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Prostatitis/Prostate Infection

Education/General Information

Prostatitis is an inflammation of the prostate that often causes swelling or pain. There are three levels of prostatitis: nonbacterial prostatitis, acute bacterial prostatitis and chronic prostatitis.

  • Nonbacterial prostatitis, or chronic pelvic pain syndrome, is the most common type of prostatitis. It may be caused by stress or irregular sexual activity. Symptoms include frequent urination and pain in the lower abdomen or back.
  • Acute bacterial prostatitis is a sudden bacterial infection marked by inflammation of the prostate. This is the least common form of prostatitis, but the symptoms are usually severe. Patients with this condition have an acute urinary tract infection with increased urinary frequency and urgency, need to urinate often at night, and pain in the low back, pelvis and genital area. They often have fever, chills, nausea, vomiting and burning when urinating. This condition commonly occurs in older and middle-aged men.
  • Chronic prostatitis is characterized by recurrent urinary tract infections in men. When symptoms do appear, they are generally less severe than acute bacterial prostatitis and are rarely accompanied by fever. This condition can affect any age group, but is most common in young and middle-aged men.

Diagnosis

An accurate diagnosis is crucial because the treatment is different for the different types of prostatitis. In addition, it is extremely important to make sure that the symptoms are not being caused by other conditions such as urethritis, cystitis, an enlarged prostate or cancer. To help the physician make an accurate diagnosis, several types of examinations are useful.

  • Your doctor will take a urine sample to determine whether the problem is in the urethra, bladder or prostate.
  • Your doctor will perform a digital rectal exam to make sure your prostate feels normal in shape and size.
  • Your doctor may also collect a sample of prostatic fluid by pressing on your prostate to force fluid out into the urethra.
  • A prostate-specific antigen (PSA) test may be performed to test for infection and cancer, and to rule out other problems.
  • If more serious problems are detected, your doctor may perform a transrectal ultrasound to view your prostate more clearly. Cytoscopy may also be used to rule out other conditions when no infection is present. This test uses a slender device inserted into the urethra to examine the bladder and prostate.

Treatment

Nonbacterial prostatitis is most often treated with anti-inflammatories or muscle relaxants. Other options may include hot baths, relaxing when urinating, drinking more fluids or dietary changes. Some people may benefit from avoiding spicy foods and caffeinated or acidic drinks. Activities that aggravate the condition, such as bicycling, may need to be eliminated as well.

If acute bacterial prostatitis is diagnosed, the patient will need to take antibiotics for a minimum of 14 days. Sometimes, this means being admitted to the hospital and being given intravenous antibiotics. A catheter is sometimes required if the patient has difficulty urinating. Almost all acute infections can be cured with this treatment. Frequently, the antibiotics will be continued for as long as four weeks. Acute bacterial prostatitis requires prompt treatment, as the condition can lead to bladder infections, abscesses in the prostate or, in extreme cases, completely blocked urine flow. Bed rest, stool softeners and increased fluid intake may also be recommended.

Chronic prostatitis is typically treated with antibiotics for four to 12 weeks. About 75 percent of all cases of chronic bacterial prostatitis clear up with this treatment. For cases that do not respond to this treatment, long-term, low-dose antibiotic therapy may be recommended to relieve the symptoms. In some rare cases, surgery on either the urethra or prostate may be recommended if there is an identified problem that needs attention, such as scar tissue in the urethra.

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