Is prostate fluid test painful?

Sometimes, because of many strange symptoms of the prostate, people have to go to the hospital for a prostate examination. However, during the prostate examination, one of the tests is a prostate fluid test, which makes many people worry that there may be pain. First of all, you can consult a doctor before the examination, because everyone's physical sensation is different. Generally, there will be no pain during the examination.

Check items

(1) Acid phosphatase content. Acid phosphatase mainly originates from the prostate, and its content is positively correlated with zinc concentration. When suffering from prostate cancer, both levels increase significantly. Therefore, the content of acid phosphatase can be used as an objective indicator for the diagnosis, treatment, and follow-up of prostate cancer.

(2) Zinc ion concentration. The prostate is one of the tissues with the highest zinc content in the body, and the zinc concentration in prostatic fluid is also very high. The prostate can synthesize zinc-containing peptides with antibacterial effects, so the zinc content is related to the bactericidal ability and antibacterial mechanism of prostatic fluid. In chronic prostatitis, the zinc concentration drops from the normal 480 micrograms/ml to about 148 micrograms/ml. When the ejaculatory duct is blocked and azoospermia occurs, the zinc concentration in semen increases significantly. This is because the proportion of prostatic fluid in semen increases significantly.

(3) Acidity and alkalinity. Under normal circumstances, prostatic fluid is slightly acidic, but sometimes it is alkaline, with a pH range of about 6.7 to 7.3. The pH of prostatic fluid becomes more alkaline with age. When inflammation occurs, the pH can increase to 7.7 to 8.5.

(4) Citrate concentration. The secretion of citric acid is controlled and regulated by androgens. The citric acid level is positively correlated with the zinc concentration (that is, when one increases, the other also increases proportionally). The normal citric acid concentration is about 19 mg/ml, and it drops to about 6.4 mg/ml in patients with prostatitis.

Extraction method

Prostatic fluid collection by rectal digital examination

The method of prostate massage is very simple. The patient's family can also help with the massage. The massage method is introduced as follows: First, the patient should empty his bowels, then lie on the bed in a knee-chest position or side-lying position. The operator wears a finger glove or a milk glove on the index finger of the right hand, or a condom can be used instead. Apply a small amount of vaseline or paraffin oil on the finger glove. During the operation, massage around the anus for a few times to relax the anal muscles, then slowly insert the index finger into the anus, with the fingertip downward. About 3-4 cm below it, you can touch the chestnut-sized prostate, with a shallow groove in the center. Press the two lobes of the prostate from the outside to the inside and below for 3-4 times, and then press the central groove from top to bottom for 3-4 times in sequence. At this time, the patient will feel like urinating, and milky white liquid will flow out of the urethra. Use a glass slide to collect it and send it for examination. If no liquid flows out, you can collect urine for testing after the massage. As long as the urine is turbid after the massage, it means that a small amount of prostatic fluid has entered the urethra after being squeezed by the massage and flushed out by the urine.

B-ultrasound is also a common method for prostate examination, including transrectal detection and transpubic upper abdominal detection, which can accurately measure the prostate with an error of no more than 5%. It has important diagnostic significance for various prostate diseases and has the advantages of being simple, non-invasive, non-destructive and fast.

X-ray examinations are of great value in the diagnosis of prostate diseases. For example, plain films can detect whether there is calcification or stones in the prostate. Contrast imaging can help detect whether there is prostate hyperplasia or prostate cancer.

CT examination is even more important for the differential diagnosis of prostate diseases. Prostate puncture biopsy is very useful for clarifying the nature of prostate masses, and is of great help in clarifying the tissue typing and cytological characteristics of prostate tumors. It can be performed by transrectal needle aspiration biopsy or perineal puncture biopsy. It is painful and traumatic, but very necessary. In addition, lower urinary tract urodynamics examination is very helpful in diagnosing prostate hyperplasia. Cystoscopy can directly observe the hyperplasia of the posterior urethra, seminal colliculus, and the middle and lateral lobes of the prostate, which is also very important for diagnosing prostate diseases.