Prostatitis

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Overview
Diagnosis
Treatment

What is Prostatitis?

Prostatitis is the general name for an inflammation of the prostate gland, a walnut-sized organ located in front of the rectum and right below the bladder. The function of the prostate gland is to produce part of the seminal fluid, the solution that carries sperm.

More than one million patients visit their doctors every year for the treatment of prostatitis.

According to the National Institute for Diabetes & Digestive & Kidney Disease, prostatitis may account for up to 25 percent of all office visits by young and middle-aged men with genitourinary complaints.

Types of Prostatitis

Acute bacterial prostatitis: A sudden bacterial infection that causes inflammation of the prostate. Acute bacterial prostatitis is the least common type of prostatitis.
Chronic bacterial prostatitis: Causes repetitive urinary tract infections that come from bacterial that chronically infect the prostate gland.
Chronic prostatitis/chronic pelvic pain syndrome: An inflammation of the prostate and irritation of the surrounding nerves. This is the most common type of prostatitis.
Asymptomatic inflammatory prostatitis: An inflammation of the prostate with no symptoms.

Prostatitis Causes

Prostatitis may be acute or chronic, and may not be inflammatory. Some types of prostatitis are caused by a bacterial infection, and others are not. How the prostate becomes infected is not clearly understood.

It is possible that infected urine may flow backward from the urethra into parts of the prostate gland. Rectal bacteria may also find their way into the prostate.

Prostatitis Risk Factors

Certain conditions or medical procedures increase the risk of contracting prostatitis:

A medical instrument, such as a urinary catheter, inserted during a medical procedure
Rectal intercourse
An abnormal urinary tract
A recent bladder infection
An enlarged prostate gland

Symptoms of Prostatitis

Prostatitis symptoms depend on the cause and may develop slowly or suddenly. Symptoms may include:

Blood in urine
Cloudy urine
Difficulty urinating
Flu-like symptoms (acute bacterial prostatitis)
Frequent urination
Painful urination
Painful ejaculation
Pain in the penis, testicles, scrotum, or perineum (the area between the scrotum and anus)
Pain in the abdomen, groin, or lower back
Urgent urination

Men who experience symptoms that are sudden and severe, and include chills and fever, should seek medical help immediately.

Diagnosing Prostatitis

The doctor will ask the patient about symptoms and medical history, and perform a physical exam. Diagnosis of prostatitis is usually based on the symptoms and digital rectal exam.

Tests may include:

Physical exam/digital rectal exam: In this test, the doctor places a gloved finger into the rectum to feel the back wall of the prostate. In prostatitis, the prostate is usually tender and soft. Your doctor may also complete an analysis of urine and prostate fluid expressed after the exam.
Urine tests: Your doctor may have a sample of your urine analyzed, or sent to a lab, to check for infection.
Bladder function tests: This will help determine the function of the bladder.
Blood tests: Your doctor may examine samples of your blood for signs of infection.
Imaging tests: Your doctor might order a CT scan of your urinary tract and prostate or a sonogram of your prostate.

Prostatitis Treatment

Treatment for bacterial prostatitis is different from treatment for nonbacterial prostatitis, so it is very important to get the correct diagnosis. It is also important to make sure that the symptoms are not being caused by a different urologic condition.

The most common treatment for prostatitis are antibiotics and/or anti-inflammatory drugs. Other forms of treatment may include more aggressive surgical treatments if necessary.

For patient referral or consultations, contact the Department of Urology at 412-692-4100.