Prostatitis

What is prostatitis?

Prostatitis is swelling and tenderness of the prostate gland. It is a common problem in men. The prostate gland is part of a man's reproductive system. It is, on average, a little bigger than a walnut. It is located between the base of the bladder and the beginning of the penis. It surrounds the upper part of the urethra. (The urethra carries urine from the bladder out through the penis.) The prostate makes the fluid that nourishes and carries sperm.

There are 3 types of prostatitis:

• acute bacterial prostatitis
• chronic prostatitis
• nonbacterial prostatitis.

How does it occur?

The swelling and tenderness is often caused by a bacterial infection.

• Usually the bacteria come from other infected parts of the urinary tract, such as the bladder or kidneys.
• The bacteria can spread to the prostate through the urethra after sex with someone who is infected.
• The bacteria can also be spread to the prostate through the bloodstream.

Sometimes the prostate becomes swollen and tender (inflamed) without infection.

What are the symptoms?

The symptoms of the different types of prostatitis vary somewhat.

If you have acute bacterial prostatitis, you have clear signs of illness and you need to get treatment promptly. The symptoms most often are:

• fever
• chills
• sweats
• lower back pain.

You may have:

• pain behind the scrotum
• pain when you urinate
• frequent and urgent urination
• pain when you have a bowel movement.

It may also be hard for you to pass urine.

The symptoms of chronic prostatitis and nonbacterial prostatitis are more subtle. They develop more slowly and are milder. Possible symptoms are:

• slight discomfort when you urinate, often felt at the base of the penis
• mild lower backache
• aches in the penis, scrotum, or middle to lower abdomen
• pain during or after the release of semen during sex
• small amounts of blood in the semen.

How is it diagnosed?

Your healthcare provider will ask about your symptoms. Your provider will examine your abdomen and scrotum to rule out other possible medical problems. You may have one or more of the following exams and tests:

• a rectal exam
• tests of a sample of urine
• tests of fluid from the prostate.

Your healthcare provider may ask you to provide a urine sample before a rectal exam of the prostate. During the rectal exam, your provider will press on the prostate. This will cause fluid from the prostate to enter your urinary tract. After the rectal exam you will provide another sample of urine. This will help your provider know if the prostate or the urinary tract is infected.

Your provider may conclude that you have nonbacterial prostatitis if you have symptoms but neither the urine culture nor the prostate secretions show evidence of infection.

How is it treated?

An infection is treated with antibiotic medicine. For severe symptoms, you may need to spend some time in the hospital for intravenous (IV) antibiotics.

Sometimes it is helpful to treat nonbacterial prostatitis with antibiotics.

You may find that some foods, such as spicy foods or foods that contain caffeine, seem to cause prostate symptoms. Ask your healthcare provider if avoiding these foods might be helpful.

How long will the effects last?

The symptoms of an infection usually get better with antibiotics in a few days. Sometimes the symptoms continue for 1 to 2 weeks after you start taking the medicine.

Symptoms may come back if not all of the bacteria in the prostate gland are killed by the antibiotic. Symptoms may also return if bacteria from the urinary tract or from sexual contact reinfect the prostate. If this happens, you may need to take antibiotics again.

After an infection is treated you may have X-rays or ultrasound scans of your urinary tract. These images of your pelvic area help rule out causes or complications of prostatitis, such as kidney infection or an abscess of the prostate gland.

How can I help prevent prostatitis?

• Avoid sexually transmitted infections to reduce the risk of prostatitis. For example, use latex or polyurethane condoms during sexual intercourse. Have just 1 sexual partner who is not sexually active with anyone else.
• Practice good genital hygiene. If you are a man who has not been circumcised, good hygiene includes gently pulling back the foreskin to wash the tip of the penis every time you bathe or shower. This helps to prevent urinary tract infections, which can lead to prostatitis.
• Get prompt treatment of any urinary tract problems. This reduces the chance of prostate infection.