Infections - Diagnosis

Prostatitis

Doctors develop a ‘differential diagnosis’ by weighing the results of a patient’s history (symptoms such as painful urination), physical exam (signs such as a tender prostate examination), and diagnostic tests (for instance, the presence or absence of bacteria and inflammatory cells in prostatic secretions), against their own experience, and their awareness of known diseases. By a process of elimination, doctors arrive at a ‘working diagnosis’ (educated guess) they use to name a patient’s complaints. In conventional medicine, subsequent treatments are based on the disease’s name. Although this “naming ceremony” makes the doctor and patient feel better, it doesn’t necessarily correlate with the true cause of the illness, or mean that the symptoms will disappear after treatment (particularly if the wrong name is given). Prostatitis is notorious in this regard. Men are often told they have prostatitis and are prescribed antibiotics (usually without further testing) if they simply complain of prostate pain during a digital rectal examination, even though muscle spasms or a rough exam, not infection, is to blame (only 5% of prostatitis is caused by a bacterial infection). Nevertheless, doctors routinely treat every type of prostatitis with antibiotics. Not surprisingly, two-thirds of these men fail to improve. Although frustrating for the physician, the consequences of assigning a wrong diagnosis can be devastating for the patient who is subjected to months (even years) of unrewarding doctor visits, expensive and invasive tests (which are usually normal), and a grocery list of medications – all to no avail. That’s why it’s crucial for doctors to make an accurate diagnosis. Your physician will need to perform a urinalysis to check for infection or blood cells. A digital rectal exam to palpate the prostate will also be performed. And a sample of prostatic fluid which is obtained by pressing on the prostate during the digital rectal exam will be collected. This fluid is examined for white blood cells and bacteria. In some cases a culture is done.

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