Prostatitis is inflammation of the prostate gland. The prostate is a walnut-sized gland in men that surrounds the urethra. The prostate produces a fluid that is part of semen.
Acute bacterial (least common of the four types, but the most common in men under 35)
Asymptomatic inflammatory prostatitis
Chronic bacterial (not very common, but affects mostly men between 40-70)
Chronic nonbacterial/prostadynia (most common type)
Note: Prostadynia (also known as chronic pelvic pain syndrome) is a condition associated with similar symptoms as chronic nonbacterial prostatitis, but which has no evidence of prostatic inflammation.
Causes
Acute and some chronic bacterial prostatitis are caused by bacteria that infect the prostate gland. The bacteria usually come from the urinary tract or rectum. The causes of nonbacterial prostatitis can be difficult to identify, but some feel this may be caused by nonbacterial pathogens such as chlamydia, virus, fungus, or mycoplasma. The causes of prostatodynia can be even more difficult to identify, but can be associated with stress and/or disorders of pelvic floor muscle tension.
Risk Factors
A risk factor is something that increases your chance of getting a disease or condition.
Risk factors include:
Medical procedures that involve inserting a catheter or other tubing into your urethra or rectum
The doctor will ask about your symptoms and medical history, and perform a physical exam. Diagnosis of prostatitis is usually based on the symptoms and massaging the prostate gland. In this test, the doctor places a lubricated, gloved finger into the rectum to feel the back wall of the prostate. In prostatitis, the prostate is usually tender and soft.
Other tests may include:
Analysis of urine and prostate fluid expressed after massaging the prostate gland
Bladder function tests
Treatment
Treatment depends on the type of prostatitis:
Infectious Prostatitis
Acute bacterial prostatitis is treated with oral antibiotics for 1-2 weeks.The commonly used drugs include quinolones (norfloxacin, ciprofloxacin, levofloxacin) or trimethoprim. In severe cases, treatment with intravenous antibiotics may be necessary. Chronic bacterial prostatitis is also treated with oral antibiotics for 4-12 weeks. Other medications include:
Stool softeners
Anti-inflammatory medications
Other analgesics or pain medications
Avoiding alcohol or caffeinated beverages
Alpha-blockers such as Flomax
5-alpha reductase inhibitors such as Proscar or Avodart
Non-infectious Prostatitis
Often patients are initially given a course of antibiotics. This is just in case an infectious cause was missed. Other treatments include:
Alpha-blockers such as Flomax
5-alpha reductase inhibitors such as Proscar or Avodart
Anti-inflammatory medications such as ibuprofen
Pain killers
Warm sitz baths
Repeated prostate massages
Prevention
There are no guidelines for preventing prostatitis.
RESOURCES:
American Foundation for Urologic Disease http://www.afud.org
The Prostatitis Foundation http://www.prostatitis.org
References:
American Academy of Family Physicians website. Available at: http://www.aafp.org.
The Merck Manual of Medical Information—Home Edition. Simon and Schuster, Inc.; 2000.
National Kidney and Urologic Diseases Information Clearinghouse website. Available at: http://kidney.niddk.nih.gov/.
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;175:619-23.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
