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Prostatitis: What It Is, Symptoms, Causes And Treatment

When most men think about their prostate, it's to worry about whether they have prostate cancer or not. But another condition is far more common and plenty painful.

Prostatitis involves inflammation of the prostate gland and sometimes the areas around it. Not only is prostatitis highly treatable, but it is highly prevalent among men. According to the Prostate Cancer Foundation, it is the leading cause of urinary tract infections in men, resulting in approximately 2 million doctor's visits each year in the United States. In fact, it's estimated that half of all men will experience prostatitis at some point.

The U.S. National Center for Health Statistics further reveals that about 25% of men who seek medical attention for urological problems exhibit symptoms of prostatitis. Here, experts give the rundown on prostatitis, including its various types, causes, common symptoms and available treatments.

What is prostatitis?

Prostatitis, a condition characterized by the inflammation of the prostate gland, is known for its frequent and often debilitating pain. According to the Cleveland Clinic, it is a complex condition that can lead to various symptoms, including infection, inflammation and pain.

Two types of prostatitis are associated with urinary tract infections (UTIs), while the remaining types may not have an infectious origin. Regardless of the type, prostatitis is commonly recognized for the intense pain its sufferers feel, which can significantly impact a man's quality of life.

Types of prostatitis

According to the U.S. National Institute of Diabetes and Digestive and Kidney Diseases, there are four distinct types of prostatitis, each with its own characteristics:

Prostatitis causes

According to the U.S. National Institutes of Health, the causes of prostatitis vary depending on the specific type of the condition:

  • Chronic prostatitis or chronic pelvic pain syndrome: The exact cause of chronic prostatitis/chronic pelvic pain syndrome remains unknown. It is widely believed that a microorganism, not a bacterial infection, may be responsible for triggering the condition.
  • Acute and chronic bacterial prostatitis: Bacterial prostatitis is caused by an infection in the prostate gland. The infection is believed to occur when bacteria travel from the urethra (the tube through which urine passes) into the prostate, leading to inflammation and associated symptoms.

    • It's important to know that acute bacterial prostatitis can be caused by various types of bacteria commonly associated with urinary tract infections. Additionally, prostatitis can also result from infections transmitted through sexual contact.

    However, "you don't need to avoid sex if you have prostatitis. Typically, sex won't worsen prostatitis. But some men who have prostatitis have pain with ejaculation," Dr. Patricio Gargollo, a urologist with the Mayo Clinic, said in a recent article.

    Prostatitis symptoms

    Prostatitis has many symptoms that can significantly impact a man's daily life and well-being, especially when left untreated. Here are some common symptoms associated with prostatitis, according to Johns Hopkins Medicine:

  • Frequent urination
  • Dysuria (a burning or stinging sensation during urination, making it uncomfortable or painful)
  • Reduced urine flow
  • Rectal pain or pressure
  • Fever and chills
  • Lower back or pelvic pain
  • Urethral discharge during bowel movements
  • Erectile dysfunction or decreased sex drive
  • Uncomfortable sensations in the rectal or genital area

    • Also, the symptoms of prostatitis can mimic those of other medical conditions or issues. Therefore, seeking medical advice from a health care provider for an accurate diagnosis is important.

    Prostatitis treatment

    The treatment for prostatitis is determined by age, overall health, medical history, the severity of the condition, individual tolerance for specific treatments, expected duration and patient preference. The specific type of prostatitis also plays a significant role in determining the appropriate treatment. Here are some general treatment options for prostatitis, followed by specific treatments based on the different types of prostatitis.

    Treatment for prostatitis typically involves a combination of approaches to relieve symptoms, eliminate infection (if present), reduce inflammation and improve overall prostate health. These may include:

  • Medications
  • Alpha blockers
  • Pain relievers
  • Physical therapy

    • But more specifically, the type of treatment recommended is typically based on the different types of prostatitis. Johns Hopkins Medicine indicates typical treatments for prostatitis as follows:

  • Acute bacterial prostatitis: Hospitalization may require administering intravenous antibiotics and providing supportive care. Oral antibiotics are typically prescribed for a few weeks after hospitalization, to wipe out the infection.
  • Chronic bacterial prostatitis: Similar to acute bacterial prostatitis, long-term antibiotic therapy is necessary. This can range from several weeks to months to effectively treat persistent infection.
  • Chronic prostatitis/chronic pelvic pain syndrome: Treatment focuses on managing symptoms. It may include medications for pain relief, alpha blockers to relax the muscles, physical therapy and lifestyle modifications to ease symptoms.
  • Asymptomatic inflammatory prostatitis: Asymptomatic inflammatory prostatitis generally does not require treatment unless there are specific complications or underlying conditions.

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    Citation: Prostatitis: What it is, symptoms, causes and treatment (2023, May 31) retrieved 31 May 2023 from https://medicalxpress.Com/news/2023-05-prostatitis-symptoms-treatment.Html

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    Causes And Treatment Of Chronic Prostatitis

    Chronic prostatitis refers to pain in the prostate that lasts at least 3 months. It happens due to inflammation of the prostate. It can affect sexual function and the ability to urinate. Possible causes include bacterial infections and damage to the pelvic nerves.

    Acute prostatitis is an infection or pain in the prostate gland lasting less than 3 months.

    In this article, we look at the causes and symptoms of chronic prostatitis. We also cover diagnosis, treatment, and home and alternative remedies.

    The prostate is a small gland that forms part of the lower urinary tract in males. It sits in front of the rectum, under the bladder, and surrounds the urethra, the tube that carries urine and semen out through the penis.

    The prostate is part of the male reproductive system and produces one of the fluids that make up semen. The muscles of this gland also help push semen into the urethra during ejaculation.

    Due to its location and function, prostate problems can affect urination as well as sexual function.

    Prostatitis is an inflammation of the prostate that can often be painful. It can be chronic or acute.

    Chronic prostatitis develops gradually and can last for months or even years. Doctors consider prostatitis to be chronic if symptoms continue for 3 months or more. It may not respond well to initial treatment.

    Acute prostatitis appears suddenly and is temporary. It may only last a few days or weeks and often responds well to treatment. If it persists, it may become chronic prostatitis.

    Prostatitis is the leading cause of urinary tract issues for men under 50 years of age, and the third most common urinary tract issue for men over 50.

    What other prostate problems are there?

    Prostatitis can be bacterial or nonbacterial.

    Chronic bacterial prostatitis

    A bacterial infection of the prostate causes chronic bacterial prostatitis.

    It can result from:

  • various bacteria, such as Klebsiella, Proteus, or Escherichia coli
  • Chlamydia
  • bacteria that remain despite antibiotic treatment for another infection, such as an acute prostate infection or urinary tract infection

    • The symptoms of chronic bacterial prostatitis are often less severe than those of acute bacterial prostatitis. A person who has previously had an acute infection might notice that their symptoms get better but do not go away.

    Chronic non-bacterial prostatitis, or chronic pelvic pain syndrome

    This is a non-bacterial form of prostatitis that can have many causes and is harder to treat.

    It can occur when:

  • Chronic pain persists after a previous prostate infection goes away.
  • The urinary sphincter does not relax while emptying the bladder, so that pressure on the urinary tract causes urine flows into the prostate, causing an inflammatory response.
  • Nerve damage leads to overactivity in the pelvic nerves, triggering pain without inflammation.
  • Damage to the urinary tract results from surgery or a physical injury.
  • A person is facing psychological stress.
  • Microorganisms other than bacteria infect the prostate gland.

    • The main symptom of chronic prostatitis is genital or pelvic pain. For some people, the pain feels like a gnawing ache. For others, it is intense and sharp. The pain may come and go or always be present.

    Other symptoms of chronic prostatitis include:

    Anyone with these symptoms should see a doctor as soon as possible. They may be a sign of another health condition that needs urgent attention. Untreated, they could lead to complications.

    Is there a link between prostatitis and prostate cancer?

    People with symptoms of prostatitis should see a doctor. If a bacterial infection is present, seeking medical help as soon as possible can help prevent it spreading.

    To diagnose prostatitis, a doctor will most likely:

  • ask about symptoms
  • ask about the person's medical history
  • carry out a rectal or prostate examination

    • During a rectal exam, a doctor inserts a finger into the person's rectum to check the prostate for swelling and inflammation. They may also look for signs of infection, such as discharge from the penis or swollen lymph nodes.

    A doctor may recommend antibiotics if they suspect the problem is due to a bacterial infection.

    They may recommend further tests if symptoms do not improve with antibiotics or there are no signs of an infection.

    Options include:

  • a urine test, semen test, or blood test to look for signs of infection or other prostate issues
  • a urine test before and after prostatic massage, which may help identify signs of infection
  • urodynamic tests to see how well the urinary system stores and releases urine
  • a prostate biopsy, where a doctor uses a needle to remove a small sample of tissue from the prostate for analysis
  • an ultrasound of the prostate or urethra
  • a cystoscopy, where a doctor uses a small scope to look inside the bladder or urethra

    • What types of physical examination are there?

    Treatment for chronic prostatitis will depend on the cause.

    People with chronic prostatitis due to a bacterial infection or recurrent infections may need antibiotics for up to 6 months.

    Other treatment options include:

  • intravenous antibiotics for severe infections
  • muscle relaxants to relieve spasms of the pelvic muscles
  • non-steroidal anti-inflammatory drugs (NSAIDs) to relieve pain
  • alpha-blockers to treat urination difficulties
  • surgery to remove scar tissue in the urethra, which can help with urination difficulties
  • counseling to help with psychological stress and anxiety

    • Various home and alternative treatments may support medical treatment for chronic prostatitis.

    Kegel exercises

    Kegel exercises, also known as pelvic floor exercises, can help improve urination difficulties in people with chronic prostatitis. The exercises work by strengthening the muscles around the bladder and penis.

    To do these exercises:

  • Sit in a comfortable position.
  • Locate the pelvic muscles by pretending to stop urination mid-flow.
  • Tighten and relax the pelvic muscles 10 to 15 times in a row.
  • Repeat several times a day.
  • As the excises get easier, increase the time for holding the muscle in and the number of repetitions.

    • It may take a few months before a person notices the results.

    What are Kegel exercises for males?

    Other remedies

    Other home and alternative remedies that may provide symptom relief for people with chronic prostatitis include:

    People should always speak with a doctor before trying a new or alternative remedy, as some options may interact with other medications or may be unsafe for some people.

    Can saw palmetto help reduce an enlarged prostate gland?

    Here are some questions people often ask about prostatitis.

    What are some common signs and symptoms of prostatitis?

    Common signs of prostatitis include:

  • needing to pee more frequently or more urgently but having difficulty when doing so
  • needing to urinate more at night
  • pain in the genitals, pelvis, or lower back
  • having a urinary tract infection
  • painful ejaculation
    • What is the fastest way to get rid of prostatitis?

    A doctor will prescribe antibiotics if a bacterial infection appears to be present. If tests show another cause, they will prescribe treatment appropriately. Some home and alternative remedies may help support medical treatment.

    Does prostatitis go away?

    Acute prostatitis may go away with antibiotics, but it may return or linger and become chronic prostatitis. If prostatitis does not go away with initial treatment, a person should speak with their doctor. They will help find a solution.

    Chronic prostatitis is a long-term condition that can cause pain and difficulties with urination. Anyone with symptoms of prostatitis should see a doctor.

    Treatment depends on the cause and symptoms. If an infection is present, a person may need antibiotics. Kegel exercises and certain home and alternative remedies may also help relieve symptoms.


    Prostatitis

    Overview

    Prostatitis is a disorder of the prostate gland usually associated with inflammation. Prostatitis often causes painful or difficult urination, as well as pain in the groin, pelvic area or genitals. Bacterial infections cause some but not all cases of prostatitis.

    The prostate gland, about the size of a walnut, is located just below the bladder in men. It surrounds the top portion of the tube that drains urine from the bladder (urethra). The prostate and other sex glands produce the fluid that transports sperm during ejaculation (semen).

    Types

    There are generally four types of prostatitis:

  • Acute bacterial prostatitis, a bacterial infection of the prostate usually with sudden, severe symptoms
  • Chronic bacterial prostatitis, ongoing or recurring bacterial infection usually with less severe symptoms
  • Chronic prostatitis/chronic pelvic pain syndrome, ongoing or recurring pelvic pain and urinary tract symptoms with no evidence of infection
  • Asymptomatic inflammatory prostatitis, signs of an inflamed prostate with no symptoms
    • Symptoms

    Signs and symptoms of prostatitis can vary depending on the type of disorder. They may include:

  • Pain or burning sensation when urinating (dysuria)
  • Difficulty urinating, such as dribbling or hesitant urination
  • Frequent urination, particularly at night (nocturia)
  • Urgent need to urinate
  • Cloudy urine
  • Blood in the urine
  • Pain in the abdomen, groin or lower back
  • Pain in the area between the scrotum and rectum (perineum)
  • Pain or discomfort of the penis or testicles
  • Painful ejaculation
  • Fever, chills, muscle aches and other flu-like symptoms (with acute bacterial prostatitis)
    • When to see a doctor

    Several conditions can contribute to the signs and symptoms associated with prostatitis. It's important to get an accurate diagnosis and treatment as soon as possible.

    Get immediate care if you have any of the following:

  • Inability to urinate
  • Painful or difficult urination, accompanied by fever
  • Blood in your urine
  • Severe discomfort or pain in the pelvic area or genitals
    • Causes

    Causes vary depending on the type of prostatitis.

  • Acute bacterial prostatitis is usually caused by common strains of bacteria. The infection may have spread from other parts of the urinary or reproductive systems.
  • Chronic bacterial prostatitis generally has the same cause as acute bacterial infection. It may occur when treatment for an acute infection isn't long enough or fails to kill all the bacteria.
  • Chronic prostatitis/chronic pelvic pain syndrome is not well understood. Research suggests that multiple factors may collectively play a role. These include previous infection, nervous system dysfunction, immune system dysfunction, psychological stress or irregular hormone activity.
  • Asymptomatic inflammatory prostatitis, which has no known cause, is generally found only during an exam for other medical conditions and is not treated.
    • Prostate gland © Provided by Mayo Clinic Prostate gland Risk factors

    Risk factors for prostatitis include:

  • Young or middle-aged adulthood
  • Previous prostatitis
  • Infection of the urinary or reproductive system
  • HIV infection or AIDS
  • Use of a tube inserted into the urethra to drain the bladder (urinary catheter)
  • Diagnostic sampling of prostate tissue (biopsy)

    • Additional risk factors for chronic prostatitis/chronic pelvic pain syndrome may include:

  • Psychological stress
  • Nerve damage in the pelvic region due to surgery or trauma
    • Complications

    Complications of acute or chronic prostatitis can include:

  • Bacterial infection of the blood (bacteremia)
  • Inflammation of the coiled tube attached to the back of the testicle (epididymitis)
  • Pus-filled cavity in the prostate (prostatic abscess)
  • Infection that spreads to the upper pelvic bone or lower spine

    • Complications of chronic prostatitis/chronic pelvic pain syndrome may include:

  • Anxiety or depression
  • Sexual dysfunction, such as the inability to get and maintain an erection (erectile dysfunction)
  • Changes in sperm and semen that may cause infertility

    • There's no direct evidence that prostatitis can lead to prostate cancer. Researchers are investigating whether chronic inflammation of the prostate is a risk factor for cancer.

    Diagnosis

    The symptoms associated with prostatitis can be caused by a number of conditions. You may be referred to a specialist in urinary and reproductive system disorders (urologist). Your health care provider will conduct a physical exam, review your symptoms and medical history, and order tests to determine the cause and rule out certain conditions.

    Test for diagnosing bacterial infections

    Diagnostic tests to assess for infection will likely include:

  • Digital rectal exam. With this procedure, your health care provider inserts a lubricated, gloved finger into your rectum to detect inflammation of the prostate.
  • Urine test. You'll need to provide a urine sample to be tested for the presence and type of bacterial infection.
  • Blood test. Blood samples may be tested for signs of infection and other prostate problems.
  • Prostatic specimen test. In some cases, a health care provider may gently massage the prostate during a rectal exam to release prostate fluid into your urethra. A urine sample after the massage expels the prostate fluid for bacterial testing.
    • Other tests

    If initial tests show no sign of infection, you may undergo other tests, including:

  • Urodynamic tests. A variety of tests can be used to measure how well the bladder and urethra hold and release urine. These tests can help characterize problems with urinating and identify the source of problems.
  • Imaging. Imaging tests may be ordered for identifying irregularities in the prostate, abnormal growths or other problems in the pelvic region that may be contributing to pain.
    • Treatment

    Treatment for prostatitis depends on the specific type diagnosed and your symptoms.

    Treating infection

    If you have acute or chronic bacterial prostatitis, you'll take antibiotics. Acute disease may require intravenous (IV) antibiotics in the hospital for a short period. The entire course of antibiotic treatment is usually 4 to 6 weeks -- or longer in some cases. Taking all the prescribed medication is important for eliminating the infection and reducing the risk of chronic bacterial prostatitis.

    Treating urinary symptoms

    Medications, called alpha-blockers, help relax the bladder neck and the muscle fibers where your prostate joins your bladder. This treatment might ease urinary symptoms, such as painful or difficult urination. While this is commonly prescribed for men with chronic prostatitis/chronic pelvic pain syndrome, it may be prescribed to relieve urinary symptoms of bacterial infections.

    Treating pain

    Your health care provider may prescribe pain medication or recommend nonprescription drugs, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, others).

    Managing psychological symptoms

    Your health care provider may recommend psychotherapy with a mental health care professional to help you manage stress, depression or anxiety that may be associated with chronic pain.

    Lifestyle and home remedies

    The following remedies might ease some symptoms of prostatitis:

  • Soak in a warm bath (sitz bath) or use a heating pad.
  • Limit or avoid alcohol, caffeine, and spicy or acidic foods, which can irritate your bladder.
  • Drink plenty of water. This will cause you to urinate more and help flush bacteria from your bladder.
    • Alternative medicine

    Alternative therapies that show some promise for reducing symptoms of prostatitis include:

  • Biofeedback. A biofeedback specialist uses signals from monitoring equipment to teach you to control certain body functions and responses, including relaxing your muscles.
  • Acupuncture. This treatment for pain management involves inserting very thin needles through your skin to various depths at certain points on your body.
  • Herbal remedies. Some studies suggest that rye grass pollen extract (cernilton) may help manage pain associated with chronic prostatitis/chronic pelvic pain syndrome. There is insufficient evidence for other herbal remedies for treating pain associated with prostatitis.

    • Discuss your use of alternative medicine practices and herbal treatments with your doctor.

    Preparing for an appointment

    A review of your symptoms and medical history will be an important part of the examination with your health care provider. Be prepared to answer the following questions:

  • When did your symptoms begin?
  • Are your symptoms constant, or do they come and go?
  • Are you experiencing pain? Where?
  • Do you experience pain when urinating?
  • Do you have difficulty urinating, such as dribbling or hesitant urination?
  • Have you observed bloody or cloudy urine?
  • Have you experienced a sudden, urgent need to urinate?
  • Are you urinating more often than usual?
  • How often do you need to urinate in the night?
  • Do you experience pain when ejaculating?
  • Have you been diagnosed with bacterial prostatitis or a urinary tract infection in the past? When?
  • Did you take all of the pills for that infection?
  • Have you had a recent injury to your groin?
  • What medications, dietary supplements, herbal products and vitamins do you take?

    • ©2023 Mayo Foundation for Medical Education and Research (MRMER). All rights reserved.





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