Prostatic fluid examination for white blood cells

The examination of prostatic fluid is a routine examination. You should do this examination when you feel inflammation. This will allow you to visually see whether there is a possibility of lesions in your prostate. The most important thing is that it can detect the white blood cell index. Once the white blood cell index shows an abnormality, it means that inflammation has occurred in your body and further examination is necessary.

The diagnosis can be made based on the patient's medical history, symptoms, rectal indications, prostatic fluid examination, and four-cup test results. Since prostatitis often develops from other infections in the body, such as urinary tract infection, seminal vesiculitis, epididymitis, and inflammation near the rectum, a comprehensive examination of the urogenital system and rectum is necessary when diagnosing prostatitis.

1. Examination of external genitalia

Exclude urethral stenosis or other diseases that may affect urination (such as phimosis, penile tumor, etc.).

2. Digital rectal examination (DRE)

Rectal examination is a simple but important diagnostic method that needs to be performed after the bladder is empty. The boundaries, size, and texture of the prostate should be noted. In prostate hyperplasia, the gland may increase in length, width, or both. The degree of prostate enlargement is described in different clinical methods.

There is a certain error in rectal examination in estimating the size of the prostate. If the middle lobe protrudes into the bladder, the enlargement of the prostate gland will not be obvious during rectal examination. At the same time, if a suspicious nodule is found on the prostate during rectal examination, a puncture biopsy should be performed to rule out the possibility of prostate cancer. The proportion of patients with abnormal DRE who are finally diagnosed with prostate cancer is 26%~34%, and the positive rate tends to increase with age. At the same time, attention should be paid to the contraction function of the anal sphincter to rule out neurogenic bladder dysfunction.

3. Regional neurological examination (including movement and sensation)

Examination of the perianal and perineal nervous systems to detect neurogenic bladder dysfunction.

4. Urine routine

To determine whether patients with lower urinary tract symptoms (LUTS) have hematuria, proteinuria, purulent urine, and glycosuria.

5. Ultrasound examination

Observe the size, shape and structure of the prostate, whether there is abnormal echo, the degree of protrusion into the bladder, and the postvoid residual volume. Commonly used methods include transrectal and transabdominal ultrasound examinations. The former is more accurate but requires higher equipment, while the latter is simple and can be widely used.

Transrectal B-ultrasound examination can also measure the volume of the prostate, and from the sonogram during urination, the deformation and displacement of the urethra can be judged, the dynamic changes of lower urinary tract obstruction can be understood, and the status after treatment can also be understood. Transabdominal B-ultrasound examination is more commonly used in China, but it is not as good as transrectal B-ultrasound examination in observing the internal structure of the gland.