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.
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