort in the perineum, lower abdomen, lumbosacral region, and other areas, which worsen after prolonged sitting and cycling. The rectal digital examination showed significant tenderness in the levator ani muscles on both sides, and the palpation of the prostate was normal without tenderness. Previously, this condition was known as piriformis levator muscle syndrome. Microscopic examination of prostate fluid showed normal results, and bacterial culture showed no growth.
3. Tuberculosis of the prostate
Symptoms are similar to chronic prostatitis, but there is often a history of urinary tuberculosis or tuberculosis lesions in other parts of the body. Digital rectal examination shows that the prostate is irregular nodules, the epididymis is swollen and hard, the vas deferens has beaded induration, and tuberculous bacteria are detected in the prostatic fluid by direct smear or PCR.
