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Diagnostics
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Recent Advancements in the Diagnostics of Prostatitis
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Recent Advancements in the Diagnostics of Prostatitis

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Diagnostic Microbiology and Infectious Disease".

Deadline for manuscript submissions: 30 September 2025 | Viewed by 1670

Special Issue Editors

Dr. Alberto Trinchieri

E-Mail Website
Guest Editor
School of Urology, University of Milan, 20122 Milan, Italy
Interests: urinary calculi; urinary tract infection; prostatitis
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Florian Wagenlehner

E-Mail Website
Guest Editor
Department of Urology, Pediatric Urology and Andrology, Justus-Liebig-University, Giessen, Germany
Interests: urinary tract infections; diagnosis; novel antibiotics; clinical studies
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue offers a compelling glimpse into the groundbreaking strides made in the field. It showcases cutting-edge research that has revolutionized the diagnosis of this prevalent and often challenging condition. From innovative biomarker discoveries and diverse diagnostic microbiology methods to advanced imaging techniques, the contributions highlight the integration of precision medicine principles, enhancing early detection and treatment personalization. Moreover, the Special Issue delves into the complexities of prostatitis, addressing the need for multi-disciplinary approaches and the role of patient-centered care. Overall, this Special Issue underscores the importance of ongoing research efforts in advancing diagnostic capabilities, ultimately improving patient outcomes and the quality of life for those affected by prostatitis.

Dr. Alberto Trinchieri
Prof. Dr. Florian Wagenlehner
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • prostatitis
  • diagnostics
  • biomarkers
  • microbiology
  • imaging technologies
  • MRI
  • ultrasound
  • precision medicine
  • inflammatory proteins
  • genetic markers
  • artificial intelligence

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Published Papers (3 papers)

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Research

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16 pages, 543 KiB  
Communication
16S rRNA Gene Sequence Analysis of V6–V8 Region Provides Limited Advantage in Diagnosis of Chronic Prostatitis
by Jens Rosellen, Moritz Fritzenwanker, Hans-Christian Schuppe, Undraga Schagdarsurengin, Florian Wagenlehner and Adrian Pilatz
Diagnostics 2025, 15(8), 1003; https://doi.org/10.3390/diagnostics15081003 - 15 Apr 2025
Viewed by 416
Abstract
Background: 16S rRNA analysis has been used in various diseases to identify pathogenic bacteria. In particular, pathogens that are difficult to cultivate or previously unknown can be detected with great certainty. In chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), a distinction between bacterial [...] Read more.
Background: 16S rRNA analysis has been used in various diseases to identify pathogenic bacteria. In particular, pathogens that are difficult to cultivate or previously unknown can be detected with great certainty. In chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), a distinction between bacterial and non-bacterial genesis is essential with regard to categorization and therapy. The objective of this study is to investigate the value of 16S rRNA gene sequence analysis in the routine management of patients with CP/CPPS especially after failure to detect a pathogen in conventional culture and polymerase chain reaction for sexually transmitted diseases (STI-PCR). Methods: In total, 228 patients with CP/CPPS were prospectively enrolled and received a comprehensive andrological work-up. Microbial analysis consisted of standard bacterial cultures and the detection of sexually transmitted pathogens by PCR using urine specimens from a 2-glass test and semen analysis. 16S rRNA gene sequence analysis was performed in patients with urine and semen of patients without bacterial pathogens in microbiological culture and STI-PCR. Results: In 184 of 199 (92%) patients with negative ejaculate culture and negative STI-PCR, no pathogen could be detected by 16S rRNA analysis and in the case of a positive result, the analysis only showed non-pathogenic bacteria of the normal flora. There was no statistical association between the 16S rRNA analysis and the inflammatory markers or the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) scores. Conclusions: At least in our study cohort, the 16S rRNA analysis provided no additional benefit following microbiological culture and STI-PCR in the categorization of patients with CP/CPPS. Full article
(This article belongs to the Special Issue Recent Advancements in the Diagnostics of Prostatitis)
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15 pages, 844 KiB  
Article
Pathogen Detection and Diagnostic Scenarios in Chronic Prostatitis
by Vittorio Magri, Gianpaolo Perletti and Konstantinos Stamatiou
Diagnostics 2025, 15(6), 762; https://doi.org/10.3390/diagnostics15060762 - 18 Mar 2025
Viewed by 594
Abstract
Background/Objectives: Chronic prostatitis (CP) is characterized by a variety of symptoms, including pelvic pain, urinary disturbances, and sexual dysfunction, often without clear signs of infection, which complicates its diagnosis. For decades, the NIH consensus definitions and the Meares–Stamey 4-glass test have been the [...] Read more.
Background/Objectives: Chronic prostatitis (CP) is characterized by a variety of symptoms, including pelvic pain, urinary disturbances, and sexual dysfunction, often without clear signs of infection, which complicates its diagnosis. For decades, the NIH consensus definitions and the Meares–Stamey 4-glass test have been the cornerstone of diagnosing and classifying CP. However, emerging research suggests that some cases with negative microbiological findings may still respond to antibacterial therapy, potentially due to undiagnosed infections. This study aimed to compare four lower genito-urinary tract diagnostic methods to identify which is most effective at detecting causative pathogens in CP patients. Two simplified tests, each involving only two specimens, were also simulated. Methods: This retrospective study examined a database of patients diagnosed with chronic prostatitis according to NIH criteria. Patients aged 18–59 underwent clinical and microbiological diagnostic assessments using four testing modalities: the Meares–Stamey 4-glass “gold standard” test, the two-glass pre–post-massage test, and two tests incorporating post-massage semen samples, namely the five-glass test and the VB2-semen test. The diagnostic outcomes and pathogen detection rates for each test were compared using the ANOVA and the Pearson’s chi-squared tests. Results: Compared to the four-glass and two-glass tests, the five-glass and VB2-semen tests detected similar proportions of E. coli and other Gram-negative traditional prostatic pathogens. However, they were more effective in detecting significantly higher percentages of Enterococci. Moreover, the five-glass and VB2-semen tests, which included semen samples, identified a broader spectrum of pathogens and significantly higher proportions of sexually transmitted pathogens. Conclusions: Tests that included semen samples were more effective at detecting Gram-positive pathogens such as Enterococci and sexually transmitted pathogens. We advocate for incorporating semen samples into the standard four-glass test to enhance diagnostic accuracy and improve the targeted antibacterial treatment of chronic prostatitis. Full article
(This article belongs to the Special Issue Recent Advancements in the Diagnostics of Prostatitis)
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Review

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11 pages, 396 KiB  
Review
Could Urology’s Antimicrobial Stewardship Be Enhanced by the Routine Use of the Meares and Stamey Test?
by Simone Botti, Tommaso Ceccato, Michele Rizzo, Giovanni Liguori, Alessandro Zucchi, Alessandro Palmieri, Truls E. Bjerklund Johansen and Tommaso Cai
Diagnostics 2025, 15(8), 1002; https://doi.org/10.3390/diagnostics15081002 - 14 Apr 2025
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Abstract
Background/Objectives: Chronic bacterial prostatitis (CBP) is a prevalent urological condition significantly impacting patients’ quality of life. Accurate diagnosis is essential to differentiate bacterial from non-bacterial prostatitis and to guide appropriate antimicrobial therapy. In the context of antimicrobial resistance (AMR), the Meares and [...] Read more.
Background/Objectives: Chronic bacterial prostatitis (CBP) is a prevalent urological condition significantly impacting patients’ quality of life. Accurate diagnosis is essential to differentiate bacterial from non-bacterial prostatitis and to guide appropriate antimicrobial therapy. In the context of antimicrobial resistance (AMR), the Meares and Stamey (M&S) test is a valuable diagnostic tool for targeted antibiotic use and a valuable antimicrobial stewardship (AMS) measure. Despite its clinical relevance, its adoption is limited by practical and logistical challenges. Methods: Relevant databases were searched by using methods recommended by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The keywords used included “Meares and Stamey test,” “antimicrobial stewardship and prostatitis,” and “chronic bacterial prostatitis and Meares.” Results: We enclosed seven studies: one single-center prospective observational comparative study, two national surveys, three cross-sectional studies, and one consensus conference. The M&S test remains the gold standard for diagnosing CBP, offering high specificity in identifying bacterial infections localized within the prostate. The test enables precise pathogen identification and facilitates targeted antimicrobial therapy. Despite its clinical relevance, its adoption is hindered by procedural complexity, patient discomfort, and the apparent need for specialized personnel and facilities. Alternative diagnostic methods, such as the two-glass pre- and post-massage test (PPMT), have demonstrated comparable diagnostic sensitivity while being more practical and time-efficient. Additionally, emerging microbiological techniques are under investigation to increase the M&S test’s sensitivity. Conclusions: The M&S test plays a crucial role in AMS by ensuring targeted antimicrobial therapy in CBP. Overcoming its limitations through patient stratification, clinician education, and the integration of emerging microbiological techniques is essential to enhance its applicability in modern urological practice. Full article
(This article belongs to the Special Issue Recent Advancements in the Diagnostics of Prostatitis)
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