Prostatitis

Prostatitis, an inflammation or infection of the prostate gland, can affect men of any age. As the most common urological problem in men aged 50 and older, prostatitis is not contagious and is not transmitted from sexual activity.

The prostate is a walnut-sized male organ within the male urinary system that lies next to the bladder. Its main function is producing semen, or the fluid that carries sperm during ejaculation. Prostatitis often causes urinary symptoms because the prostate surrounds the urethra, the tube carrying urine out of the body.

Prostatitis Symptoms

Each distinct type of prostatitis has unique symptoms. They include:

Chronic pelvic pain syndrome (CPPS): This is the most common type of prostatitis and affects about 90% of men who have the condition. Symptoms include painful ejaculation characterized by long-lasting pelvic pain, but without evidence of inflammation or bacterial infection. Bladder and rectal pressure or pain are common. The exact cause of CPPS is usually unclear.
Asymptomatic inflammatory prostatitis does not produce any symptoms, but a physician may find infection-fighting cells in the patient’s semen while diagnosing other conditions like prostate cancer or enlargement.
Acute bacterial prostatitis is the least common form of prostatitis, but easiest form of the condition to treat. The condition comes on suddenly, often accompanied by fever, severe burning during urination, inability to empty the bladder, and low back or groin pain. This condition requires immediate medical care. Left untreated, acute bacterial prostatitis may cause sterility, inability to urinate, and even bacteremia (bacteria in the blood).
Chronic bacterial prostatitis is also uncommon. Men with this condition experience less intense symptoms, but for a longer period of time. They may have frequent urinary tract infections (UTIs). Bacterial prostatitis is caused by bacteria from infected urine that backs up into the prostate ducts. Men who have had catheterization, injury to the area or a recent bladder infection are at greater risk.

Prostatitis Causes

Although the cause of prostatitis is usually unknown, contributing factors that increase the likelihood of developing the condition include:

Infections not found during standard tests
Sexually transmitted infections/diseases (STIs/STDs)
Persistent bladder infections
Pelvic muscle spasm
Strenuous physical activity with a full bladder

Diagnosis

Before diagnosing prostatitis, your physician must rule other problems like prostate cancer or an enlarged prostate. Apart from taking a medical history, your doctor will perform physical exam that includes a digital rectal exam (DRE), where the prostate is checked for size, tenderness, and the possibility of cancer. Your doctor may order urine or semen tests to check for an infection to identify which bacteria are involved. The urethra, bladder, and prostate will be examined with a tiny telescope-like instrument (cystoscopy) and urine flow studies also may be ordered.

In addition to identifying prostatitis, chronic pelvic pain syndrome (CPPS) is diagnosed after other probable causes have been eliminated and when prostatitis has lasted for three or more months. Often, it is a diagnosis of exclusion after other conditions have been ruled out.

Prostatitis Treatment

Acute and chronic bacterial prostatitis can be treated effectively with antibiotics. Patients must continue to take medication as prescribed (which may be for weeks or months), even if their symptoms improve. This helps prevent a new infection.

Effective treatments may include the following:

Alpha blockers such as Flomax may improve urinary symptoms by relaxing bladder muscles
Muscle relaxants
Pain relievers such as ibuprofen or naproxen
Herbal remedies such as Quercetin or bee pollen
Physical therapy, including pelvic exercises or biofeedback
Warm baths and relaxation techniques
Dietary changes such as discontinuing caffeinated, spicy, and acidic foods and beverages
Experimental treatments with heat (microwave) therapy, which are being evaluated