Prostate Infection (Prostatitis)

The prostate is a small gland in the male reproductive system located below the bladder and surrounding the urethra. Prostatitis is the inflammation or infection of the prostate and is diagnosed as one of three types: acute bacterial prostatitis, chronic bacterial prostatitis, or chronic non-bacterial prostatitis/chronic pelvic pain syndrome.

Bacteria cause both acute and chronic bacterial prostatitis, though despite their names they are not contagious. The bacteria that cause prostatitis may get into the prostate by the backward flow of infected urine into the prostate ducts. The cause of chronic non-bacterial prostatitis/chronic pelvic pain syndrome is unknown but is thought to be a variant of interstitial cystitis (a chronic inflammatory disease of the bladder).

The patient may experience no symptoms at all, or symptoms that are sudden and severe. When present, symptoms may include:

• Fever and chills
• More frequent urination, especially at night
• Difficulty urinating
• Blood in the urine
• Pain in the lower back, the lower abdomen, or in the area between the scrotum and the anus
• Tender or swollen prostate
• Painful ejaculation

The symptoms of prostatitis often mimic those of other urinary tract or prostate disorders. You may first notice these symptoms yourself, or your physician may detect a problem during a routine checkup. Among the most common tests:

• Digital rectal exam: The physician inserts a lubricated, gloved finger into the rectum and feels your prostate through the rectal wall. This exam gives the physician a general idea of the size and condition of the gland.
• Prostatic fluid analysis: The prostate gland is massaged to produce a fluid sample for microscopic evaluation.
• Blood and/or urine tests: A blood or urine sample may be taken to determine which type of prostatitis you have or to look for other causes of your discomfort.

Treatment of prostatitis depends on the type with which you are diagnosed:

Acute bacterial prostatitis:

• Medication: Typically this infection can be treated with antibiotics, pain, and fever medicines, as well as stool softeners, fluids, and rest. If you are unable to urinate or need to take antibiotics intravenously, you may be admitted to the hospital. Treatment will last two to six weeks.

Chronic bacterial prostatitis:

• Medication: Chronic prostatitis will require antibiotics for a longer period of time, usually six to 12 weeks. Sometimes low-dose antibiotics are prescribed long term.
• Surgical treatment: Sometimes the physician will recommend the surgical removal part of the prostate to correct blockage of the urine flow.

Chronic non-bacterial prostatitis/chronic pelvic pain syndrome:

• Medication: The physician may prescribe alpha blockers like tamsulosin, which relax the muscle tissue in the prostate and reduce difficulties urinating. Physicians may also prescribe medications that reduce prostate size, such as finesteride. Anti-inflammatory medicines may also help.
• Lifestyle changes: Avoid spicy foods, caffeinated, or carbonated drinks or acidic foods that contain vitamin C. Heat (soaking in a warm bath), regular exercise, and stress reduction may also help.