Prostatitis

Prostatitis refers to four different conditions that affect the prostate gland. Two types of prostatitis are linked to urinary tract infections (UTIs). Other types are not. Men with prostatitis may have infection, inflammation and/or pain. Adult men of any age can get prostatitis.

Causes of Prostatitis #

Different types of prostatitis have different causes. Risk factors for chronic pelvic pain syndrome (CPPS), the most common type, aren’t clear.

Potential contributors to CPPS include:

• Autoimmune diseases.

• Pelvic floor muscle spasms.

• Stress.

Potential causes of bacterial forms of prostatitis include:

• Bladder infections or bladder stones.

• Surgery or biopsy requiring use of a urinary catheter.

• Prostate stones.

• Urinary retention (not emptying the bladder completely).

• UTIs.

Types of Prostatitis #

Acute bacterial prostatitis #

A UTI causes an infection in the prostate gland. Symptoms include fever and chills. You may experience painful and frequent urination or have trouble urinating. Acute bacterial prostatitis requires immediate medical treatment.

Chronic bacterial prostatitis #

Bacteria become trapped in the prostate gland, causing recurrent UTIs that are difficult to treat.

Chronic pelvic pain syndrome, or CPPS #

CPPS is the most common prostatitis type. Prostate gland inflammation occurs in approximately 1 out of 3 men. As the name implies, this type causes chronic pain in the pelvis, perineum (the area between the scrotum and rectum) and genitals.

Asymptomatic inflammatory prostatitis #

This condition causes prostate gland inflammation but no symptoms. You may learn you have this condition after getting tests to find the cause of other problems. For example, a semen analysis for infertility may detect asymptomatic inflammatory prostatitis. This type doesn’t need treatment.

Symptoms of Prostatitis #

• Pain in the penis, testicles or perineum (area between the testicles and rectum). The pain may radiate to the lower back.

• Frequent urge to urinate.

• Painful urination (dysuria).

• Weak urine flow or urine stream that starts and stops.

• Painful ejaculation or pain during intercourse.

• Blood in semen (hematospermia).

• Erectile dysfunction.

Diagnosis of Prostatitis #

Digital rectal exam: Your provider inserts a gloved, lubricated finger into the rectum to check the prostate gland for pain and swelling. This exam may include prostate massage to collect a sample of seminal fluid.

Urinalysis #

A urinalysis and urine culture check for bacteria and UTIs.

Blood test #

A blood test measures PSA, a protein made by the prostate gland. High levels may indicate prostatitis, BPH or prostate cancer.

More invasive tests for prostatitis include:

Cystoscopy #

A cystoscopy can look for other urinary tract problems but does not diagnose prostatitis. Your provider uses a cystoscope (a pencil-sized lighted tube with a camera or viewing lens on the end) to view inside the bladder and urethra.

Transrectal ultrasound #

Men with acute bacterial prostatitis or chronic bacterial prostatitis that doesn’t improve with antibiotics may get a transrectal ultrasound. A slender ultrasound probe inserted into the rectum uses sound waves to produce images of the prostate gland. This test can show prostate gland abnormalities, abscesses or stones.

Treatment of Prostatitis #

Urinary #

Medications, such as tamsulosin (Flomax) and alfuzosin (Uroxatral), relax muscles around the prostate and bladder to improve urine flow.

Psychosocial #

Stress management can help. Some men benefit from counseling or medications for anxiety, depression and catastrophizing (over-reaction to minor stresses common in people with chronic pain).

Organ #

Quercetin and bee pollen supplements may relieve a swollen, inflamed prostate gland.

Infection #

Antibiotics kill infection-causing bacteria.

Neurologic #

Prescription pain medicines, such as amitriptyline (Elavil) and gabapentin (Gralise), relieve neurogenic pain. This pain can include fibromyalgia or pain that extends into the legs, arms or back.

Tenderness #

Pelvic floor physical therapy may include myofascial release (gentle massage to ease tension on tight pelvic floor muscles). This therapy can reduce or eliminate muscle spasms.