| In any case, the urine test will probably tell you
you don't have diabetes or kidney disease or any of a number of
metabolic disorders. However, it won't tell you you don't have an
infection. To look further for an infection, you'll need a 4-jar
test, an EPS culture or a semen culture, or maybe all three. These
are all discussed below.
The Four Glass Test
In 1968 two urologists, Meares and Stamey, published a paper about
the four glass test for prostatitis. In those days doctors collected
urine for examination in sterile glasses. Today, of course, sterile
plastic specimen containers are generally used. (Meares EM and Stamey
TA: Bacteriologic localization patterns in bacterial prostatitis
and urethritis. Invest Urol. 1968 Mar;5(5):492-518.)
Patients are asked to urinate their first 10 ccs of urine into
a sterile cup. Then, they are asked to urinate 10 ccs of urine from
their midstream into a sterile cup. Next, their prostate is massaged
and expressed prostatic secretions are collected. Finally, another
10 ccs of urine is collected to finish the "four glass collection."
Doctors call these samples:
VB1 - voided bladder 1, which represents the urethra.
VB2 - voided bladder 2, which represents the bladder.
EPS - expressed prostatic fluid, which represents the prostate.
VB3 - voided bladder 3, which also represents the prostate.
These samples are all cultured and if one specimen grows far more
bacteria than the others, it is felt that the infection has been
localized to the urethra, bladder, or prostate, depending on which
specimen grows bacteria.
The Two Glass Test
Urologist J. Curtis Nickel has suggested that a 2 glass test may
suffice where only the EPS and the VB3 specimen are collected. (Nickel
JC: The Pre and Post Massage Test (PPMT): a simple screen for prostatitis.
Tech Urol. 1997 Spring;3(1):38-43.)
The One Glass Test
Urologist Wolfgang Weider, et al., showed that their is a 90 percent
correlation between the VB3 specimen having high numbers of white
blood cells and the EPS having high numbers of white blood cells.
(Schneider H, Ludwig M, Hossain HM, Diemer T, Weidner W: The 2001
Giessen Cohort Study on patients with prostatitis syndrome--an evaluation
of inflammatory status and search for microorganisms 10 years after
a first analysis. Andrologia. 2003 Oct;35(5):258- 62.)
Cultures and other tests
Once prostate fluid and VB3 specimens are obtained and the white
blood cells are counted, the diagnostic workup moves on to searching
for microbes in many cases.
The following is a short list of microbial tests that can be
done:
aerobic cultures
anaerobic cultures
special cultures for hard to culture organisms
Chlamydia tests
Mycoplasma tests
Ureaplasma tests
Tuberculosis tests
PCR tests
Immune florescence tests
|
