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Features of blood and urine tests for prostatitis and decoding of indicators
Correct and timely diagnosis is the key to success in the treatment of any disease, this, of course, also applies to diseases associated with various pathologies of the prostate gland, including prostatitis. Violations in the work of this most important male organ manifest themselves in different ways There are many types and forms of diseases, and their treatment regimens vary greatly: from conservative to radical prostatectomy. Therefore, the appointment of the necessary tests and their correct interpretation play a decisive role in the successful treatment of prostate diseases and the return of the patient to his usual way of life. Tests for prostatitis - when, how and what to take, how to prepare for them?
How to identify relevant research
The initial examination for prostatitis in men is the most important step in the treatment of prostate diseases, it is on the basis of the collected anamnesis that the urologist determines what tests are needed to make the correct diagnosis. Despite the large number of developed methods of complex diagnostics, the approach to the appointment of research should be strictly individual, the patient needs to pass exactly those tests that will later help determine the effective tactics for treating men with prostate pathologies.
When compiling an anamnesis, the doctor needs to collect and analyze the following information:
- Find out how long a man has had symptoms.
- In what order they appeared.
- Have there been exacerbations of prostatitis, and what factors provoked them.
- Has the man ever had an STD?
- Does the patient have problems in his sexual life and which ones.
- Are there any external factors contributing to prostatitis.
- Have you had prostate problems before, have you been treated?
- Whether this man had previous prostate surgery.
After the interview, the doctor conducts a rectal examination and preliminarily determines changes in the structure of the prostate and the possible presence of a neoplasm.
Based on the collected history, the doctor can develop an individual diagnostic algorithm.
What is studied most often
In diseases of the prostate, as in many other diseases, the most important and informative are blood and urine tests. Urinalysis is one of the most informative types of laboratory tests in the diagnosis of prostatitis and differentiation of acute and chronic stages of the disease. If prostatitis is suspected, the patient must pass three different types of urine tests: general, bacteriological, cytological. General and biochemical blood tests are mandatory for acute and chronic prostatitis, since their indicators are as informative as possible for the correct diagnosis, these tests are taken by all patients.
An increase in the alkaline level in the urine often indicates developing prostatitis.
A general urinalysis for prostatitis helps to determine the presence of pathological changes in the prostate, especially at the initial stage of the disease, when the patient does not yet experience any particular problems with urination. The color, smell, transparency and acidity of urine is determined, and a qualitative and quantitative assessment of the ratio of chemical compounds is also carried out. So, if the indicators of urine acidity are defined as alkaline, this may indicate the presence of prostatitis. To conduct the study and interpret its results, a minimum amount of urine is sufficient. Only a microscope is used for research.
When referring a patient for a general urine test, it is necessary to explain the rules for preparing for the collection of material so that the indicators are as reliable as possible:
- Cytological analysis of urine.
Urine cytology is also very important for diagnosing prostatitis, it is usually taken along with a general analysis, but can be done using a three-glass sample. This type of examination provides information on the composition of cells, but in general, for an objective picture of cytology, it is better to prescribe a study of ejaculate and scraping from the urethra. Preparation for this type of analysis for prostatitis is the same as for a general urine test. When deciphering the results, attention is paid to leukocyturia, these indicators in men with prostatitis are significantly increased. Epithelial cells and erythrocyturia are not characteristic signs of prostate inflammation.
- Bacteriological analysis of urine.
The presence of microflora and fungi in the urine test indicates infectious prostatitis.
Bacteriological examination of urine is used in urology as an additional method for determining the presence of prostatitis.This indicator helps to identify the presence of infection, as well as determine the type of pathogen and its sensitivity to medications. The analysis is carried out within a few days, sowing on nutrient media of three portions of urine is done daily. When deciphering the results, attention is drawn to the presence of parasites, fungi and bacteria in the urine of men, these indicators indicate the presence of inflammation. Also, with prostatitis in the third portion of urine, an increase in several times the level of microorganisms is found. Preparation for this study requires particularly careful hygienic preparation, for which a weak solution of potassium permanganate can be used. It is also important to conduct an analysis no later than two hours after urine collection.
The presence and development of inflammation of the prostate is determined by the results of a general analysis, the most important indicators of the examination during decoding are the level of leukocytes and ESR, if these indicators are increased, then an inflammatory process is going on in the man's body. Also, for men, the level of hemoglobin is important, its decrease can signal the presence of prostate neoplasms. Blood for a general analysis must be taken from a finger, preparation for analysis consists in refusing to take any food eight hours before blood sampling, as well as excluding any medications and, of course, alcohol a day before the study.
Blood for biochemical research is taken from a vein, preparation for it is the same as for a general analysis for prostatitis
A blood test for PSA often becomes a decisive confirmation of the diagnosis.
Research for acute and chronic prostatitis must necessarily include a blood test for PSA - a specific antigen that is a marker of malignant neoplasm. A high level of PSA in the blood most likely indicates problems with the prostate gland. This analysis alone does not allow to determine the nature of the disease and unequivocally identify a malignant disease, prostate adenoma or chronic prostatitis, the level of PSA in the blood of men can be increased even after suffering inflammatory diseases of the genitourinary system of men. But if an increase in the level of PSA in the blood is detected, a number of additional studies should be carried out to identify a possible malignant neoplasm.
This type of study is handed over only for chronic prostatitis, it cannot be carried out in the acute stage of the disease. For the study, it is necessary to conduct rectal palpation of the prostate gland, during which material is taken for analysis. The study of prostate secretion allows you to identify inflammatory processes in the prostate, as well as determine their intensity. Also, the presence of a urogenital infection can be confirmed by the analysis of urethral secretion and the study of ejaculate. Additional studies for prostatitis are spermogram, ultrasound and other methods of instrumental diagnostics.
In conclusion, it should be recalled once again that the prognosis of a complete cure for prostate diseases depends on a properly conducted examination. It is necessary to take tests for prostatitis strictly in accordance with the recommendations of the attending physician, this is the key to successful diagnosis and subsequent treatment, taking into account all indicators.
What tests will you need to take for prostatitis
Prostatitis has no characteristic symptoms, so it is impossible to make an accurate diagnosis based on the complaints of a man alone. Comprehensive diagnostics is needed, in which various laboratory studies of bacteriological material play a special role. Consider what tests for prostatitis a man will have to pass, we will give brief information on them. We will also tell you what values are normal, and when we can talk about inflammation in the prostate gland.
What happens in the doctor's office
No one will take blood or other material for research unless there is a referral from a doctor. It is for this reason that in the event of pain in the perineum, difficulty urinating and poor potency, a man should visit a urologist.
At the appointment, the doctor will first of all collect an anamnesis - information about existing diseases, complaints, lifestyle, surgeries, etc. This data helps to make assumptions about what disease a patient has and will be taken into account when making a diagnosis.
If you suspect acute or chronic prostatitis, you can not do without palpation of the prostate. This diagnostic event can cause pain when the inflammatory process is running, but, most often, causes only a feeling of mild discomfort. Palpation is carried out with a finger through the rectum, as a result, the doctor will be able to obtain some information about the condition of the prostate gland:
- its consistency;
- dimensions;
- the presence of soreness.
In acute inflammatory processes, as well as in the case of calculous prostatitis, rectal examination is not performed. The risk of complications in this case is high and is not comparable with the diagnostic value of the method.
After receiving the necessary information, the doctor will write a referral for a series of tests. Their list may be adjusted, depending on the situation.
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STI test
Chlamydial prostatitis and some other forms are caused by sexually transmitted infections. Most often, infection occurs unnoticed by a man - microorganisms may not manifest themselves for a long time. However, it is necessary to establish the fact of their presence or absence, the success of therapy depends on this.
The following tests are used to diagnose STDs in men:
- PCR diagnostics - scraping from the mucous membrane of the urethra is examined;
- polymerase chain reaction of prostate secretion and sperm;
- ELISA blood test.
Three days before the material is taken, it is forbidden to have sex, drink antibacterial drugs. Three hours before taking tests, you can not urinate and wash yourself with soap or other disinfectants. Violation of these rules will lead to a false result, the treatment of prostatitis will not be effective
Blood tests for prostatitis
In addition to checking for sexually transmitted diseases, a man will have to donate blood for a biochemical and general blood test. This is a mandatory analysis with which you can set the following indicators:
- erythrocyte sedimentation rate (ESR);
- the content of erythrocytes and leukocytes;
- red blood cell volume;
- platelet content;
- hemoglobin concentration and other parameters.
According to biochemical analysis, it is possible to establish the content of glucose, cholesterol, urea, residual nitrogen and other substances.
The following indicators of blood tests are characteristic of the inflammatory process in the body: leukocyte count >9x109, ESR >5 mm/h, hemoglobin
However, these values do not indicate inflammation in the prostate. To clarify the diagnosis, it is necessary to take into account the results of other tests, as well as instrumental examination.
Clinical urinalysis
Urine examination is also mandatory in the diagnosis of the disease. In the laboratory, they can measure the volume of a liquid, fix its smell, color, foaminess, and transparency. Microscopic examination is also used, during which it is possible to detect epithelial cells, salts, granular and leukocyte cylinders.
The inflammatory process will be indicated by leukocyturia, in which the field of view can contain from seven to 20 leukocytes. Pathogenic microflora detected after urine culture can indicate bacterial prostatitis. In the case of severe inflammatory processes, it will also be possible to identify purulent impurities in the fluid.
PSA blood test
Prostate-specific antigen PSA (PSA) is a tumor marker, the excess of which, in some cases, makes it possible to differentiate prostatitis from prostate cancer. A blood test for PSA is recommended for all men over the age of 40, regardless of complaints - they are at risk.
The PSA norm in men is highly dependent on age:
- up to 50 years - 2.3 ng/ml;
- up to 60 years - 3.4 ng/ml;
- up to 70 years - 4.4 ng / ml.
In men older than 70 years, the value of 6.4 ng / ml is considered the norm. If this figure is higher, you can suspect the presence of prostate cancer.
Prostate secretion analysis
By examining the juice of the prostate gland, it is possible to establish whether infection of the organ has taken place. Normally, the secret is sterile, but pathogenic and opportunistic organisms can enter the prostate, which will be revealed after testing.
To get the secret of the prostate gland, the doctor makes a rectal massage of the prostate with a finger. After a short exposure to iron, it becomes activated and secretes a viscous liquid, which under normal conditions serves to dilute the ejaculate to the desired consistency. The juice is collected in a container, then sent for biochemical and cytological examination.
Based on the results, the following indicators will be taken into account:
- color and smell;
- pH and density;
- lecithin grains;
- presence and number of leukocytes and epithelial cells;
- presence/absence of microflora.
With prostatitis, the number of leukocytes is increased, while the number of leukocyte grains is greatly reduced. It is also possible to change the color of the secret to pale yellow, which may indicate purulent-inflammatory processes (prostate abscess).
The presence of trichomonas or chlamydia suggests chronic bacterial prostatitis. The absence of bacteria against the background of signs of inflammation may indicate chronic pelvic pain syndrome CPPS or abacterial prostatitis.
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Sperm analysis
If for some reason it is not possible to take the secret of the prostate, the doctor may send you to donate a seed for such a study. Due to the anatomical structure of the reproductive system, the ejaculate contains prostatic juice, so inflammatory processes in the prostate gland affect the characteristics of sperm.
In case of inflammation in the prostate area, the following changes will occur in the patient's sperm:
- erythrocytes will appear in small quantities;
- leukocytes will be detected, which should not be;
- in some cases, agglutinins will be found - accumulations of dead and twisted spermatozoa;
- reaction from acidic will change to alkaline;
- The number of dead spermatozoa can reach 80%.
Sometimes in men of reproductive age, a significant decrease in the number of viable spermatozoa is detected. If this deviation is not caused by genetic disorders and is not associated with a hormonal failure, then we can talk about involvement in the inflammatory process of the testes.
This picture is also characteristic of a cancerous tumor in the prostate.
How to interpret test results
Some men seek to decipher the results of laboratory tests on their own. This is possible if you know about the indicators in the norm and own the terminology. However, laboratory tests alone are not enough to make a diagnosis, this must also be taken into account.
Prostatitis may be indicated by the following changes in biological material:
- the content of leukocytes in the urine is above three;
- The results of PCR diagnostics revealed causative agents of venereal diseases;
- more than 12 leukocytes in prostate secretion, more than 1-2 erythrocytes;
- agglutination and aggregation in semen;
- ESR >5 mm/h
The final diagnosis is made on the basis of abdominal and transrectal ultrasound, MRI, CT and other types of instrumental examination.
Conclusion
Now you know what tests are taken for suspected prostatitis and how to decipher them. Diagnostic methods may differ depending on the clinic and the specific situation. So, a biochemical analysis of semen is almost never prescribed.
Spermogram is also not needed in the diagnosis of prostatitis, but you can see its signs in it. Most often, this study is done due to infertility, and inflammation in the prostate is detected by chance. If the doctor does not send for some kind of analysis, this does not mean his incompetence.
Tests for prostatitis
What tests for prostatitis should be taken in the clinic, a detailed plan for examining the prostate gland and deciphering the results about this in this article.
Prostatitis is a disease that requires timely diagnosis. The sooner an accurate diagnosis is made, the more effective the treatment will be. The scheme of drug therapy is determined after additional examinations. In addition, they perform special analyzes that help to find out which factor provoked the development of the process.
Diagnosis of prostatitis begins with a consultation and examination by a specialist. The doctor listens to the patient's complaints, examines the anamnesis, and, if necessary, directs him to instrumental and laboratory tests. If there is a suspicion of acute or chronic prostatitis, the patient must undergo a series of specific tests to help make the final diagnosis.
When should I take tests if prostatitis is suspected
If you find the following symptoms in yourself, then you need to conduct tests to refute or confirm the diagnosis of prostatitis:
- problems with urination (frequent urge, pain, urinary retention);
- burning in the perineum;
- pain during bowel movements;
- long night erections;
- high fatigue and psychological problems.
What tests are done for prostatitis in men
Prostatitis is a common problem that every man can face after 30-40 years. Therefore, it is desirable for all men to know what examinations are carried out if prostate inflammation is suspected.
Examination plan for prostatitis
1. General analysis of urine and blood.
2. Scraping from the urethra, analysis of the secretion of the prostate, semen and blood by PCR for all sexually transmitted infections (The essence of the method is to obtain the DNA of the pathogen and compare it with a database of all STIs, including HIV, syphilis, hepatitis B and C.) .
3.Culture of prostate secretion and determination of sensitivity to antibiotics.
4. Microscopic examination of the secret of the prostate.
5. Urine analysis for bacteriological culture.
6. Bacteriological examination of the ejaculate.
8. Plus more research.
But not in all cases it is possible to find the pathogen, that is, to make a diagnosis of bacterial chronic prostatitis, most often the pathogen cannot be detected. But, if the patient has symptoms, in this case we are talking about abacterial prostatitis, the treatment of which is based mainly on the suppression of chronic pelvic pain syndrome.
Let's take a closer look at what tests should be taken for prostatitis.
History taking for prostatitis
An andrologist or urologist asks the patient about previous chronic and acute diseases, operations on the genitourinary organs, what complaints he is concerned about, when he was last examined and if he underwent examination, what were the test results and the diagnosis.
Palpation and prostate massage
There are cases when there are no symptoms of an acute inflammatory process, but there are prerequisites for the onset of chronic prostatitis. In such situations, functional tests and palpation of the prostate gland are indicated.
The main test of manual examination is prostate massage. The state of the gland is judged based on the sensations that the massage causes. They also take into account the consistency of the organ and its possible increase in size.
In case of acute inflammation, prostate massage cannot be performed! In this case, it can cause severe pain. In addition, massage with acute inflammation can provoke the entry of pathogenic microbes into the blood. And this is very dangerous, because it can lead to such a formidable complication as sepsis.
Laboratory tests for prostatitis
Tests for sexually transmitted infections
Before taking smears, scrapings or cultures for sexually transmitted infections, you must not:
- 3 hours to urinate before taking the material;
- use disinfectants;
- the last sexual contact should be at least 36 hours before taking the material;
- use antibiotics or uroseptics inside.
Types of tests for infections in prostatitis
PCR scraping from the urethra for all sexually transmitted infections (chlamydia, ureaplasma, gardnerella, mycoplasma, Trichomonas, gonococcus, Candida fungi, etc.)
Blood for infection by ELISA (IgA and IgM antibodies).
PCR diagnostics of prostate secretion, semen and morning urine.
Urine analysis for prostatitis in men
A urinalysis is mandatory. A urine culture may be done to identify pathogens. The typical causative agent is Escherichia coli. With catarrhal prostatitis in the general analysis of urine, obvious changes are not always observed. In advanced forms of the disease, after a manual test, purulent threads are noted in the urine that precipitate.
Blood test
A general blood test for prostatitis shows an increased number of leukocytes with a shift in the formula to the left, an increase in ESR (erythrocyte sedimentation rate). These are typical signs that indicate that an inflammatory process is taking place in the body. By the height of these indicators, one can determine the nature of the course of the disease and its stage.
In some cases, inflammation of the prostate is allergic in nature. Therefore, they conduct a blood test for an allergic reaction. They also take blood from a vein for biochemical analysis. It is very important to determine the indicators of electrolytes (blood urea nitrogen and creatinine), especially with obstruction and urinary retention.
Prostate secretion analysis
The main tests that allow you to accurately diagnose, analysis of prostate secretion and bacteriological analysis of urine. These tests detect microbes such as: E. coli, staphylococcus aureus, streptococcus, etc.
Analysis of the secret involves a microscopic examination of the discharged gland. This method gives doctors the opportunity to find out if there are any unhealthy impurities in the secret, how the inflammatory process proceeds, and what condition the prostate is in.
A biochemical and cytological study of the secret is being carried out. In addition, seeding is carried out, which allows you to assess the sensitivity of pathogenic flora to antibiotics.
The study of the secret is indicated for chronic prostatitis. The acute form of the disease must be excluded before analysis. And the sampling procedure is as follows: the prostate is stimulated intrarectally, a secret is secreted from the urethra (normally viscous and transparent), which is collected on a glass slide. The resulting samples are examined under a microscope. Normally, after about 20 minutes, the material takes on the appearance of a fern. In the case of prostatitis, only fragments are visible under a microscope. If the massage did not lead to a secret, after stimulation it is necessary to collect urine for analysis.Together with urine, the accumulated secret is also excreted. This allows you to evaluate the necessary indicators by conducting a study of the urine itself. When the inflammation reaches the late stages and the process develops rapidly, obvious changes are revealed in the composition of the urine. To determine the pathogens that caused acute inflammation, urine culture is performed.
Microscopic examination of the secretion of the prostate pay attention to leukocytes, lecithin grains, erythrocytes, epithelial cells, macrophages. In a healthy man, the number of leukocytes in the secretion of the prostate should not exceed 5 in the field of view.
There are several ways to collect urine for analysis. At the same time, care must be taken to prevent infection from the environment from entering the urine. The first way is to collect material for analysis using a swab. It is applied to the opening of the urethra so that it absorbs some urine. Before the procedure, the skin is disinfected to prevent infection from entering the collected urine. Infection can greatly affect the results of the analysis, up to a complete change in the picture. In this case, the procedure will need to be carried out again.
A more reliable method is to collect urine using a urinary catheter. This eliminates the possibility of infection from the external environment. The material is collected under sterile conditions and the catheter itself must be sterile. Urine is placed in a sterile container and cultured on a nutrient medium. The results of the analysis become known in a few days. This time is necessary for the culture to grow and the type of pathogen to be determined.
PCR diagnostics are also carried out. This study involves the detection of latent infections in the urine. The test helps to identify the DNA of the pathogen. At the slightest hint of the presence of bacteria, the sample is positive. Such diagnostics helps to determine the type of inflammation and its degree.
Bacteriological analysis of seminal fluid
An alternative to prostate culture is semen culture. This study is resorted to if the sowing of the secret did not give accurate results, or when the secret could not be obtained in its pure form.
Laboratory examination of the ejaculate is also an accurate diagnostic method for inflammation of the prostate gland. The information content of the study is explained by the fact that seminal fluid passes through the prostate and contains its secret. In men suffering from prostatitis, a large number of leukocytes are detected in the seminal fluid. In addition, there are single erythrocytes. There are clots of weak or dead spermatozoa called agglutinins. Their formation is associated with disorders of the immune system and the process of sensitization, which triggers the pathogen.
In healthy men, the reaction of seminal fluid should be acidic. But under the influence of the inflammatory process, it becomes alkaline, which adversely affects the viability of germ cells. With prostatitis, up to 80% of sedentary or dead spermatozoa can be detected in semen.
In some cases, the analysis of seminal fluid reveals quantitative changes, i.e. the total number of spermatozoa decreases. This indicates the spread of inflammation to the testicles. If mutated sex cells appear, hormonal problems or genetic disorders can be suspected. With such a picture, a malignant process is not excluded. But it is impossible to say with absolute certainty that this is some stage of prostate cancer.
Urethral juice analysis
Another type of diagnosis is the analysis of urethral juice. The procedure is carried out using a probe with a swab. The resulting material is subjected to laboratory research. The analysis makes it possible to determine whether the inflammation has passed to the urethra.
The studies listed above are included in the list of basic analyses. When prostatitis is combined with other diseases, a number of additional studies will be required, which are aimed at identifying secondary pathology.
Methods of additional diagnostics of prostatitis
Additional examination methods include:
Ultrasound of the bladder. The fact is that infections in the urinary tract can lead to congestive prostatitis.
Computed tomography. This method makes it possible to obtain a detailed picture of the pelvic organs.
Transrectal sonography and transrectal ultrasound of the prostate (TrUS). This ultrasound method helps the doctor to see changes in the prostate using a rectal sensor, allows you to assess the condition of the prostate and seminal vesicles. In this case, the volumes of formations are precisely determined. With prostate adenoma and malignant processes, this study is mandatory.
Extended spermogram with MAR test and Kruger test. Indicated for men who cannot conceive a child.This study makes it possible to find out whether prostatitis has affected the ability to fertilize, that is, how the qualitative and quantitative composition of spermatozoa has changed.
Study for PSA. It is performed with suspicion of a malignant tumor after the age of 45.
Deciphering the results of the analysis for prostatitis
Urine analysis. In healthy men, the content of leukocytes is not more than 3. There is no blood in the urine normally.
PCR diagnostics. The presence of DNA of pathogens of sexually transmitted diseases is determined.
Study of prostate juice. The content of leukocytes is not more than 12. Epithelium and erythrocytes are normally single. There should be no other indicators.
Ejaculate analysis. Its volume normally ranges from 2 to 6 ml. There is no mucus, leukocytes - no more than 1 million / ml. The number of live sperm should be at least half. Agglutination and aggregation should not be detected. According to the morphological structure, from 40 to 60% of all germ cells should be from normal spermatozoa.
Uzi and TruZI. During the procedure, the specialist evaluates the density and volume of the prostate. For seminal vesicles, the norm is no more than 5 cm.
Deviation of test results from the norm may indicate an inflammatory process in the prostate gland.
How to prepare for a prostatitis test
The procedure for taking tests for prostatitis requires careful preparation. Otherwise, the results of the study may be unreliable. There is no need to limit the amount of fluid taken. However, 8 hours before the procedure, it is advisable to give up juices, coffee and alcohol.
Urine should be collected in a clean container. Before its collection, a hygienic procedure without the use of detergents is necessary. Do not eat food with natural dyes (beets, blueberries, carrots, herbs) and take drugs with dyes (for example, ascorbic acid dragees). Do not take diuretics, antibiotics and other drugs that affect the results.
Before collecting the secretion of the prostate gland, you will need to massage it. This procedure is performed by a doctor. A three-day sexual abstinence is also required, but not more than 5 days.
To prepare for the spermogram, sexual rest will have to be observed from 5 to 7 days. You can not bathe in the bath and take antibiotics. In addition, you need to give up carbonated drinks and alcohol.
Proper preparation for tests will make it possible to accurately determine the diagnosis and select the appropriate treatment.
