Prostatitis
Prostatitis is a disorder of the prostate gland, often accompanied by inflammatory pain. Prostatitis often causes difficulty or pain when urinating and pain in the groin, pelvic area or genitals. Some, but not all, cases of prostatitis are caused by a bacterial infection.
The prostate, about the size of a walnut, is just below the bladder in men. It surrounds the top of the tube that drains urine from the bladder (urethra). The prostate and other sex glands secrete the fluid that sperm travel through when you ejaculate (semen).
There are four types of prostatitis:
Acute bacterial prostatitis, a bacterial infection of the prostate, often with sudden, acute symptoms Chronic bacterial prostatitis, a persistent or recurrent bacterial infection, often with less severe symptoms Chronic prostatitis/pelvic pain syndrome, persistent or recurrent symptoms of pelvic and urinary tract pain, with no signs of infection Asymptomatic prostatitis, which involves signs of prostatitis without symptoms
Symptoms Signs and symptoms of prostatitis may vary depending on the type of prostatitis: They may include:
Pain or burning during urination (dysuria) Difficulty passing urine, such as dripping or splashing Frequent urination, especially at night (nocturia) Feeling an 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 (scrotum) and rectum (perineum) Pain or discomfort in the penis or testicles Pain during ejaculation Fever, chills, muscle aches and other flu-like symptoms (in the case of acute bacterial prostatitis) When to see a doctor Several conditions can cause the signs and symptoms of prostatitis. It’s important to diagnose the condition accurately and receive treatment as soon as possible.
Get immediate care if you experience any of the following:
Inability to urinate Difficult or painful urination, accompanied by a fever Blood in your urine Severe discomfort or pain in your pelvic or genital area
Treatment of prostatitis
Diagnosis The symptoms associated with prostatitis can be caused by a number of conditions. You may be referred to a doctor who specializes in disorders of the urinary and reproductive system (urologist). Your doctor will perform a physical exam, review your symptoms and medical history, and order tests to determine the cause and rule out certain conditions.
Diagnosing a bacterial infection Diagnostic tests to detect an infection are likely to include
Finger rectal exam. In this procedure, your doctor inserts a gloved finger lubricated with lubricant into your rectum to look for prostatitis. Urinalysis. You’ll need to provide a urine sample to be analyzed for the presence and type of bacterial infection. Blood analysis. Blood samples may be analyzed to look for signs of prostatitis or other issues with the prostate. Analyzing a sample of the prostate. In some cases, your doctor may gently massage the prostate during a rectal exam to force fluid from the prostate into the urethra. The prostate fluid is then removed along with a sample of urine after the massage to be analyzed for a bacterial infection. Other tests If initial tests don’t show any signs of infection, you may undergo other tests, including
Urodynamic tests. Several tests can be used to measure the ability of the bladder and urethra to hold and release urine. These tests can help detect the nature of urinary issues and identify the source of the issue. Imaging. Your doctor may order imaging tests to identify prostate abnormalities, abnormal growths or other pelvic issues that may contribute to pain
Treatment Treatment for prostatitis depends on the type of inflammation detected by the diagnosis and your symptoms.
Infection treatment If you have acute or chronic bacterial prostatitis, you’ll receive antibiotics. Acute disease may require intravenous antibiotics in the hospital for a short time. The full course of antibiotic therapy usually takes 4 to 6 weeks, or longer in some cases. It is important to take all prescribed medications to eliminate the infection and minimize the likelihood of developing chronic bacterial prostatitis.
Treat urinary tract symptoms. Medications called alpha-blockers help relax the bladder neck and the muscle fibers where the prostate connects to the bladder. This treatment may relieve urinary tract symptoms, such as painful or difficult urination. While these medications are prescribed for men with chronic prostatitis/chronic pelvic pain syndrome, they may be prescribed to relieve urinary tract symptoms caused by a bacterial infection.
Pain management Your doctor may prescribe pain medications or recommend over-the-counter medications, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, others).
Treating psychological symptoms Your doctor may recommend psychotherapy with a mental health care professional to help you manage stress and treat depression or anxiety that may accompany chronic pain.