Prostatitis: Causes, Treatment and Prevention

Overview

Approximately half of all men experience symptoms of prostatitis at some point in their lives. Countless cases are reported each year, and it is classified as the most common urinary tract issue in men younger than 50 and the third most common issue over 50.

Prostatitis results in pain, infection, and inflammation of the prostate gland. However, men with asymptomatic inflammatory prostatitis don’t experience any symptoms. Although acute prostatitis is classified as a medical emergency, treatment must be sought promptly. If you have any specific questions related to the causes of prostatitis or ‘how I cured my prostatitis’, this article may be the best read for you. 

What is prostatitis?

Prostatitis refers to conditions, including acute and chronic bacterial prostatitis and chronic pelvic pain syndrome. The term refers to inflammation of the gland, usually caused by an infection that results in pain. Typically, prostatitis refers to four types of conditions that affect the prostate gland. Two of these types of prostatitis are related to urinary tract infections (UTIs). Adult men from any age group can get prostatitis. However, often men are misdiagnosed and actually have a different condition. It’s difficult to get accurate information about prostatitis, so it is essential to consult a doctor. 

What is the prostate gland?

The perineum male anatomy may be a bit challenging to understand. The prostate gland is classified as a part of the male reproductive system. The prostate is composed of fibromuscular tissue that resides in the pelvic cavity, weighing about 20 grams. It is located just below your bladder, in front of the rectum. The urethra, the tube which carries urine and semen out of the body, passes through the center of the gland.

The primary purpose of the prostate is to produce fluid for semen, which transports sperm during the male orgasm. The base of the gland resides at the neck of the urinary bladder that surrounds the proximal portion of the urethra. The urethra consists of a spongy urethra, but when it courses through the prostate, it is called a prostatic urethra that eventually exits from the apex of the gland. 

What are the types of prostatitis?

Acute bacterial prostatitis: A urinary tract infection usually causes bacterial prostatitis in the prostate gland. Symptoms of acute bacterial prostatitis include prostate pain, fever and chills. Furthermore, you may experience frequent and painful urination or have trouble urinating. Acute bacterial prostatitis mostly requires immediate medical attention. 

Chronic bacterial prostatitis: In the case of chronic prostatitis, bacteria become entrapped in the prostate gland. This results in recurrent UTIs that are often difficult to treat. Chronic prostatitis symptoms may include pain or burning with urination, foul-smelling urine, blood in the urine or semen, pain with ejaculation, and pain with bowel movements. The symptoms begin gradually and may last three months or longer. 

Chronic pelvic pain syndrome: This is the most common type of prostatitis. Prostate gland inflammation can occur in approximately 1 out of 3 men leading to chronic pain in the pelvis, perineum and genitals.

Asymptomatic inflammatory prostatitis: This condition causes prostate gland inflammation but does not cause any symptoms. This is sometimes referred to as nonbacterial prostatitis. This may be an incidental finding when you may find out that you have this condition after getting tests to determine the cause of any other conditions. Usually, no treatment is required. 

What causes prostatitis?

Various types of prostatitis have different causes. Risk factors for chronic pelvic pain syndrome haven’t been identified yet. However, the following conditions contribute to the cause:

• Stress.
• Autoimmune diseases.
• Pelvic floor muscle spasms.

Causes of bacterial forms of prostatitis largely include:

• Bladder infections
• UTIs
• Use of a urinary catheter during surgery or biopsy
• Prostate stones
• Bladder stones
• Urinary retention.

What are the symptoms of prostatitis?

Prostatitis symptoms vary depending on the cause and type. For example, people with asymptomatic inflammatory prostatitis don’t experience any symptoms.

Whereas men with chronic bacterial prostatitis or chronic pelvic pain syndrome may experience the following:

• Painful or difficult urination
• Burning sensation after ejaculating and urinating
• Pain in the penis or burning sensation in the penis
• Frequent urge to urinate.
• Weak urine flow.
• Pain radiating to the lower back.
• Pain in testicles or perineum.
• A urine stream that starts and stops.
• Pain during intercourse
• Painful ejaculation 
• Blood in semen 
• Erectile dysfunction

Acute bacterial prostatitis usually causes fever and chills an requires prompt treatment. 

Who is at risk of getting prostatitis?

Prostatitis can affect any age group. However, incidence peaks in men occur between the ages 20 and 40 and then those over 70. For men under 50, prostatitis is the most common urinary tract problem. 

Other factors can also increase your risk, including having:

• insertion of a urinary catheter
• a bladder infection
• trauma to the pelvis 
• past episodes of prostatitis
• an enlarged prostate

Having unprotected sex without any barrier method and being HIV-positive can increase your chances of developing prostatitis.

How is prostatitis diagnosed?

Prostatitis is diagnosed after evaluating your symptoms and performing a physical exam. Less invasive tests for checking for prostatitis include:

• Digital rectal exam: This is carried out by your doctor, who inserts a gloved, lubricated finger into the rectum to check the size of the prostate gland fand to check for pain. A prostate massage can be one, or a collection of a sample of seminal fluid can be made.
• Urinalysis: A urinalysis and urine culture is ordered to check for urinary tract infection and to identify the bacteria.
• Blood test: A blood test measures PSA levels. High levels can indicate prostatitis, BPH or prostate cancer.

Other tests done that are considered invasive tests for prostatitis diagnosis include:

• Cystoscopy: A cystoscopy can identify other urinary tract problems but is not a diagnostic test for prostatitis. A cystoscope can be used to view inside the bladder and urethra to identify the problem.
• Transrectal ultrasound: Transrectal ultrasound is usually done in men with acute or chronic bacterial prostatitis that isn’t cured by antibiotics. This imaging can reveal prostate gland abnormalities, stones or abscesses. 

Bacterial forms of prostatitis treatment

Prostatitis treatment usually involves taking prostatitis antibiotics. Prostatitis treatment antibiotics can kill bacteria that cause bacterial types of prostatitis. Men with acute bacterial prostatitis may require a prolonged course of antibiotics, such as 14 to 30 days of antibiotics. Often IV antibiotics in the hospital are initiated. Eliminating chronic bacterial prostatitis is very challenging, cure prostatitis in 60 days is often not possible, and treatment of up to three months of antibiotics may be required to sterilize the prostate. Low-dose antibiotics can be used long-term to prevent recurrences. The best antibiotic for prostatitis include doxycycline for prostatitis or ciprofloxacin for prostatitis. 

In some cases, men need surgery to remove prostate stones or scar tissue. Rarely do surgeons remove part or all of the prostate gland (prostatectomy), depending on the person’s condition. 

Complications of prostatitis

There is a chance of developing sepsis in men with acute bacterial prostatitis. This widespread infection can be life-threatening and requires prompt medical treatment.

Men who have chronic bacterial prostatitis require many antibiotics to treat recurring infections. Unfortunately, this can lead to an upset stomach or antibiotic resistance, which makes the treatment ineffective. 

Asymptomatic inflammatory prostatitis can lead to low sperm count in turn affecting fertility.

Prevention of Prostatitis

Immediate and proper treatment for UTIs may prevent the infection from spreading to the prostate. It is essential to  consult a doctor if you are having pain in your perineum when sitting. Addressing this problem without delay can help prevent chronic pelvic pain syndrome.

How is chronic pelvic pain syndrome (CPPS) managed or treated?

The treatment for prostatitis is differenet depending on the type and cause. For example, asymptomatic inflammatory prostatitis requires no treatment.

For chronic pelvic pain syndrome, your physician use a system called UPOINT to allocate symptoms into six categories. Moreover, treatment; largely depend on the signs that you’re experiencing.

The majority of men with CPPS notice marked improvement with the UPOINT system. The system incorporates the following symptoms and treatments:

• Urinary: Medications, such as tamsulosin and alfuzosin. These cause the relaxation of muscles around the prostate and bladder which in turn helps improve urine flow.
• Infection: Antibiotics kill bacteria causing the infection.
• Psychosocial: Stress management can do wonders. Some men benefit from medications for anxiety, depression or counselling. This helps deal with chronic pain. 
• Neurologic: Pain medicines like gabapentin and amitriptyline help relieve neurogenic pain. These are prescribed for pain caused by fibromyalgia as well.
• Tenderness: Pelvic floor physical therapy helps ease the tension on tight pelvic floor muscles. Furthermore, it may help to eliminate muscle spasms.
• Organ: Bee pollen supplements may relieve inflammation of the prostate gland.

Other Conditions with similar symptoms

Conditions that can cause similar symptoms to those experienced due to chronic prostatitis include:

• prostate cancer
• urinary retention
• bladder stones
• Musculoskeletal pain and constipation 

If is advised to seek medical attention if you have any of these symptoms so that appropriate treatment can be started. 

When to Consult a Doctor?

Prostatitis is a prevalent condition that affects many men. Unfortunately, there’s a lot of confusion regarding the disease, and it is best to consult a doctor for advice. Our doctors at Your Doctors Online can help diagnose and provide the correct treatment for prostatitis. 

FAQs About Prostatitis Answered by Your Doctors Online Team