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Prostatitis

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Condition Detail

(Prostadynia)

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.

Anatomy of the Prostate Gland

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

Prevention

There is no known way to prevent prostatitis.

RESOURCES

American Urological Association Foundation http://www.urologyhealth.org

The Prostatitis Foundation http://www.prostatitis.org

CANADIAN RESOURCES

Canadian Urological Association http://www.cua.org

Men's Health Centre http://www.menshealthcentre.net

References

Acute prostatitis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated March 7, 2013. Accessed April 16, 2013.

Prostatitis. National Kidney and Urologic Diseases Information Clearinghouse website. Available at: http://kidney.niddk.nih.gov/KUDiseases/pubs/prostatitis/index.aspx. Updated June 29, 2013. Accessed April 16, 2013.

Prostatitis (prostate infection). Urology Care Foundation website. Available at: http://www.urologyhealth.org/urology/index.cfm?article=15. Accessed April 16, 2013.

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;175:619-623.

Sharp VJ, Takacs EB, Powell CR. Prostatitis: diagnosis and treatment. Am Fam Physician. 2010 Aug 15;82(4):397-406.

Revision Information

Reviewer: Brian Randall, MD
Review Date: 04/2013 -
Update Date: 04/16/2013 -

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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