Chronic Prostatitis

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What to expect in evaluation of Chronic Pelvic Pain...

  1. A detailed history and physical examination. This is the most important part of your visit, providing an insight into other tests that might be needed; and, most importantly, what therapies will likely be helpful. Patients have often been evaluated by multiple clinicians in the past. Records from these encounters should be obtained and brought with you on your first visit to our Center. These records may include information that will greatly facilitate your care. Typical records may include: office notes, operative reports, pathology reports, urodynamic evaluation (bladder function testing), urinalysis reports, urine culture reports, urine cytology reports, CAT scans, MRIs, etc.
  2. Laboratory exams may include a urinalysis, a urine culture, blood tests (including PSA -prostate specific antigen) and in some instances, a urine cytology (a test for cancer cells in the urinary tract). A "prostate massage" may be performed during the physical examination. This procedure is rather uncomfortable as it entails squeezing the prostate during a digital rectal examination. Seminal fluid obtained during this exam or in the urine obtained after the exam may give clues to your diagnosis. Interestingly, some patients have significant symptom relief after this procedure.
  3. Other testing. Further testing depends upon the information obtained through your history, physical examination and initial laboratory testing. Other recommended tests may include:
    1. Testing for sexually transmitted diseases
    2. Assessment of bladder emptying. Usually performed with a simple ultrasound (Bladder Scan) in the office.
    3. Urodynamic evaluation. This is a sophisticated test that evaluates your bladder's function and may also provide information about your pelvic floor muscles.
    4. Cystoscopy. This procedure involves passing a flexible "telescope" into the bladder through your urethra. Cystoscopy can provide information about inflammation, scar tissue, cancers, bladder stones, or prostate enlargement that might be present.
    5. Ultrasound exams. May include ultrasound of the prostate, scrotum, and/or kidneys.
    6. CAT scans or MRI of Abdomen and/or pelvis