Prostatitis

Prostatitis is a painful inflammation of the prostate. It is a common condition that can affect men at any age.

Prostatitis can be caused by an infection or inflammation that isn't related to an infection. Prostatitis is classified into 4 types by the National Institute of Diabetes and Digestive and Kidney Diseases in the US.

Acute bacterial prostatitis is caused by bacteria. It is called acute because the symptoms start suddenly and may be severe. It is the least common type of prostatitis, but it is the easiest to treat.

Chronic (long-term) bacterial prostatitis is caused by bacteria and often lingers for several months. The symptoms are usually milder than acute bacterial prostatitis and tend to come and go. Chronic bacterial prostatitis can cause urinary symptoms such as burning or pain during urination, but it doesn't cause fever or chills. It appears to be more common in older men with benign prostatic hyperplasia.

Chronic non-bacterial prostatitis/chronic pelvic pain syndrome (CP/CPPS) is the most common type of prostatitis. It is a chronic condition that isn't caused by bacteria. It causes pain or discomfort in the pelvis that may come and go.

Asymptomatic inflammatory prostatitis doesn't cause any symptoms and doesn't need to be treated. It is often diagnosed when doctors do tests to look for other conditions, such as prostate cancer, or to find the cause of infertility. Doctors diagnose asymptomatic inflammatory prostatitis when there are white blood cells in the prostate or prostatic fluid.

Prostatitis can be caused by an infection with bacteria, viruses or fungi. Surgical procedures, such as a prostate biopsy or getting a catheter, can expose the prostate or urethra to infection.

Having unprotected sex can expose the prostate to sexually transmitted infections (STIs) that can cause prostatitis. It is important to note that prostatitis itself isn't contagious, but STIs are.

Other risks for prostatitis are:

• muscle spasms of the bladder or pelvic floor
• a blockage (obstruction) in the bladder or in an ejaculatory duct (pathway from the seminal vesicles to the urethra for fluid that helps make up semen)
• trauma that causes inflammation or nerve damage in the pelvis
• a history of urinary tract infections

The signs and symptoms of prostatitis may include:

• blood in the urine or semen
• burning or pain during urination
• difficult or painful ejaculation
• discharge from the urethra
• pain or discomfort in the genitals, groin, lower abdomen or lower back
• pain or pressure in the rectum
• needing to urinate often (called urinary frequency)
• strong urge to urinate (called urinary urgency)
• decreased urinary stream
• trouble passing urine
• fever, chills and muscle aches
• recurring urinary tract infections
• sexual problems or loss of sex drive

If the signs and symptoms of prostatitis are present, or if the doctor suspects prostatitis, tests will be done to make a diagnosis.

Your doctor may do a physical exam, including a digital rectal exam (DRE). The prostate may feel tender when the doctor touches it.

Your doctor may also order the following tests:

• urine tests, including urinalysis, to check for bacteria and white blood cells in the urine
• a complete blood count (CBC)
• the prostate-specific antigen (PSA) test, but this test usually isn’t done until the inflammation in the prostate has gone away
• blood chemistry tests

If you are having trouble urinating, your doctor may order an ultrasound to see how much urine is trapped in the bladder.

Find out more about these tests and procedures.

The following are treatment options for prostatitis.

Antibiotics are used to treat a bacterial infection.

Alpha-blockers are drugs that relax the muscles near the prostate. This can relieve pressure on the urethra and allow urine to flow more easily.

Muscle relaxants may be given to help lessen bladder contractions. They can help to reduce leakage of urine and the sense of urgency to urinate.

Phytotherapy is a type of herbal medicine (an alternative therapy) that uses natural extracts to treat disease. Doctors sometimes prescribe the phytotherapy herbal medicines quercetin or Cernilton to treat CP/CPPS. Quercetin is an extract found in red wine, green tea and onions. Cernilton is a flower pollen extract. These drugs have been shown to reduce inflammation in the prostate and help relieve symptoms in men with CP/CPPS.

A catheter is a flexible tube that may be put into the bladder through the urethra to help you pass urine.

Supportive therapy may be given to relieve pain and discomfort. Your doctor may prescribe medicines to relieve fever and pain or to soften your stool (poop). You may be given fluids by mouth (orally) or through a needle in a vein (intravenously) to help prevent dehydration. The healthcare team may also recommend relaxation exercises for the muscles of the pelvic floor and warm baths that cover just the hips and buttocks (called a sitz bath).