newsprompt.coCOMMON PROSTATE PROBLEMS
Prostatitis is swelling and inflammation of the prostate gland, a walnut-sized gland situated directly below the bladder in men. The prostate gland produces fluid (semen) that nourishes and transports sperm.
Prostatitis often causes painful or difficult urination. Other symptoms include pain in the groin, pelvic area or genitals and sometimes flu-like symptoms.
Prostatitis affects men of all ages but tends to be more common in men 50 or younger. The condition has a number of causes. Sometimes the cause isn’t identified. If prostatitis is caused by a bacterial infection, it can usually be treated with antibiotics.
Depending on the cause, prostatitis can come on gradually or suddenly. It might improve quickly, either on its own or with treatment. Some types of prostatitis last for months or keep recurring (chronic prostatitis).
Symptoms
Prostatitis signs and symptoms depend on the cause. They can include:
Pain or burning sensation when urinating (dysuria)
Difficulty urinating, such as dribbling or hesitant urination
Frequent urination, particularly at night (nocturia)
Urgent need to urinate
Cloudy urine
Blood in the urine
Pain in the abdomen, groin or lower back
Pain in the area between the scrotum and rectum (perineum)
Pain or discomfort of the penis or testicles
Painful ejaculation
Flu-like signs and symptoms (with bacterial prostatitis)
Causes
Acute bacterial prostatitis is often caused by common strains of bacteria. The infection can start when bacteria in urine leak into your prostate. Antibiotics are used to treat the infection. If they don’t eliminate the bacteria prostatitis might recur or be difficult to treat (chronic bacterial prostatitis).
Nerve damage in the lower urinary tract, which can be caused by an operation or trauma to the area, might contribute to prostatitis not caused by a bacterial infection. In many cases of prostatitis, the cause isn’t identified.
Risk factors
Risk factors for prostatitis include:
Being a young or middle-aged
Having had prostatitis
Having an infection in the bladder or the tube that transports semen and urine to the penis (urethra)
Having pelvic trauma, such as an injury from bicycling or horseback riding
Using a tube inserted into the urethra to drain the bladder (urinary catheter)
Contracting a disease
Having had a prostate biopsy
Complications
Complications of prostatitis can include:
Bacterial infection of the blood (bacteremia)
Inflammation of the coiled tube attached to the back of the testicle (epididymitis)
Pus-filled cavity in the prostate (prostatic abscess)
Semen abnormalities and infertility, which can occur with chronic prostatitis
There’s no direct evidence that prostatitis can lead to prostate tumor.
Diagnosis
Diagnosing prostatitis involves ruling out other conditions as the cause of your symptoms and determining what kind of prostatitis you have. Your physician will ask about your clinical history and your symptoms. He or she will also do a physical exam, which will likely include a digital rectal examination.
Initial diagnostic tests might include:
Urine tests. Your physician might have a sample of your urine analyzed to look for signs of infection in your urine (urinalysis). Your physician might also send a sample of your urine to a lab to determine if you have an infection.
Blood tests. Your physician might examine samples of your blood for signs of infection and other prostate problems.
Post-prostatic massage. In rare cases, your physician might massage your prostate and test the secretions.
Imaging tests. In some cases, your physician might order a CT scan of your urinary tract and prostate or a sonogram of your prostate. CT scan images provide more detailed information than plain X-rays do. A sonogram is the visual image produced by an ultrasound.
Based on your symptoms and test results, your physician might conclude that you have one of the following types of prostatitis:
Acute bacterial prostatitis. Often caused by common strains of bacteria, this type of prostatitis generally starts suddenly and causes flu-like signs and symptoms, such as fever, chills, nausea and vomiting.
Chronic bacterial prostatitis. When antibiotics don’t eliminate the bacteria causing prostatitis, you can develop recurring or difficult-to-treat infections. Between bouts of chronic bacterial prostatitis, you might have no symptoms or only minor ones.
Chronic prostatitis/chronic pelvic pain syndrome. This type of prostatitis — the most common —isn’t caused by bacteria. Often an exact cause can’t be identified. For some men, symptoms stay about the same over time. For others, the symptoms go through cycles of being more and less severe.
Asymptomatic inflammatory prostatitis. This type of prostatitis doesn’t cause symptoms and is usually found only by chance when you’re undergoing tests for other conditions. It doesn’t require treatment.
Treatment
Prostatitis treatments depend on the underlying cause. They can include:
Antibiotics. This is the most commonly prescribed treatment for prostatitis. Your physician will choose your treatment based on the type of bacteria that might be causing your infection.
If you have severe symptoms, you might need intravenous (IV) antibiotics. You’ll likely need to take oral antibiotics for four to six weeks but might need longer treatment for chronic or recurring prostatitis.
Alpha blockers. These treatments help relax the bladder neck and the muscle fibers where your prostate joins your bladder. This treatment might ease symptoms, such as painful urination.
Lifestyle and home remedies
The following might ease some symptoms of prostatitis:
Soak in a warm bath (sitz bath) or use a heating pad.
Limit or avoid spirits, caffeine, and spicy or acidic foods, which can irritate your bladder.
Avoid activities that can irritate your prostate, such as prolonged sitting or bicycling.
Drink plenty of non-caffeine beverages. This will cause you to urinate more and help flush bacteria from your bladder.
Alternative substances
Alternative therapies that show some promise for reducing symptoms of prostatitis include:
Biofeedback. A biofeedback specialist uses signals from monitoring equipment to teach you to control certain body functions and responses, including relaxing your muscles.
Acupuncture. This involves inserting very thin needles through your skin to various depths at certain points on your body.
Herbal remedies and supplements. There’s no evidence that herbs and supplements improve prostatitis, although many men take them. Some herbal treatments for prostatitis include rye grass (cernilton), a chemical found in green tea, onions and other plants (quercetin) and extract of the saw palmetto plant.
