Prostatitis refers to the inflammation of the prostate gland.
The prostate gland, present only in males, produces the fluid portion of semen. It wraps around the urethra, and is located in front of the rectum, below the bladder. Prostatitis is most often caused by bacteria (from various sources) infecting the prostate.
A recent infection elsewhere in the body, especially infection of the bladder or urinary tract, increases the risk of prostatitis. Injury to the groin, specifically the area between the scrotum and anus, also increases the odds of developing prostatitis. Having an enlarged prostate, congenital abnormalities, certain STDs, or HIV/AIDS is also a risk factor. Furthermore, bacteria can be introduced into the area after a urinary scope, prostate biopsy, or catheter insertion.
Prostatitis can be broken down into four types:
Acute bacterial prostatitis: Although uncommon, this type can be quite serious. Occurring at any age, symptoms appear without warning and quickly intensify.
Chronic bacterial prostatitis: This type is milder than acute bacterial prostatitis, but proves harder to treat. The infection often comes and goes. Symptoms may be bothersome and longer-lasting, but are not as severe as an acute infection.
Chronic prostatitis: With this type, symptoms tend to wax and wane. The prostate is inflamed, but the exact cause is unknown. Signs and symptoms are similar to other forms of prostatitis, except bacteria is not present. Stress, nerve damage, or injury may play a role.
Asymptomatic inflammatory prostatitis: No outward symptoms appear with this form of prostatitis. It may be discovered during a routine physical exam or after blood work.
Symptoms are similar between all four types, although they may range in severity. Symptoms include:
Urgency, frequency, or burning with urination
Pain in the penis, low back, pelvis, or rectal area
Difficulty urinating, or urinating small amounts
Fever and chills (acute)
Discharge through the urethra
Erectile dysfunction or low libido
Throbbing in the genital or rectal area
After a detailed medical history and physical exam, further testing may be required to diagnose prostatitis. A urine or semen culture may be collected. A digital rectal exam might be performed to check for tenderness and swelling of the prostate. Prostate fluid may also be massaged out and examined during this time. A cystoscopy, transrectal ultrasound, or CT scan may also be performed to provide a visual image of the prostate.
Treatment is based on the patient’s age, overall health and wellness, symptoms present, and the type of prostatitis diagnosed. If bacteria are present, antibiotics will be necessary. For acute cases, antibiotic therapy is usually two to four weeks, while chronic cases will require antibiotics for much longer.
Medications may be needed to help relieve pain and reduce inflammation. Some individuals may need medicines to help relax the urinary muscles and improve urination. Home interventions such as warm baths, heating pads, or prostate massage (to help relieve pressure) may be helpful. Surgery, although rare, could be necessary.