What is Prostatitis?

Prostatitis is an inflammatory infection of the prostate gland. Pain and swelling are common with this condition. The prostate gland, which resides in men below their bladder, generates semen.

Men of any age can develop prostatitis. However, men over 50 appear more vulnerable to prostate inflammation. The onset of prostatitis can occur gradually or immediately, and the condition might last a few months or, in the case of chronic recurring prostatitis, much longer. Prostatitis is linked to prostate cancer.

Symptoms

The symptoms of prostatitis depend on whether the condition is acute or chronic. Prostatitis symptoms also differ based on the underlying cause of the inflammation, such as bacteria. It is also possible for prostatitis to occur without pain or other symptoms. This is called asymptomatic inflammatory prostatitis.

Acute Prostatitis Symptoms

Acute prostate inflammation symptoms include:

• Urinary tract infection (UTI)
• Unable to urinate
• Chills
• Fever
• Body discomfort
• Increased urination
• Nausea
• Urgent urination
• Difficulty urinating
• Weak urine stream
• Vomiting
• Burning
• Painful urination
• Groin pain
• Lower back pain
• Abdomen pain
• Inability to empty bladder
• Increased nighttime urination

Chronic Prostatitis

Chronic prostatitis is when an inflamed prostate last three or more months. The most common symptom is pain.

Chronic inflamed prostate symptoms include:

• Groin pain
• Scrotum pain
• Anus pain
• Lower back pain
• Lower abdomen pain
• Pain in the penis
• Pain when ejaculating
• Urinary tract infection
• Blocked urination
• Urgent urination
• Increased urination
• Difficulty urinating
• Weak urine stream
• Increased urination during sleep

Causes

Most prostatitis causes are unknown. Often, it is the nerves in the pelvis that cause pain due to localized inflammation. Bacteria can also cause prostatitis. Bacteria can enter the prostate through contaminated urine flowing backward from the urethra.

Other potential inflamed prostate causes:

• Stress
• Injury
• Inflamed nerves
• Urinary tract infections
• Enlarged prostate
• Prostate cancer
• Urethral scar tissue
• Narrowed urethra
• Prostate stones
• Tension in pelvic floor muscles

Risk Factors

There are several potential risk factors for developing prostatitis. The risk factors include age, health conditions, and surgeries.

Risk factors for prostatitis include:

• Being over 50 years of age.
• Undergoing a surgery such as a prostate biopsy.
• Experiencing a bladder infection.
• Using a catheter or other medical device inserted in your urethra.
• Previous prostatitis.
• Pelvic trauma, such as injuries from riding a motorcycle, bicycle, or horseback riding.
• Contracting HIV/AIDS.

Diagnosis

To make a prostatitis diagnosis, your doctor will refer you to a urologist, a specialist in diagnosing and treating urological conditions. A urologist will use several different tests to accurately identify the type of prostatitis. Each type of prostatitis requires a specific treatment.

Possible diagnostic tests for prostatitis:

• Physical Exam
• Ultrasound
• Urine and prostate fluid tests
• Cystoscopy
• Urine Flow Studies (Urodynamics)

Physical Exam

A physical exam is the first step in diagnosing Prostatitis.

The physical exam may include a digital rectal examination. This test is done by inserting a lubricated, gloved finger into the rectum and feeling for any abnormalities or masses within the prostate gland.

Ultrasound

An ultrasound is an imaging test that uses sound waves to produce images of the body. It is a safe and mildly uncomfortable procedure that can be performed in your doctor's office or at another medical facility.

The urologist will use an ultrasound to look for abnormalities in your prostate.

Urine and Prostate Fluid Tests

Urine and prostate fluid tests can be used to diagnose prostatitis. The tests show bacteria in urine samples or prostate fluid. The test results would be considered abnormal if there is infection or inflammation present.

Cystoscopy

A cystoscopy is an examination of the inside of the bladder, prostate, and urethra with an instrument called a cystoscope. A doctor inserts a thin, lighted tube — the cystoscope — into your bladder through your urethra to check for any signs or symptoms of prostatitis.

Urine Flow Studies

Urine flow studies are a series of tests to check for urinary obstructions and strength or urine flow. These tests can help your doctor determine the type of prostatitis you have, the underlying cause, and how to properly treat your condition.

Urine flow studies might include:

• Uroflowmetry — The uroflowmetry test calculates the amount of urine that comes out of your body and how fast the urine exits your body.
• Cystometry — This test examines bladder function.
• Urethral Pressure Profile — The urethral pressure profile is a test that measures the pressure of urine as it travels through your urethra.
• Electromyography (EMG) — An EMG test checks the electrical activity in your pelvic floor.
• Voiding Pressure Study — A pressure flow study measures the amount of pressure in your bladder when you urinate. This study also measures how fast the urine is flowing.

Treatment & Recovery

There are a variety of prostatitis treatment options based on the specific type.

Prostate inflammation treatment options:

• Antibiotics — Antibiotics are medications used to treat infections. Your doctor may recommend that you take medications for at least two weeks. Sometimes, they may recommend up to 6-8 weeks. 
• Anti-inflammatory agents — Your doctor might prescribe pain medication and muscle relaxers to reduce your symptoms and mitigate pain.
• Prostatic massage — This treatment involves emptying the prostate ducts of fluids and physiotherapy to relax the surrounding muscles.
• Biofeedback — In this treatment, a specialist teaches you to release tension in your pelvic floor muscles.
• Lifestyle changes — There are many things you can do at home to reduce symptoms and manage your prostatitis. These include relaxation techniques, hot baths, heating pads, donut pillows, dietary changes, and acupuncture.
• Surgery — Prostatitis surgery is a rare but available treatment option.

Complications

Your medical team will likely make you aware of possible complications of prostatitis. These complications can impact your comfort, health, and ability to reproduce. While prostatitis is loosely linked to prostate cancer, there is currently no clear and direct evidence of causation.

Complications of prostatitis:

• Prostatic abscess — This is a collection of pus in the prostate. Prostatic abscesses are usually due to bacterial infections and often require surgical drainage.
• Epididymitis — This is inflammation of the epididymis, a tube found at the back of the testicle. Epididymitis typically presents with pain and swelling in the scrotum.
• Bacteremia — This is blood infected with bacteria.
• Reproductive Issues — Prostatitis can result in abnormalities in your semen and infertility.

If you or a loved one experience any of the symptoms of prostatitis, please contact a urologist at Baptist Health.