The Pre and Post Massage Test (PPMT): a simple screen for prostatitis

Abstract

The segmented quantitative culture technique originally described more than 25 years ago is acknowledged as the best test to diagnose prostatitis. However, it, is not widely used in clinical practice. This is especially true in primary care settings, but even most urologists appear to have abandoned the procedure. Herein is proposed a simple and cost-effective screen for prostatitis, which involves the culture and microscopic examination of urine before and after prostatic massage. This Pre and Post Massage Test (PPMT) was applied to a personal series of 53 patients and 59 patients from the literature in whom the results of the segmented cultures are available and the results were reevaluated. In this selected patient population the PPMT alone led to the same diagnosis in 102 (91.1%). Within the expected limitations of this retrospective review, the calculated sensitivity and specificity of the PPMT were both 91%. This report should provoke researchers to review their prostatitis data, stimulate discussion, and hopefully convince physicians that adoption of a simpler diagnostic plan for prostatitis is far superior to doing no workup at all.