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Prostatitis refers to infection or inflammation of the prostate. It can be bacterial or non-bacterial. Nonbacterial prostatitis and prostate inflammation are the more common types of prostatitis.
The prostate is a small, walnut-sized gland in men. It is located below the bladder and surrounds the upper portion of the urethra (where urine exits). The function of the prostate is to secrete fluids that make up part of the semen. The prostate may be a source of many health problems in men, the most common being benign prostatic hyperplasia (BPH), prostatitis (infection of the prostate), and cancer.
Prostatitis refers to infection or inflammation of the prostate. It can be bacterial or non-bacterial. Nonbacterial prostatitis and prostate inflammation are the more common types of prostatitis. The exact cause of these non-bacterial prostatitis conditions is not known, but may be due to persistent infection, inflammation and/or pelvic muscle spasm. This also referred to as chronic pelvic pain syndrome. Bacterial prostatitis is a less common type of prostatitis and is always caused by bacterial infection. These conditions can affect any age group, but are most common in young and middle-aged men.
The cause of prostatitis is not well understood. In bacterial prostatitis, it is thought that bacteria can get into the prostate from the urethra by backward flow of infected urine into the prostate ducts. Bacterial prostatitis is not contagious and is not considered to be a sexually transmitted disease. A sexual partner cannot catch this infection.
Certain conditions or medical procedures increase the risk of contracting bacterial prostatitis. There is a higher risk if the man has recently had a prostate biopsy, catheter, or other instrument inserted into his urethra, an abnormality of his urinary tract or a recent bladder infection.
Chronic prostatitis/chronic pelvic pain syndrome may be caused by the nerves and muscles in the pelvis that cause pain in the area, either as a response to the prostate infection or inflammation or as an isolated problem itself.
*If you have recently had a prostate biopsy and are experiencing any of these symptoms, please notify your doctor immediately.
Prostatitis is typically diagnosed based on your symptoms and a prostate exam. The exam is performed with the provider inserting a gloved finger into the rectum and examining the prostate gland, noting any abnormalities in size, contour, or consistency. An inflamed prostate will often be a different consistency, and can also be painful on exam. A urine analysis is also done, and can tell us if there is any type of infection or inflammation. Since prostatitis cannot be confirmed with these tools, we treat based on suspicion.
In some severe or recurrent cases, we can also do a prostate ultrasound to check for calcifications. Calcifications, if present in the prostate, can hold onto bacteria making the infection difficult to treat. We may also perform a cystoscopy, which involves a small camera advanced through the urethra, prostate, and bladder. This allows us to diagnose any other issues that may be causing your symptoms.
The diagnosis of the various types of prostatitis can be very difficult and sometimes quite frustrating for the patient and his physician. The symptoms are variable and there is much overlap in symptoms between the various types of prostatitis. Once the patient has been treated with antibiotics, it can be difficult to differentiate a bacterial prostatitis from chronic pelvic pain syndrome.
Antibiotics – Prostatitis is usually treated with a 7-14 day course of antibiotics. Sometimes the antibiotics need to be extended or altered based on how your symptoms are improving.
Anti-inflammatory medications – Taking medications such as ibuprofen or Advil can help alleviate some of the symptoms.
Alpha Blockers (Flomax, Rapaflo, etc) – These medications help to relax the prostate and urethra and can improve urinary symptoms, and are also prescribed for a short period of time.
Lifestyle changes – Various heat therapies (including local heat therapy with heating pad) and relaxation exercises may alleviate some of the symptoms. You may be advised to discontinue some foods (e.g. spicy) and drinks (e.g. caffeinated, acidic) and avoid circumstances (e.g. bicycle riding) that exacerbate the problem.
Pelvic Floor Physical Therapy – This is a very effective form of physical therapy for continuing symptoms of prostatitis or chronic pelvic pain syndrome. The physical therapist is specialized with working on the pelvic floor muscles with relaxation techniques that can help the symptoms you are experiencing.