Prostatitis Diagnosis & Treatment
The prostate is a gland about the size of a walnut that surrounds the urethra and adds fluid to the semen during ejaculation. The first signs of a prostate problem is often painful urination or a frequent need to urinate.
For men younger than age 50, the most common prostate problem is prostatitis, or inflammation of the prostate. For men older than 50, the most common prostate problem is prostate enlargement. This condition is also called benign prostatic hyperplasia or BPH.
Prostatitis is swelling or inflammation of the prostate gland, a small walnut-shaped gland located below the bladder in men. It produces semen, the fluid which contains sperm.
There are four types of prostatitis
1. Chronic nonbacterial prostatitis (or chronic pelvic pain syndrome). This is the most common form, and doctors are not sure what causes it. Symptoms are chronic, which means they may last for a long period of time; they may improve only to worsen again.
2. Chronic bacterial prostatitis. This is another chronic form of prostatitis. It is caused by an infection of the prostate.
3. Acute bacterial prostatitis. Caused by bacteria in the prostate, this type is the least common. It is acute because it may occur suddenly and can be serious. You may be admitted to the hospital for treatment.
4. Asymptomatic inflammatory prostatitis. This type usually has no symptoms and may only be discovered if you are having problems which may be related such as infertility (failure to produce offspring after multiple attempts at conception).
Symptoms of prostatitis may occur suddenly or develop over of a period of time, including:
- Pain in the prostate gland, back, and/or genitals
- Painful ejaculation
- Difficult or painful urination
- Frequent urination
- Bladder infection
- Blood in semen or urine
- You may have difficulty passing urine and/or you may have bacteria in your urine.
- Your fertility may be affected since the prostate gland may be impaired in its production of semen.
Prostatitis may also increase your level of prostate-specific antigen (PSA) (substance secreted by prostate cells, used in diagnosing cancer). Your doctor will want to do tests to confirm your higher PSA is caused by prostatitis and not by prostate cancer.
Your doctor may perform one or more of the following evaluations to determine which type of prostatitis you have and which treatment will be most effective:
- Detailed medical history. Your doctor will ask information about your health to be sure you do not have another illness causing your symptoms.
- Physical Exam.
- Digital Rectal Exam. Using a gloved and lubricated finger, your doctor will insert one finger into your rectum and feel your prostate gland to determine if it is enlarged.
- Analysis of urine. This includes lab tests that show the presence of bacteria, white blood cells, or other elements in urine associated with prostatitis.
Your and your doctor will plan your treatment based on what type of prostatitis you have. Treatment options include:
- Antibiotics. You may need to take these drugs that fight infection for a long period of time. If you have a more serious case of prostatitis, you may need to be hospitalized to have intravenous or IV antibiotics (delivered via a vein in your arm).
- Alpha Blockers. These medications relax the muscles of the bladder and may help you to urinate more easily.
- Over-the-counter pain relievers. Medications such as ibuprofen (Advil, Motrin, etc.), Tylenol, and Aspirin may help relieve symptoms such as back and groin pain.
- Muscle relaxants. These medicines can help relieve pain caused by an enlarged prostate pressing on nearby muscles.
- Exercise. A physical therapist may show you exercises to stretch and strengthen the muscles of the pelvic area to help relieve your symptoms.
- Sitz Bath. Soaking in a tub of warm water or applying warm water to your pelvic area can relieve symptoms.
- Biofeedback. A trained therapist can measure when certain muscles are tensed or relaxed and can teach you how to relax specific muscles, relieving some of your symptoms.
- Surgery. If you have bacterial prostatitis, you may need surgery to open blocked ducts (the tiny tubes that carry semen within the prostate). This may help relieve your symptoms and can improve fertility.
Treatment for prostatitis is usually effective. Your symptoms should resolve. However, all forms of this condition may recur and your symptoms may return. If this happens, you may need to repeat treatment.
Tips for controlling symptoms
- Drink plenty of water so you can urinate frequently, flushing out the prostatic urethra.
- Have regular sexual activity or ejaculations, which may provide some defense against infection by flushing out the urethra.
- Limit or avoid caffeine, alcohol, and spicy foods.
- If you ride a bicycle, use a "split seat" to reduce to pressure on your prostate.
For more information
The Prostatitis Foundation
1063 30th Street, Box 8
Smithshire, IL 61478
Toll-Free: (888) 891-4200
Fax: (309) 325-7184
Web: www.prostatitis.org American Urological Association
1000 Corporate Boulevard
Linthicum, MD 21090
Phone: (410) 689-3700
Fax: (410) 689-3800