Prostatitis

Prostatitis is a condition that involves inflammation of the prostate and sometimes the area around it. There are several types of prostatitis, each with a range of symptoms. Some men with the disease will experience severe pain and others will not be bothered; and the rest fall in between the two. However, the symptoms of the disease do have a significant impact on a man’s quality of life.

Types of prostatitis and their causes

  • Acute bacterial prostatitis: It is the least common type of prostatitis but the most easily recognized. It is usually caused by a sudden bacterial infection and easy to diagnose because of the typical symptoms and signs. It is a severe urinary tract infection associated often with fevers and chills, and a visit to a doctor or hospital is required. Acute bacterial prostatitis can affect any age group. The symptoms include painful urination; inability to empty the bladder, pain in the lower back, abdomen or pelvic area; and fever and chills.
  • Chronic bacterial prostatitis: It is similar to acute bacterial prostatitis but the symptoms develop gradually and are less severe. Characterized by recurrent urinary tract infections in men; this condition can affect any age group but is most common in young and middle-aged men.
  • Chronic prostatitis/chronic pelvic pain syndrome/Nonbacterial prostatitis /prostatodynia: It is the most common types of prostatitis. The exact cause of this non-bacterial prostatitis condition is unknown. However, the disease could stem from persistent infection, inflammation and/or pelvic muscle spasms. Inflammation in the prostate can also occur without symptoms. For patients experiencing symptoms they do include; pain in the genitals and pelvic area, difficulty or pain urinating, and sometimes pain during or after ejaculation.
  • Asymptomatic inflammatory prostatitis: There are men with prostatitis but have no symptoms, despite having an inflammation of the prostate. Diagnosis is made when the patient is being evaluated for symptoms unrelated to prostatitis. In cases such as these is evidence of inflammation is found in biopsied tissue or specimens of urine, semen or prostatic fluid.

What causes prostatitis?

The direct causes of prostatitis are not fully known by the medical community. However, there are several accepted theories. Some cases of prostatitis are clearly related to acute and chronic bacterial prostatitis infections. These infections get into the prostate from the urethra by backward flow of infected urine into the prostate ducts. Bacterial prostatitis is not contagious and is not a sexually transmitted disease. Certain conditions or medical procedures increase the risk of contracting bacterial prostatitis. There is a higher risk if the man has recently had a catheter or other instrument inserted into his urethra, an abnormality of his urinary tract or a recent bladder infection.

Chronic prostatitis/chronic pelvic pain syndrome may be caused by atypical organisms such as chlamydia, mycoplasma (which may be transmitted by sexual contact) ureaplasma or may also be due to a chemical or immunologic reaction to an initial injury or previous infection. The nerves and muscles in the pelvis may cause pain in the area, either as a response to the prostate infection or inflammation or as an isolated problem itself.

What are the symptoms of prostatitis?

The symptoms depend on the type of prostatitis infection the man is suffering from. Often men do not notice any symptoms, while some experience symptoms similar to that of a urinary tract infection. However, other diseases can cause the same or similar symptoms. It is very important to be evaluated by a medical professional to determine if the patient has prostatitis and which type so that it can be properly treated.

With acute bacterial prostatitis, the symptoms are severe and sudden and may cause the patient to seek emergency medical care. Common symptoms also include chills, fever, severe burning during urination and the inability to empty the bladder.

In chronic bacterial prostatitis, the symptoms are similar to the acute bacterial prostatitis infections but it does not produce a fever. Other symptoms are burning during urination; urinary frequency, especially at night; perineal, testicular, bladder and low back pain; and painful ejaculation. The condition can be episodic, with flare-ups and remissions, associated with infection, treatment and subsequent recurrence.

What is the treatment for prostatitis?

Acute bacterial prostatitis treatment:

Treatment for acute bacterial prostatitis is a prescription for antibiotics by mouth, usually ciprofloxacin or tetracycline. Home care includes drinking plenty of fluids, medications for pain control, and rest. If the patient is acutely ill or has a compromised immune system (for example, is taking chemotherapy or other immune suppression drugs or has HIV/AIDS), hospitalization for intravenous antibiotics and care may be required.

Chronic bacterial prostatitis treatment:

Chronic bacterial prostatitis treatment is with long-term antibiotics, up to eight weeks, with ciprofloxacin, sulfa drugs or erythromycin. Even with appropriate therapy, this type of prostatitis can recur. It is uncertain as to why, but it may be due to a poorly emptying bladder. A small amount of stagnant urine allows the potential for recurrent infection to occur. This situation can be caused by benign prostatic hypertrophy (BPH), bladder stones, or prostate stones.

Chronic prostatitis without infection treatment:

Chronic prostatitis without infection treatment addresses chronic pain control and may include physical therapy and relaxation techniques as well as tricyclic antidepressant medications. Other medication possibilities include alpha-adrenergic blockers. Tamsulosin and terazosin are drugs that block the non-heart adrenaline receptors and are used in treating BPH and bladder outlet obstruction. Allowing better bladder emptying may help minimize symptoms.

Asymptomatic inflammatory prostatitis treatment:

Treatment is not required for this type of prostatitis. In patients undergoing infertility assessment, this inflammation may be treated with a course of either a nonsteroidal anti-inflammatory medication (ibuprofen, Motrin, Advil) or antibiotics.