Prostatitis

Definition

Prostatitis is swelling of the prostate gland. The prostate is a walnut-sized gland in men that surrounds the urethra. It produces a fluid that is part of semen.

Anatomy of the Prostate Gland
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There are four types of prostatitis:

  • Acute bacterial prostatitis
  • Chronic bacterial prostatitis
  • Chronic pelvic pain syndrome
  • Asymptomatic inflammatory prostatitis

Causes

Acute and chronic bacterial prostatitis are caused by an infection. A bacteria enters the prostate—usually from the urinary tract or rectum.

The causes of chronic pelvic pain syndrome and asymptomatic inflammatory prostatitis are not clearly understood. In some people, it is possible that a cause may not be found.

Risk Factors

Prostatitis is most common in men who use catheters. Other factors that may increase your risk of prostatitis include:

  • Unprotected sex
  • Phimosis—inability of the foreskin to fully retract over the head of the penis
  • Narrowing of the urethra, the tube that carries urine from the bladder to the outside of the body
  • Enlarged prostate
  • History of urinary tract infections

Symptoms

Symptoms depend on the category of prostatitis syndrome. In many people, symptoms may not appear. In others, they may appear as another condition.

Symptoms may include:

  • Needing to urinate frequently and/or urgently
  • Pain or burning while urinating
  • Difficulty urinating
  • Lower abdominal pain or pressure
  • Penile, rectal, or perineal discomfort
  • Lower back pain
  • Fever or chills
  • Difficulty getting an erection

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. A digital rectal exam may be done as part of the physical exam.

Your bodily fluids and tissues may be tested. This can be done with:

  • Urine tests
  • Prostate massage
  • Prostate biopsy

Treatment

Treatment depends on the type of prostatitis:

Infectious Prostatitis

Acute and chronic bacterial prostatitis are treated with oral antibiotics. Antibiotics may be given over 4-12 weeks. The antibiotics may be given through an IV for severe infections.

Other medications to help manage symptoms include:

  • Stool softeners
  • Anti-inflammatory medications
  • Pain medication
  • Alpha-blockers or 5-alpha reductase inhibitors to help with urine flow

Your doctor may recommend that you avoid alcohol and caffeinated beverages.

Noninfectious Prostatitis

Antibiotics may be recommended if an infection is possible. Other treatments to manage symptoms include:

  • Alpha-blockers or 5-alpha reductase inhibitors
  • Anti-inflammatory medications such as ibuprofen
  • Pain medication
  • Warm sitz baths
  • Repeated prostate massages

Prevention

You may be able to prevent prostatitis if you:

  • Practice safe sex. Protect yourself from sexually transmitted diseases (STDs) by using condoms.
  • Emptying your bladder regularly and as soon as you feel the urge

Revision Information

  • Prostatitis Foundation

    http://www.prostatitis.org

  • Urology Care Foundation

    http://www.urologyhealth.org

  • Canadian Urological Association

    http://www.cua.org

  • Men's Health Centre

    http://www.menshealthcentre.net

  • Acute prostatitis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated May 17, 2013. Accessed March 3, 2014.

  • Propert KJ, McNaughton-Collins M, et al. A prospective study of symptoms and quality of life in men with chronic prostatitis/chronic pelvic pain syndrome: The National Institutes of Health Chronic Prostatitis Cohort Study. J Urol. 2006;175:619-623.

  • Prostatitis. National Kidney and Urologic Diseases Information Clearinghouse website. Available at: http://kidney.niddk.nih.gov/KUDiseases/pubs/prostatitis/index.aspx. Updated June 29, 2012. Accessed March 3, 2014.

  • Prostatitis (prostate infection). Urology Care Foundation website. Available at: http://www.urologyhealth.org/urology/index.cfm?article=15. Updated 2013. Accessed March 3, 2014.

  • Sharp VJ, Takacs EB, et al. Prostatitis: diagnosis and treatment. Am Fam Physician. 2010 Aug 15;82(4):397-406.

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