Prostatitis

Prostatitis -- an inflammation or infection of the prostate gland -- affects many young to middle-aged men. Symptoms include painful urination, urinary frequency and urgency, and pain in the lower back and genital area. There are four main types of prostatitis -- some of which improve with antibiotics. However, other forms do not respond to antibiotics and require a different treatment approach.

 

Prostatitis: An Overview

Prostatitis is an inflammation or infection of the prostate gland. It affects at least half of all men at some time in their lives. Having prostatitis does not increase your risk of developing any other prostate disease, such as prostate cancer.
 

Causes of Prostatitis

The cause of prostatitis can vary.  In some cases, prostatitis is caused by a bacterial infection. In these cases, prostatitis treatment involves antibiotics. But the more common forms of prostatitis are not associated with any known infecting organism. Thus, antibiotics are often ineffective in treating the nonbacterial forms of the disease.

 

Types of Prostatitis

The term prostatitis actually encompasses four disorders:
 
  • Acute bacterial prostatitis
  • Chronic bacterial prostatitis
  • Chronic prostatitis or chronic pelvic pain syndrome
  • Asymptomatic inflammatory prostatitis.

 

Acute bacterial prostatitis and chronic bacterial prostatitis are relatively uncommon.   Chronic prostatitis is the most common.

 

Symptoms of Prostatitis

Inflammation of the prostate gland causes the symptoms of prostatitis, which include:
 
  • Urinary frequency and urgency
  • Burning or painful urination (dysuria)
  • Pain in the lower back and genital area.
     
Other symptoms can also occur with prostatitis.
 

Diagnosing Prostatitis

Several tests, such as a digital rectal exam (DRE) and a urine test, can be done to see if you have prostatitis. Getting an accurate diagnosis of your exact type of prostatitis is the key to getting the best prostatitis treatment. Even if you have no prostatitis symptoms, you should follow your doctor's suggestion to complete treatment.
 

Can Prostatitis Be Transmitted?

Prostatitis is not contagious. It is not spread through sexual contact. Your partner cannot catch this infection from you.
 

Prostatitis Treatment Options Based on the Type

Prostatitis may account for up to 25 percent of all office visits by young and middle-aged men for complaints involving the genital and urinary systems.
 
The treatment for prostatitis will depend on the type. 
 
Acute Bacterial Prostatitis
Acute bacterial prostatitis is the least common of the four types, but it is also the easiest to diagnose and treat effectively. Men with this disease often have:
 
  • Chills
  • Fever
  • Pain in the lower back and genital area
  • Urinary frequency
  • Urgency to urinate -- often at night
  • Burning or painful urination
  • Body aches
  • A demonstrable infection of the urinary tract as evidenced by white blood cells and bacteria in the urine.
     
The treatment for this type of prostatitis is an appropriate antibiotic.
 
Chronic Bacterial Prostatitis
Chronic bacterial prostatitis is also relatively uncommon. This type of prostatitis is acute prostatitis associated with an underlying defect in the prostate, which becomes a focal point for bacterial infection to linger in the urinary tract. Effective treatment usually requires identifying and removing the defect and then treating the infection with antibiotics. However, antibiotics often do not cure this condition.
 
Chronic Prostatitis/Chronic Pelvic Pain Syndrome
Chronic prostatitis/chronic pelvic pain syndrome is the most common but least understood form of the disease. Characteristics include:
 
  • It is found in men of any age
  • Its symptoms go away and then return without warning
  • It may be inflammatory or noninflammatory.
 
In the inflammatory form of this type of prostatitis, urine, semen, and other fluids from the prostate show no evidence of a known infecting organism, but do contain the kinds of cells the body usually produces to fight infection. In the noninflammatory form, no evidence of inflammation -- including infection-fighting cells -- is present.
 
Antibiotics will not help this form of prostatitis. You may have to work with your doctor to find a treatment that works for you. Changing your diet or taking warm baths may help. Your doctor may give you a medicine called an alpha-blocker to relax the muscle tissue in the prostate. No single solution works for everyone with this condition.
 
Asymptomatic Inflammatory Prostatitis
A diagnosis of asymptomatic inflammatory prostatitis is made when the patient does not complain of pain or discomfort but has infection-fighting cells in his semen. Doctors usually find this form of prostatitis when looking for causes of infertility or testing for prostate cancer.
 
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Written by/reviewed by: Arthur Schoenstadt, MD
Last reviewed by: Arthur Schoenstadt, MD