If your health professional suspects that you have prostatitis, he or she will begin with a complete medical history and physical exam. The type of prostatitis you have cannot be determined solely from your history and symptoms. Your doctor will do tests to determine the cause of your prostatitis.

Acute prostatitis is the least common type but the easiest to diagnose. If acute prostatitis is suspected, a urine culture will be done to test for the presence and type of bacteria.

If your history and physical exam show that you do not have acute prostatitis, a pre- and post-massage test (PPMT) or expressed prostatic secretions test may be done to determine which type of prostatitis you have. An expressed prostatic secretions test is not done if acute prostatitis is suspected, because when the prostate is inflamed or infected, massaging it to obtain a sample for tests is very painful and possibly dangerous. Some health professionals believe that massaging an infected prostate increases the risk of developing a bacterial infection of the blood (septicemia).

More tests may be necessary if:

• Your symptoms do not improve with treatment.
• You continue to have prostate infections.
• The symptoms could be caused by bladder or prostate cancer.
• Your health professional suspects you have a complication related to prostatitis, such as an abscess.

Tests that may be done include:

• Complete blood count (CBC).
• Digital rectal exam, to check for growths in the prostate gland or to see if it is larger than normal.
• Blood culture, to check for bacteria in your blood if you have acute prostatitis.
• Computed tomography (CT) scan or magnetic resonance imaging (MRI) of your pelvic area.
• Transrectal ultrasound of your pelvic area.
• Prostate specific antigen (PSA) to rule out prostate cancer.