Prostatitis
(Prostadynia)
by Rick Alan
Definition
Prostatitis is swelling of the prostate gland. The prostate is a walnut-sized gland in men that surrounds the urethra. It produces a fluid that is part of semen.
Anatomy of the Prostate Gland
Copyright © Nucleus Medical Media, Inc.
There are four types of prostatitis:
- Acute bacterial prostatitis
- Chronic bacterial prostatitis
- Chronic pelvic pain syndrome
- Asymptomatic inflammatory prostatitis
Causes
Acute and chronic bacterial prostatitis are caused by an infection. A bacteria enters the prostate usually come from the urinary tract or rectum.
The causes of chronic pelvic pain syndrome and asymptomatic inflammatory prostatitis are not clearly understood. In some people, it is possible that a cause may not be found.
Risk Factors
Prostatitis is most common in men who use catheters. Other factors that may increase your risk of prostatitis include:
- Unprotected sex
- Phimosis—Inability of the foreskin to fully retract over the head of the penis
- Narrowing of the urethra, the tube that carries urine from the bladder to the outside
- Enlarged prostate
- History of urinary tract infections
Symptoms
Symptoms depend on the category of prostatitis syndrome. In many people, symptoms may not appear. In others, they may appear as another condition.
Symptoms may include:
- Needing to urinate frequently and/or urgently
- Pain or burning while urinating
- Difficulty urinating
- Lower abdominal pain or pressure
- Penile, rectal, or perineal discomfort
- Lower back pain
- Fever or chills
- Difficulty getting an erection
Diagnosis
The doctor will ask about your symptoms and medical history. A physical exam will be done. Tests may be done to find the cause of the symptoms and rule out other conditions. Tests may include:
- Urine test—Looks for signs of infection
- Digital rectal exam—Detects swelling or pain
- Prostate massage—Fluid released from the prostate can be analyzed to test for chronic bacterial prostatitis and chronic pain syndrome
- Prostate biopsy—Used to rule out other conditions, but may find asymptomatic inflammatory prostatitis
Treatment
Treatment depends on the type of prostatitis:
Infectious Prostatitis
Acute and chronic bacterial prostatitis are treated with oral antibiotics. Antibiotics may be given over 4-12 weeks. The antibiotics may be given through an IV for severe infections.
Other medications to help manage symptoms include:
- Stool softeners
- Anti-inflammatory medications
- Pain medication
- Alpha-blockers or 5-alpha reductase inhibitors to help with urine flow
Your doctor may recommend that you avoid alcohol and caffeinated beverages.
Noninfectious Prostatitis
Antibiotics may be recommended if an infection is possible. Other treatments to manage symptoms include:
- Alpha-blockers or 5-alpha reductase inhibitors
- Anti-inflammatory medications such as ibuprofen
- Pain medication
- Warm sitz baths
- Repeated prostate massages
RESOURCES:
American Urological Association Foundation
http://www.urologyhealth.org
The Prostatitis Foundation
http://www.prostatitis.org
CANADIAN RESOURCES:
Canadian Urological Association
http://www.cua.org
Men's Health Centre
http://www.menshealthcentre.net
REFERENCES:
Acute prostatitis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what. Updated March 7, 2013. Accessed April 16, 2013.
Prostatitis. National Kidney and Urologic Diseases Information Clearinghouse website. Available at: http://kidney.nidd.... Updated June 29, 2013. Accessed April 16, 2013.
Prostatitis (prostate infection). Urology Care Foundation website. Available at: http://www.urologyhealth.org/urology/index.cfm?article=15. Accessed April 16, 2013.
Propert KJ, McNaughton-Collins M, Leiby BE, et al. A prostpective study of symptoms and quality of life in men with chronic prostatitis/chronic pelvic pain syndrome: The National Institutes of Health Chronic Prostatitis Cohort Study. J Urol. 2006;175:619-623.
Sharp VJ, Takacs EB, Powell CR. Prostatitis: diagnosis and treatment. Am Fam Physician. 2010 Aug 15;82(4):397-406.
Last reviewed April 2013 by Brian Randall, MD
Last Updated: 4/16/2013