Facts men should know about prostatitis

Facts men should know about prostatitis

The constant urge to urinate, possibly from erectile dysfunction or pain experienced in the scrotum, are a few symptoms associated with the most common urological ailment for men under the age of 50.  Public health awareness campaigns are often focused on increasing men’s awareness on prostate health concerns.  This often includes conditions such as prostate enlargement also known as benign prostatic hyperplasia (BPH) and prostate cancer. But around 2 million American men each year will also make appointments with their doctors for a less well-known but still painful prostate problem – prostatitis. 

Prostatitis is a condition that will affect up to one in six men at some point in their life.  In fact, prostatitis is the most common urologic diagnosis in males younger than 50 years and the third most common diagnosis in men older than 50 years – after BPH and prostate cancer. 

The term prostatitis means inflammation of the prostate gland – anything word ending in “it is” means inflammation.  Unlike BPH and prostate cancer which generally affect older men, prostatitis is an equal opportunity condition affecting men of all ages.

Irritation or inflammation of the prostate gland can occur for a number of reasons.  Sometimes, bacteria-laden urine leaks back from the urethra, penetrating the prostate gland causing a bacterial infection. Use of a catheter or other instrument also can introduce infectious agents.  However, there can be no clear cause of why it is occurring.  Some other possibilities could be trauma, increased pressure on the prostate, an overactive immune system or even excessive stress which could be contributing to prostate irritation.

Whatever the cause may be, there are four type of prostatitis:

1. Acute bacterial prostatitis

This type usually comes on suddenly and can cause fever and chills in addition to pain and urinary symptoms such as painful urination, blood in the urine, a reduced or difficulty starting a urine stream, or foul-smelling urine.  It results from a bacterial infection, often from bacteria originating in the urinary tract or large intestine. 

How is it treated? – A doctor will prescribe antibiotics for four to six weeks to treat acute bacterial prostatitis.  If a man is having recurrent episodes, then the treatment may last longer.  Alpha-blockers which relax bladder muscles and reduce urinary discomfort may also be prescribed to help relieve symptoms. 

2. Chronic bacterial prostatitis

This type is also caused by bacteria, but signs and symptoms typically develop more slowly and are less severe.  Sometimes, it occurs as a complication of acute bacterial prostatitis that hasn’t been adequately treated.

How is it treated? – Antibiotics are the most common therapy used to treat chronic bacterial prostatitis.  Antibiotic therapy can be used in an attempt to cure this type of prostatitis but relapses are common.  A mainstay in the treatment for this type is the use of fluoroquinolones which are a family of synthetic broad-spectrum antibacterial drugs.  They are used to treat bacterial infections in many different parts of the body and work by killing bacteria or preventing their growth.  

3.  Chronic pelvic pain syndrome or chronic prostatitis

This feels a lot like chronic bacterial prostatitis but without the fever.  In addition, tests show no sign of bacteria in your urine or in fluid from the prostate gland.  In some cases, white blood cells found in a urine sample may signal the presence of inflammation.  Although this is the most common form of prostatitis, it’s also the most challenging to diagnose and treat because the cause is so uncertain.

How is it treated? – Any man with this type of prostatitis needs to be under the care of a urologist who is specialized in treating all types of prostatitis.  This type in particular is more difficult to find a solution to be a couple of treatment plans have included transurethral resection of the prostate (TURP) and even radical prostatectomy.  A thorough discussion and understanding with a urologist will be a man’s best bet on getting the appropriate treatment. 

4.  Asymptomatic inflammatory prostatitis

This type doesn’t cause any symptoms and is usually found during an examination done for another reason.  For example, prostatitis may increase the level of prostate-specific antigen (PSA) in your blood, which may be detected during a PSA screening test for prostate cancer.  Asymptomatic prostatitis often does not require treatment.  But if you need a repeat PSA test, your doctor may recommend a course of antibiotics first to clear the prostatitis.

How is it treated? – Even though asymptomatic inflammatory prostatitis may not have any sings of infection, any man who is told he has this condition should discuss with his doctor any necessary treatment options.  Oftentimes a man may not need any treatment at all but many doctors often prescribe antibiotics anyway.  If a man’s PSA level is elevated due to asymptomatic inflammatory prostatitis and he does go on antibiotics, he can expect his PSA levels to return to normal after about 4 to 6 weeks.