Subject: alt.support.prostate.prostatitis FAQ 2/5
Supersedes: <medicine/prostatitis-faq/part2_818363045@rtfm.mit.edu>
Date: 6 Jan 1996 23:45:56 GMT
References: <medicine/prostatitis-faq/part1_820971430@rtfm.mit.edu>
X-Last-Updated: 1995/10/16

Posting-Frequency: monthly

5.  How is prostatitis distinguished from BPH and prostate cancer?

Some of the same symptoms may be caused by BPH or prostate cancer. 

To tell the difference, a doctor may perform a digital rectal exam
(putting a rubber-gloved finger up the rectum to feel the outside
of the prostate for lumps and size) and/or order a PSA blood test. 
In some cases, a biopsy may be scheduled to rule out prostate
cancer.

If cancer is not found and if the prostate is of an appropriate
size, prostatitis can be assumed to be the problem.  A cystoscopy,
in which a tube is inserted (under anesthesia) through the penis to
look at the prostate from the inside is sometimes done to determine
if there is inflammation.  During a digital rectal exam, the doctor
may press on the prostate to force out some of the fluid; the fluid
can be examined for inflammatory cells.  

6.  How common is prostatitis?

It is estimated that at least 40% of men's visits to urologists are
caused by prostatitis.  It can affect young men, while BPH and
prostate cancer are more typical of older men.  Because prostatitis
varies in severity and because it has attracted little attention
from researchers, no one knows how many men suffer from it.

7.  Are there different kinds of prostatitis?

Most discussion of prostatitis divides it into four types. 
However, they are often hard to tell apart, and the dividing lines
are often not clear.

Acute bacterial prostatitis comes on quickly, can cause intense
pain, fever, and chills, and can require hospitalization, but is
usually cured quickly with antibiotics.

Chronic bacterial prostatitis is less intense, but is not cured
quickly.  Examination of the urine and prostatic fluid,
particularly via the Meares and Stamey technique, indicate that
disease-causing bacteria are present in the prostate.  The
condition may clear up after several months of antibiotics, or it
may not.

The symptoms of chronic nonbacterial prostatitis are the same, but
no disease-causing bacteria can be identified.  Signs of
inflammation are seen.

In prostatodynia (which means simply "prostate pain"), there is no
sign of inflammation, even though there is pain in the prostate.

Because of the limits of diagnostic tests (including the Meares and
Stamey technique), it is not clear that the last three categories
are distinct.  Another way of categorizing prostatis is as being
either "high white blood cell count," or "low blood cell count"
prostatitis, depending on the number of white blood cells--
indicating infection--which show up in the prostatic fluid under a
high powered microscope.  This is called the Drach classification.
