What are the symptoms of prostatitis? Some people have prostatitis but have no obvious symptoms of discomfort; others have symptoms similar to those of a urinary tract infection. These symptoms include painful urination, an inability to empty the bladder or a significant increase in the number of urinations compared to normal (also called frequency). When urinary frequency is significant, patients urinate more often at night, often disrupting sleep. Some other symptoms of prostatitis can occur, including pain in the penis, testicles or other parts of the pelvis, pain during or after ejaculation, and in some patients with acute prostatitis, chills and fever. Of course, other diseases can also have the symptoms mentioned above, which is why it is necessary to see a medical professional to determine if you have prostatitis, what type of prostatitis you have and what treatment is best to choose. How is prostatitis diagnosed? Doctors often use the National Institutes of Health Chronic Prostatitis Symptom Inventory (NIH-CPSI) when diagnosing prostatitis, and this scoring system is described in more detail later in this booklet. The scoring system lists a series of questions about the symptoms of prostatitis and the degree of distress the patient is experiencing. After carefully filling out the form based on your condition, discussing the results of the scoring with your doctor is one way you can personally participate in the diagnostic process. During treatment, your doctor will also ask you to answer the questions listed on the form again to determine the effectiveness of the treatment by comparing the results of the symptom scores before and after treatment. In addition to asking you to fill out a rating form, your doctor will ask you about your medical history and perform a physical examination, including a rectal examination (DRE), in which the doctor will wear gloves, apply paraffin oil to your index finger for lubrication, and then slowly insert the lubricated index finger into your rectum to examine the size, texture, and sensitivity of the prostate gland, which will provide important information to the doctor. Your doctor may massage your prostate during the examination to obtain a sample of prostate fluid. After prostate massage, prostate fluid (EPS) is drained through the external urethral opening, collected and examined under a microscope. The urine can also be examined and cultured under a microscope. Some doctors will also examine a sample of your blood or semen. The goal of these tests is to see if there are microorganisms, white blood cells, or other evidence of infection. When a patient does not have an acute infection, cystoscopy may also be applied to rule out other conditions with symptoms similar to those of prostatitis. A cystoscope has a light source and a magnifying lens that is inserted into the urethra and eased into the bladder under direct vision to allow visualization of the bladder and prostate. The doctor may also perform other tests if needed, such as uroflowmetry (the rate of urine flow during urination) and residual urine volume (the amount of urine left in the bladder after urination).