How to do a comprehensive check for prostatitis?

Patient's question:

I am a former patient of prostatitis. I have been treated for over two months, but not only has it not improved, it has worsened. I would like to undergo a comprehensive check-up again. Could you please ask the doctor: How long should I stop taking the anti-inflammatory medication before undergoing a comprehensive check-up? What kind of tests should I do to get a more thorough diagnosis of the type of prostatitis? Thank you for your reply.

Doctor's answer:

The simplest method for checking the prostate is the digital rectal exam (DRE), where the doctor uses a finger to probe the size, hyperplasia, and degree of enlargement of the prostate for preliminary diagnosis and screening. At the same time, the DRE can also examine the characteristics and composition changes of prostatic fluid.
Ultrasound is also a common method for checking the prostate, with two detection methods: transrectal ultrasound and transabdominal ultrasound. Its error rate is no more than 5%, and it offers advantages such as simplicity, non-invasiveness, and speed.
X-ray examinations hold significant value in the diagnosis of prostate diseases. For example, plain films can detect whether the prostate has calcification or stone shadows, while contrast studies can help identify whether there is benign prostatic hyperplasia or prostate cancer. CT scans are even more important for differential diagnosis of prostate diseases.
Prostate needle biopsy can clearly determine the nature of prostate masses. It can be performed via transrectal needle biopsy or perineal needle biopsy, which involves some pain and trauma but is essential for confirming the diagnosis.
Cystoscopy allows direct observation of the posterior urethra and the hyperplasia of the median and lateral lobes of the prostate, making it very important for diagnosing benign prostatic hyperplasia or hypertrophy.

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