Learning about Prostatitis

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What is prostatitis? Quite simply, it is a prostate infection.  This condition involves inflammation of the prostate, the small walnut shaped male gland that produces seminal fluid.  The direct causes of prostatitis are not fully known by the medical community, but some of the theories include past bacterial infections, irritation from urine back up, lower urinary tract issues, parasites, or viruses.  Certain medical procedures, or medications may also increase the risk of prostatitis.  Symptoms of the disease can have a major impact on a man’s quality of life in that the symptoms affect daily life.  Symptoms do depend on the type of prostatitis infection the man is suffering from, but commonly include urinary frequency, perineal, testicular, bladder and low back pain, and painful ejaculation.  A man may also experience severe burning when urinating, as well as an inability to empty the bladder – known as retention. 

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There are several different types of prostatitis, each with its own signs and symptoms.    

1. Acute bacterial prostatitis:

·         least common type of prostatitis

·         Usually caused by a sudden bacterial infection

·         Easy to diagnose because of the typical symptoms and signs

·         The symptoms include:

o   Painful urination

o   Retention

o   Pain in the lower back, abdomen or pelvic area

o   Fever and chills.

2. Chronic bacterial prostatitis:

·         Similar to acute bacterial prostatitis

·         Unlike acute bacterial prostatitis, the symptoms develop gradually and are less severe

·         Characterized by recurrent urinary tract infections

Chronic prostatitis/chronic pelvic pain syndrome/Nonbacterial prostatitis:

·         Most common types of prostatitis

·         Non-bacterial, the exact cause is unknown 

o   Possible cause - persistent infection, inflammation and/or pelvic muscle spasms.

·         Symptoms include:

o   Pain in the genitals and pelvic area

o   Difficulty or pain urinating

o   Sometimes pain during or after ejaculation.

Asymptomatic inflammatory prostatitis:

•        Prostatitis without symptoms, despite an inflammation of the prostate

•        Diagnosis is typically made when the patient is being evaluated for symptoms relating to another condition

•        Inflammation is found in biopsied tissue or urine, semen or prostatic fluid specimens

Diagnosis and Treatment:

Prostatitis can be diagnosed in several ways, but because symptoms are not always clear it can be a bit of a mystery to solve.  This is why diagnosis for prostatitis often happens when a men is being evaluated for something else, not prostate infection.  This is especially true for those who are asymptomatic.  For example a routine PSA test may be falsely elevated from prostatitis, prompting further testing.   A digital rectal exam, or DRE, can be done to check for pain for pain or discomfort in the prostate, or a transrectal ultrasound might be used to help visualize the prostate gland.  Other tests that can be done to help diagnose prostatitis are urine tests, semen culture, prostate culture and STI tests to rule out a sexually transmitted infection. The treatment for prostatitis depends on the type of prostatitis and what the cause of the infection is, if there is a clear cause.  The infection is treated with antibiotics specific to the cause of infection.  For those with chronic prostatitis, which the cause is still somewhat unclear a low-dose long term antibiotic treatment might be necessary

Quick facts about prostatitis:

  • Correct diagnosis is the key to the management of prostatitis
  • Prostatitis cannot always be cured, but doctors aim to manage the symptoms
  • Treatment should be followed even if symptoms have improved
  • Although symptoms can be severe is some cases, many with prostatitis has live a pretty normal life