Prostatitis is often described as an infection of the prostate but it can also be an inflammation and have no sign of infection.
Types of prostatitis include:
- Chronic non-bacterial prostatitis/chronic pelvic pain: This is the most common form of prostatitis, accounting for approximately 90% of cases. The inflammation condition causes urinary and genital pain but there is no sign of infection.
- Acute bacterial prostatitis: This is the least common form of prostatitis. It is a sudden bacterial infection marked by inflammation of the prostate. The symptoms are severe; increased urinary frequency and urgency, increased urination during the night and a high degree of pain in the pelvis and genitals. Often this is accompanied by typical infection symptoms such as fever, chills, nausea, vomiting, and burning when urinating. This needs fast treatment in order to prevent further infections or abscesses. Antibiotics, pain relievers, and fluids are usually sufficient to resolve the infection.
- Chronic bacterial prostatitis. This condition is the result of recurrent urinary tract infections that have entered the prostate gland. It is thought to exist for several years in some men before producing symptoms. The symptoms are similar to acute bacterial prostatitis, but are less severe and can fluctuate in intensity. The diagnosis of this condition is often challenging. It’s often difficult to find the bacteria in the urine. Treatment includes antibiotics for four to 12 weeks and other treatment for pain. Sometimes men are given suppressive low-dose, long-duration antibiotic therapy.
What Causes Prostatitis?
How the prostate becomes infected is not clear. The bacteria that cause prostatitis may get into the prostate from the urethra by backward flow of infected urine or stool from the rectum.
At one time, prostatitis was believed to be a sexually transmitted disease, but more recent research suggests that only a small number of cases are passed on through sex.
Certain conditions and medical procedures increase the risk of developing prostatitis. You are at higher risk for getting prostatitis if you:
- Recently have had a medical instrument, such as a urinary catheter (a soft, lubricated tube used to drain urine from the bladder) inserted during a medical procedure
- Engage in rectal intercourse
- Have an abnormal urinary tract
- Have had a recent bladder infection
- Have an enlarged prostate
Other causes may include autoimmune disease (an abnormal reaction of the body to the prostate tissue).
What Are the Symptoms of Prostatitis?
You may have no symptoms of prostatitis or symptoms so sudden and severe that you seek emergency medical care.
When present, symptoms include:
- Frequent urge to urinate
- Difficulty urinating
- Pain or burning during urination
- Chills and fever
Other symptoms may include pain that comes and goes low in the abdomen, around the anus, in the groin, or in the back. In some cases, bacteria can get into the vas deferens (the tube that carries sperm from the testicles to the urethra), causing groin pain or an infection of the epididymis (area near the testicles where sperm mature and are stored).
The prostate may swell, causing a less forceful urine stream. Sometimes blood in the urine and painful ejaculation are other symptoms of prostatitis.
Men may also complain of pelvic pain, pain during ejaculation, and pain with sexual intercourse.
How Is Prostatitis Diagnosed?
If your doctor suspects that you have prostatitis or another prostate problem, he or she may refer you to a urologist (a doctor who specializes in diseases of the urinary tract and the male reproductive system) to confirm the diagnosis.
Patients typically undergo a comprehensive exam, including a digital rectal exam. The doctor will be able to evaluate whether the prostate gland is enlarged or tender. Then, if the doctor is still not sure what you have, more tests may be done, such as a prostate fluid analysis for signs of infection, transrectal ultrasound, biopsy, or voiding studies. Voiding studies involve the collection and analysis of urine to determine which part of the urinary system is infected.
What Is the Treatment for Prostatitis?
Treatments vary among urologists and are tailored to the type of prostatitis you have. Correct diagnosis is crucial and treatments vary. It’s important to make sure your symptoms are not caused by urethritis (inflammation of the urethra) or some other condition that may lead to permanent bladder or kidney damage.
Treatments for prostatitis can include:
- Anti-inflammatory drugs along with warm sitz baths (sitting in two to three inches of warm water); this is the most conservative treatment for chronic prostatitis.
- Antibiotics for infectious prostatitis; these drugs are not effective treatments for noninfectious prostatitis. For acute infectious prostatitis, patients usually need to take antibiotics for 14-21 days. Almost all acute infections can be cured with this treatment.
- For chronic infectious prostatitis, antibiotics are taken for a longer period of time, usually four to 12 weeks. About 75% of all cases of chronic infectious prostatitis clear up with this treatment. For cases that don’t, taking antibiotics at a low dose for a long time may be recommended to relieve the symptoms.
- Pain medications
- Muscle relaxants
- Surgical removal of the infected portions of the prostate; a doctor may advise this treatment for severe cases of chronic prostatitis or for men whose swollen prostate is blocking the flow of urine.
Supportive therapies for chronic prostatitis, including stool softeners and prostate massage
