Prostatitis is an inflammation of the prostate gland, caused by several factors and resulting in three different conditions. It is the most common prostate problem in men under the age of 50.
Although its name and symptoms suggest an infection in the prostate gland, about 90% of cases are of the non-infectious variety. Chronic nonbacterial prostatitis is marked by pelvic pain during three out of six months in a six month period. This can be caused by urinary catheterizations and other medical procedures, or it can be idiopathic or of unknown origin. Another common reason for this situation in a man over the age of 50 is a concurrent enlarged prostate. Bacterial prostatitis, accounting for only about 10% of cases, may be acute or chronic.
The former develops from bacterial infections from sexually transmitted diseases (STD’s), unprotected anal intercourse, bladder and urinary tract infections, and urinary tract medical procedures. Chronic bacterial prostatitis results from unresolved acute prostatitis.
Symptoms of these conditions may range from mild (in chronic cases) to severe (in acute bacterial cases):
- Fever and chills (bacterial)
- Pain and/or burning while urinating
- Low urine stream or difficulty urinating
- Frequent urges to urinate
- Abdominal/pelvic/anal and/or back pain
- Testicular and/or urinary tract pain (if concurrent with another infection)
- Blood in the urine and/or semen
- Pain during intercourse or during ejaculation
- Pain with bowel movements
- Foul-smelling urine
Generally, a urologist (a doctor specializing in the urinary tract) will examine a patient to determine the problem. Often a digital rectal exam will be performed, which enables the doctor to feel if the prostate gland is swollen or tender. Also, a swollen scrotum or swollen groin lymph nodes may indicate infection(s.) Other tests can check for a bacterial infections: a prostate fluid analysis, a urinalysis, and certain blood and semen tests. Ultrasounds may also be performed on the prostate or bladder to get visual pictures of the anatomy and also to detect blockages.
For acute bacterial infections, a course of antibiotics is usually given promptly to clear up the problem. For longer-standing chronic bacterial infections, a longer course of antibiotics may be given or a low-dose of antibiotics may be given for a longer time (many months.) For patients with chronic prostatitis, surgery may be recommended to relieve the tension around the urethra for better urinary flow. For the chronic, non-bacterial variety, patients may be prescribed alpha blocker drugs which relax the prostate and bladder muscles. Hormones may also be prescribed to help shrink the prostate gland. Pain medications are commonly prescribed for all types of prostatitis.