How do doctors diagnose chronic bacterial prostatitis?

The clinical diagnosis of chronic prostatitis is based on history, symptoms and physical examination, supplemented by laboratory tests. For recurrent patients, cystourethrography, intravenous pyelogram, endoscopy, cystometry, etc. are needed to further understand the lesions present in other areas. (1) Past history: History of urethritis, urethral obstruction, urinary tract infection, and prostatitis. (2) Symptoms: Anyone with symptoms of urinary tract irritation, testicular and groin, lumbosacral, perineal pain and soreness, and no other findings on physical examination should be considered for the diagnosis of chronic prostatitis. (3) Anal examination: chronic prostatitis patients have a mildly enlarged prostate with uneven surface softness and light pressure pain. In some patients, hard node-like bumps can be palpated on the surface of the prostate, but they are not hard and are a sign of fibrosis, with the presence of a central groove. (4) Laboratory tests: including routine examination of prostatic fluid, segmental localization culture of urine and prostatic fluid, determination of pH and zinc content of prostatic fluid, prostatic tissue biopsy and culture, serum antibody titer, the latter three are less commonly used in clinical practice but have scientific significance. (5) If necessary, urethroscopy is feasible: the urethra shows chronic inflammatory changes, the seminal frenulum is elevated, and the prostatic ducts are flowing with pus. Uroflow rate determination and cystourethrography are also feasible, both of which have some screening significance.