Prostatitis

Patients suffering from prostatitis experience an inflammation of the prostate gland.

There are three forms of prostatitis, acute bacterial prostatitis, chronic bacterial prostatitis and non-bacterial prostatitis. Acute bacterial prostatitis is caused by a bacterial infection and occurs most often in young and middle-aged men. Chronic bacterial prostatitis may exsist for several years without symptoms and when symptoms do manifest, they are often less severe than symptoms of acute bacterial prostatitis. Young and middle-aged men are also the most common age group to suffer from chronic bacterial prostatitis. Non-bacterial prostatitis is also known as chronic prostatitis/chronic pelvic pain syndrome and may be inflammatory or non-inflammatory.

Bacterial prostatitis is caused by a bacterial infection. Certain conditions and medical procedures increase the risk of bacterial prostatitis. Inflammatory non-bacterial prostatitis may be caused by chlamydia or mycoplasma or a chemical or immunologic reaction. There is no known cause of non-inflammatory, non-bacterial prostatitis.

Symptoms of acute bacterial prostatitis may include:

  • Chills
  • Fever
  • Severe burning during urination
  • Incomplete bladder emptying
  • Urinary frequency and urgency

Symptoms of chronic bacterial prostatitis may include:

  • Burning during urinaiton
  • Frequent urination (especially at night)
  • Perineal, testicular, bladder and lower back pain
  • Painful ejaculation

Symptoms of non-bacterial prostatitis may include:

  • Difficult or painful urination
  • Pain in the perineum, bladder, testicles and penis
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Making a Diagnosis

The prostate gland is first examined through a digital rectal examination (DRE) to determine if it is large or tender and assess the degree of pain or discomfort the patient is feeling. Lumps or firm areas on the gland may suggest prostate cancer. Patients suffering from prostatitis may feel momentary pain or discomfort during this procedure.

Following a DRE, further evaluation may be needed. A physician may order a transrectal ultrasound to visualize the prostate gland or a prostate specificantigen (PSA) test to determine a prostate cancer diagnosis. In addition, a urine prostatic fluid sample may be ordered during a DRE to determine the cause and location of the problem.

A physician may also utilize a cystoscopy and urine flow study to determine a diagnosis of prostatitis.

Treatment

Treatment of prostatitis varies depending on the form of the condition.

In the case of acute bacterial prostatitis, patients are prescribed antibiotic medication for a minimum of 14 days. Oftentimes the medication is prescribed for a longer period of time, depending on the progress of the patient.

Patients suffering from chronic bacterial prostatitis may require antibiotic medication for 6-12 weeks. Rarely, surgery on the urethra or prostate is performed to treat chronic bacterial prostatitis.

A patient’s response to antibiotic medication will determine the length of the prescription treating non-bacterial prostatitis. Other treatments for the condition may include alpha-blockers, anti-inflammatory medication, muscle relaxants, vitamins, heat therapy, relaxation exercises, diet modification and repetitive prostatic massage.

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