What is prostate inflammation?
Men,
especially those over 50, often get alarmed at just the mention of the
prostate, and rightfully so; prostate cancer is the most common form of cancer
in men. However prostate inflammation,
also known as prostatitis, can affect men of all ages. According to the National Institutes of Health,
prostatitis is accountable for the medical visits of 25 percent of young and
middle-aged men involving their urinary and genital systems. In fact, chronic prostatitis (which
means it doesn't go away) is the number-one reason men under the age of 50
visit a urologist. In some cases, chronic prostatitis follows an attack of
acute prostatitis. Chronic prostatitis may also be related to other urinary
tract infections. Prostatitis is considered chronic if it lasts more than three
months.
The symptoms
of prostatitis are uncomfortable at best; more often they are extremely painful
and can also be dangerous. Symptoms may include pain and swelling in the area
of the prostate, fever, chills, pain in the lower back, burning or painful
urination, a need to urinate frequently and get up in the night, dribbling,
fatigue and body aches, and pain with ejaculation. Prostatitis can severely
affect the quality of life. Rigorous activity, sports, exercise - even sitting
for any length of time in an office, theater or at a sporting event - may
become too painful to tolerate. And as for sex - it's simply not an option.
What is the
prostate gland?
The prostate is a small organ located at the base of the bladder and
wrapped around the urethra, the tube that empties the bladder through the penis.
It sits in front of the rectum, and the back portion of the organ can be felt
during rectal examination by a health care practitioner.
The prostate's purpose is to help with the male reproductive system. It
makes up to 70% of the fluid that is ejaculated during intercourse, mixing its
secretions with the sperm that are made in the testicles. The prostate also
contracts at the time of ejaculation to prevent retrograde (or backward) flow
of semen into the bladder.
Because of its location, the symptoms of any prostate problem tend to be
associated with the bladder and can include urgency to urinate, frequency of
urination, burning with urination (dysuria), poor urine flow, or inability to
begin a urine stream.
Types and symptoms
There are four categories of prostate inflammation: acute bacterial,
chronic bacterial, chronic pelvic pain syndrome, and asymptomatic inflammatory.
Each of these categories has different symptoms, ranging from mild to severe.
The symptoms of prostate inflammation include:
- Acute bacterial. Acute bacterial
prostatitis is described as a sudden bacterial infection that leads to
prostate inflammation. Although this is least common form of prostatitis but the
symptoms are usually severe. Patients with this condition have an acute urinary
tract infection with increased urinary frequency and urgency, need to
urinate a lot at night, and have pain in the pelvis and genital area. Acute
bacterial prostatitis requires prompt treatment, as the condition can lead
to bladder infections, abscesses in the prostate or, in extreme cases,
completely blocked urine flow. Left untreated, the condition can cause
confusion and low blood pressure, and may be fatal. The condition is
usually treated in the hospital with intravenous antibiotics, pain
relievers, and fluids. Because acute prostate infection often is
associated with infections in other parts of the urinary tract, symptoms
may include the following:
- Increased
urinary frequency.
- Urgency to pass
urine.
- Pain with
urination.
- Difficulty
producing a normal stream.
- Pain in the
genital area.
- Pain with
ejaculation.
- High fever and
chills.
- Generalized malaise and fatigue.
- Chronic Bacterial. This condition is the result of
recurrent urinary tract infections that have entered the prostate gland.
It is thought to exist for several years in some men before producing
symptoms. The diagnosis of this condition is often challenging. It's often
difficult to find the bacteria in the urine. Treatment includes
antibiotics for four to 12 weeks and other treatment for pain. Sometimes
men are given suppressive low-dose, long-duration antibiotic therapy. Symptoms of
chronic bacterial prostatitis may be similar to acute bacterial
prostatitis, but are usually less intense. They include the following:
- Increased
urinary frequency along with pain and difficulty urinating.
- Pain in the
lower back, testes, epididymis, or penis.
- Sexual
dysfunction.
- Low-grade
fever, joint pains, and muscle aches.
- Examination may reveal urethral discharge and tender testes, or epididymis.
- Chronic pelvic pain syndrome. Chronic pelvic
pain syndrome, also called chronic nonbacterial
prostatitis is the most common of the categories since it accounts for 90
percent of the prostatitis cases. Chronic pelvic pain is sometimes
confused with the chronic inflammation of the bladder. If you suffer from
this ailment, you will experience genital and urinary pain three of the
past six months. Patients
have no bacteria in their urine, but may have other signs of inflammation.
The condition can be confused with interstitial cystitis (a chronic
inflammation of the bladder). You may feel pain on one or both sides of
your pelvis, or all over the pelvic area. The pain may increase or
decrease with certain body positions or activities. Sitting or standing
for a long time, moving your bowels, having sex, or urinating may worsen
your pain. Other common signs and symptoms include:
- Burning feeling when you
urinate.
- Feeling that your bladder has
not completely emptied after passing urine.
- Needing to urinate right away.
- Passing urine more often than
usual or you need to wake up at night often to urinate.
- Trouble starting to urinate, or
passing little amounts of urine or none at all.
- Premature or painful
ejaculation. Ejaculation is the forceful release of semen from the penis.
- Unable to have or maintain
erection. An erection is when the penis gets stiff so that sexual
intercourse (sex) is possible.
- Not being able to get your
female sexual partner pregnant when you are trying to have a baby.
- Backache, headache, neck pains,
or pain in the legs.
- Feeling tired most of the time
or getting tired very easily.
- Urine or semen that is pink or
red.
- Asymptomatic inflammatory. You will not have any symptoms when you have this illness, hence why it is asymptomatic. These patients are discovered when the prostate is biopsied for other situations such as a reason (possible cancer) for elevated PSA (prostate specific antigen) tests, or infertility. However, if the biopsy shows only inflammatory tissue changes and no cancer or other likely cause (infectious agents) for the asymptomatic inflammatory changes, then the patient is diagnosed with asymptomatic inflammatory prostatitis.
Risk
Factors
Bacterial infections cause only about 5%-10%
of cases of prostatitis. In the other 90%-95%, due to chronic pelvic pain
syndrome or asymptomatic inflammatory prostatitis described above, the cause is
not known.
At one time, infectious prostatitis was
believed to be a sexually transmitted disease, but more recent research
suggests that only a small number of cases are passed on through sex.
Certain conditions and medical procedures
increase the risk of developing prostatitis. You are at higher risk for getting
prostatitis if you:
- Recently have had a medical instrument, such as a urinary catheter (a soft, lubricated tube used to drain urine from the bladder) inserted during a medical procedure
- Engage in rectal intercourse
- Have an abnormal urinary tract
- Have had a recent bladder infection
- Have an enlarged prostate
Other causes may include autoimmune disease
(an abnormal reaction of the body to the prostate
tissue).
Treatment for Prostatitis
Treatments vary among urologists and are
tailored to the type of prostatitis you have. Correct diagnosis is crucial and
treatments vary. It's important to make sure your symptoms are not caused by
urethritis (inflammation of the urethra) or some other condition that may lead
to permanent bladder or kidney damage.
Treatments can include:
- Anti-inflammatory medicines along with warm sitz baths (sitting in two to three inches of warm water). This is the most conservative treatment for chronic prostatitis.
- Antibiotic medicine for infectious prostatitis. These drugs are not effective treatments for noninfectious prostatitis. For acute infectious prostatitis, patients usually need to take antibiotic medicine for 14 days. Almost all acute infections can be cured with this treatment.
- For chronic infectious prostatitis, antibiotic medicine is taken for a longer period of time, usually four to 12 weeks. About 75% of all cases of chronic infectious prostatitis clear up with this treatment. For cases that don't, taking antibiotics at a low dose for a long time may be recommended to relieve the symptoms.
- Pain medications.
- Muscle relaxants.
- Surgical removal of the infected portions of the prostate. A doctor may advise this treatment for severe cases of chronic prostatitis or for men whose swollen prostate is blocking the flow of urine.
- Supportive therapies for chronic prostatitis, including stool softeners and prostate massage.
Other treatments for chronic noninfectious
prostatitis include the use of the alpha blocker drugs such as Hytrin and Cardura. These drugs relax the muscles of the prostate and bladder
to improve urine flow and decrease symptoms. Other drugs that lower hormone
levels, such as Proscar, may help to
shrink the prostate gland in some men.
Some people may benefit from avoiding spicy
foods and caffeinated or acidic drinks. Activities that aggravate the
condition, such as bicycling may need to be eliminated as well.
Many cases of abacterial (nonbacterial)
prostatitis (also considered chronic pelvic pain syndrome) respond to a mix of
treatments that include exercise, myofascial trigger point release, progressive
relaxation, stress reduction, meditation, and counseling.
Prostatitis is a treatable disease. Even if
the problem cannot be cured, you can usually get relief from your symptoms by
following the recommended treatment. Be sure to follow the full course any
prescription you are given, even if you no longer have any symptoms. With
infectious prostatitis, for example, the symptoms may disappear before the
infection has completely cleared.
Sources
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