When is a prostate exam performed in evaluation of chronic bacterial prostatitis (CBP)?

Updated: Jan 15, 2019
  • Author: Samantha D Kraemer, MD; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

Prostate examination by digital rectal examination (DRE) shoud be done after collection of preprostatic massage urine specimens. The prostate may be normal in size and consistency or may seem slightly boggy. Pain during prostate examination is variable and unhelpful for classifying the type of prostatitis. [1]  In contrast, acute bacterial prostatitis is characterized by a very tender, warm, swollen, boggy gland. When acute bacterial prostatitis is suspected, prostate massage should be avoided because of the risk of causing bacteremia.

Prostatic calculi are rarely palpable on prostate examination because they are typically located deep within the prostate gland. If calculi are palpable they are a significant clue to the cause of the recurrences, because they can be a nidus for infection.


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