Prostatitis

Prostatitis is an inflammation or infection of the prostate gland. It is a very common disorder and can affect a man at any age. In fact, it is the most commonly diagnosed urologic disease in men. About 50% of adult men in the United States will be treated for prostatitis during their lifetime.
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What are the risk factors?

Most prostate problems occur in men age 60 and above. However, you are more likely to develop prostatitis when you are younger. You may also be at increased risk if:

  • Recently had a bladder infection or an infection of your urethra
  • Recently had a urinary catheter inserted during a medical procedure
  • Stop and start when urinating
  • Have a job that subjects you to strong vibrations, such as driving a truck or operating heavy equipment
  • Jog or bicycle on regular basis

What are the signs and symptoms of Prostatitis?

The signs and symptoms vary depending on the type of prostatitis:

  • Acute bacterial prostatitis:
    • Fever and Chills
    • A flu-like feeling
    • Urinary symptoms (increased urgency, difficulty or pain when urinating, inability to completely empty the bladder and blood-tinged urine)
    • Painful ejaculation
  • Chronic bacterial prostatitis:
    • A frequent and urgent need to urinate
    • Pain or a burning sensation when urinating (dysuria)
    • Pain in the prostate
    • Excessive urination during the night (nocturia)
    • Pain in the lower back and genital area
    • Difficulty starting to urinate or diminished urine flow
    • Occasional blood in semen or in urine (hematuria)
    • Painful ejaculation
    • A slight fever
    • Recurring bladder infections
  • Chronic nonbacterial (abacterial) prostatitis:
    The signs and symptoms of nonbacterial prostatitis are similar to those of chronic bacterial prostatitis, you will probably won’t have a fever. The major difference is that the tests won’t detect any bacteria in your urine or in the fluid from the prostate gland
  • Other conditions:
    Prostatitis can be difficult to diagnose because its signs and symptoms often resemble those of other conditions. For example, an infection of your bladder or the tube that carries urine from your bladder can cause an intense urge to urinate, a burning sensation and sometimes blood in your urine, similar to the signs and symptoms of prostatitis.

How is prostatitis detected?

Diagnosis is a two step process:

  • Step 1: Ruling out any other conditions that may be causing the symptoms
  • Step 2: Determining what type of prostatitis you have.

What are the different types of prostatitis?

There are three main types of prostatitis:

  • Bacterial Prostatitis: Bacterial Prostatitis can be acute or chronic. Acute bacterial prostatitis occurs in about one in ten men with prostatitis. This develops suddenly, like any other major bacterial infection. It may be caused by E.coli, Klebsiella, Pseudomonas, or other types of bacteria. Chronic bacterial prostatitis also occurs in one in ten men. This form tends to reoccur after the initial infection has been treated and symptoms disappear.
  • Nonbacterial Prostatitis: This occurs in about six out of ten men with prostatitis. The inflammation may be related to organisms other than bacteria or to factors that are unknown or difficult to determine. Symptoms are much the same as for bacterial prostatitis
  • Prostatodynia: Prostatodynia means pain in the area of the prostate gland and occurs in about three out of ten men with prostate irritation.

What are complications of prostatitis?

There is no evidence that having acute or chronic prostatitis increases your risk of prostate cancer, but it may increase the level of prostate specific antigen (PSA) in your bloodstream. PSA is a substance naturally produced in your prostate gland, and high levels in your blood may sometimes be a sign of prostate cancer. For that reason, if you have elevated PSA level and also have acute prostatitis, you should be rechecked after you’ve been treated with antibiotics and all prostate inflammation has resolved.

What are treatment options for prostatitis?

Once your physician determines the type of prostatitis, and then a treatment plan can be developed custom to your needs. Your treatment plan may include medications as well as physical therapy and in rare cases, surgery.

  • Medications:
    • Antibiotics: Antibiotics are first method of treatment for all bacterial prostatitis cases.
    • Alpha blockers: This oral medication helps relax the bladder neck and the muscle fibers where your prostate joins your bladder. This may help urinate more easily.
    • Pain Relievers: Over-the-counter pain reliever is sometimes used to help relieve the pain.
    • Muscle Relaxants: Prostatitis can be accompanied by muscle spasms. Muscle relaxants may be helpful for this.
  • Physical therapy:
    • Exercise: Stretching and relaxing the lower pelvic muscles sometimes make the muscles more limber and this may help relieve some of the symptoms. A physical therapist can show you which exercises will benefit you and how to perform them.
    • Biofeedback: This technique teaches the patient how to control certain body responses such as relaxing your muscles.
    • Sitz Bath: This technique involves soaking the lower half of your body in a tub of warm water. Warm baths can relieve pain and relax the lower abdominal muscles.
    • Prostate massage: Some patients have found that massaging the prostate helps relieve congestion by unplugging the tiny ducts blocked by inflammation.
  • Surgical procedures:  Your physician may recommend surgery to open blocked ducts if you have a bacterial form of the disease and antibiotics don’t improve symptom. Surgery is not a treatment for nonbacterial prostatitis.

What are some questions to ask my doctor?

Here are some questions that will be important to ask:

  • What type of prostatitis do I have
  • If I do not receive treatment, what might happen
  • What would you recommend and why?
  • What are the benefits and side effects of these treatments?
  • Will any treatments cause problems with my medication?(if you are taking medications)
  • What can I do to make my treatment most effective?
  • Will I need more tests? For what purpose?

This report is intended for patient education and information only. It does not constitute advice, nor should it be taken to suggest or replace professional medical care from your physician. Your treatment options may vary, depending upon medical history and current condition. Only your physician and you can determine your best option.

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