Prostatitis

Prostatitis is an inflammation of the prostate gland. Prostatitis is the most common urological diagnosis in men younger than 50, and the third most common urological diagnosis in men over 50. Five percent of men between 20 and 40 will develop prostatitis. Prostatitis is diagnosed and treated by the Urology Division of Premier Medical Group.

What causes prostatitis?

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Causes for prostatitis include:

  • Unprotected anal intercourse
  • Urinary retention
  • Abnormal urinary tract
  • Recent use of a catheter
  • Enlarged prostate
  • Autoimmune disease
  • Acute epididymitis
  • Dysfunctional voiding
  • Pelvic floor dysfunction

What are the symptoms of prostatitis?

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Some men experience no symptoms whatsoever, while others experience such immediate and extreme pain they need to seek emergency medical care. Symptoms include:

  • Difficulty in urinating
  • Frequent urge to urinate
  • Chills and fever
  • Pain or burning during urination
  • Intermittent pain in the abdomen, around the anus, groin, pelvic area, and or back

How is prostatitis diagnosed?

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Diagnosis of prostatitis begins with a complete medical history and physical examination. A thorough genital urinary exam is required including scrotal, perineal and rectal examination. The doctor performs a digital rectal exam (DRE) by inserting a gloved and lubricated finger into the patient’s rectum, just behind the prostate. The doctor can feel the prostate to see if it is swollen or tender in spots.

Other tests include:

  • Urinalysis, to help distinguish the types of prostatitis and which type of antibiotics should be used
  • Blood tests, looking for white blood cells and bacteria suggesting infection
  • PSA blood test checking levels of prostate surface antigen, which can indicate an inflamed prostate as well as prostate cancer especially when recurrent symptoms refractory to antiobiotics occur
  • Imaging may include ultrasound, X-ray, and computerized tomography (CT)

What are the types of prostatitis?

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  • Acute bacterial prostatitis is the least common of the four types and is potentially life-threatening, but it is the easiest to diagnose and treat effectively. Men with this disease often have chills; fever; pain in the lower back and genital area; urinary frequency and urgency, often at night; burning or painful urination; body aches; and a demonstrable infection of the urinary tract as evidenced by white blood cells and bacteria in the urine.
  • Chronic bacterial prostatitis, also relatively uncommon, occurs when bacteria find a spot on the prostate where they can survive. Men have urinary tract infections that seem to go away but then come back with the same bacteria.
  • Chronic prostatitis/chronic pelvic pain syndrome is the most common but least understood form of prostatitis. It may be found in men of any age. Its symptoms go away and then return without warning, and it may be inflammatory or non-inflammatory. In the inflammatory form, urine, semen, and prostatic fluid contain the kinds of cells the body usually produces to fight infection, but no bacteria can be found. In the non-inflammatory form, not even the infection-fighting cells are present.
  • Asymptomatic inflammatory prostatitis is the diagnosis given when the patient does not complain of pain or discomfort but has infection-fighting cells in his prostate fluid and semen. Doctors usually find this form of prostatitis when looking for causes of infertility or testing for prostate cancer.

What are the treatment options for prostatitis?

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The bacterial forms of prostatitis are treated with antimicrobials. Acute prostatitis may require a short hospital stay so that fluids and antimicrobials can be given through an intravenous, or IV, tube. After the initial therapy, the patient will need to take antimicrobials for 2 to 4 weeks.

Chronic bacterial prostatitis requires a longer course of therapy. The doctor may prescribe a low dose of antimicrobials for 6 months to prevent recurrent infection. If a patient has trouble emptying his bladder, the doctor may recommend medicine or surgery to correct blockage.

Antimicrobials will not help nonbacterial prostatitis. Each patient will have to work with his doctor to find an effective treatment. Changing diet or taking warm baths may help. The doctor may prescribe a medicine called an alpha blocker to relax the muscle tissue in the prostate. No single solution works for everyone with this condition.