Prostatitis - symptoms and treatment

The prostate gland is located below the bladder and in front of the rectum; it forms part of the male reproductive system along with the penis, seminal vesicles, and testicles. It is approximately the size of a walnut and surrounds the tube through which urine empties from the bladder (urethra) and its most important function is producing a fluid that makes up 50% - 75% of semen, along with fluid from other glands and sperm from the testicles. In addition, there are muscles in the prostate which when the contract will force sperm into the urethra and expel it out during ejaculation.

Prostatitis is inflammation of the prostate gland; it can be extremely painful and it may spread to the tissue surrounding the prostate gland.

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Types and causes of prostatitis

There are two main types of prostatitis:

Acute prostatitis - this form of the condition may come on suddenly and the symptoms are severe. This is a rare form of prostatitis but it can be very severe and may even be fatal and therefore required immediate treatment. This form of the condition may be caused by bacteria from the urinary tract entering the prostate gland
Chronic prostatitis - this form of the condition is the most common and symptoms may come and go for several months. In the case of chronic prostatitis, there is often no sign of infection and in these cases, the cause of the prostatitis is not known

Symptoms of prostatitis

Acute prostatitis

Symptoms of acute prostatitis may come on rapidly and be very severe; immediate medical attention should be sought. The symptoms may include:

A general feeling of malaise with aches and pains and high temperature
Nausea and vomiting
Fever
Chills
Frequent urge to urinate
Urgent urination
Frequent urination whilst sleeping
Burning pain during urination
Urinary retention (inability to empty the bladder completely)
Weak or interrupted urine stream
Urinary blockage (inability to urinate)
Urinary tract infection
Pain in the area of the groin, genitals, lower back, or lower abdomen
Pain after ejaculation

Chronic prostatitis

If a person has suffered from some of the following symptoms for at least three months they may be suffering from chronic prostatitis:

Pain on urination
Frequent urge to urinate, particularly during the night
Interrupted urination (stop-start urination)
An enlarged or tender prostate gland on examination
Pain in and around the penis, testicles, abdomen, lower back, or anus
Erectile dysfunction
Pain on ejaculation
Pain in the pelvis after sexual intercourse

These symptoms can be chronic and seriously affect a person's quality of life. However, they will gradually improve with treatment and over a period of time.

Treatment for prostatitis

The type of treatment needed for prostatitis will depend if it is acute or chronic

Acute prostatitis

In the case of acute prostatitis where the onset is rapid and severe then the usual treatment will be a 2 - 4 week course of antibiotics. If a person is very ill or unable to urinate, however, they may need to spend a period of time in the hospital.

Chronic prostatitis

As the symptoms of chronic prostatitis can come and go over a period of months, treatment tends to be aimed at controlling the symptoms when they arise. The doctor may suggest:

Painkillers
Alpha-blockers may be prescribed if a person is having problems urinating. The alpha-blockers help the muscles of the prostate gland and at the bottom of the bladder to relax
Antibiotics
A laxative may be necessary if the patient is finding defecation painful

By treating symptoms as and when they arise the condition will be less disruptive in a person's life

Risk factors - who is most likely to have prostatitis?

There are a number of factors which make it more likely for a person to have acute prostatitis:

If a person has a sexually transmitted infection
When a person has suffered from prostatitis in the past
They have had a urinary tract infection recently
If there has been an injury to the pelvis
If there has been an issue with the urinary tract
If a person has HIV or AIDS
If a person has had anal sex
If a prostate biopsy procedure has been carried out
If a urinary catheter has been placed in the urethra recently

It is more likely that a person gets chronic prostatitis:

Older men, aged between 50 and 59 years are three times more likely than men aged 20 - 39 years to suffer from chronic prostatitis
If a person has suffered from prostatitis previously
If a person has other painful abdominal conditions such as irritable bowel syndrome
If a person has been sexually abused

Diagnosis of prostatitis

There are several conditions that may exhibit similar symptoms to those of prostatitis and these conditions must be eliminated first. The doctor will ask about your symptoms and medical history. They will also carry out a physical examination which will include carrying out a rectal examination in order to check whether the prostate gland is enlarged. Blood tests and urine tests may also be taken.

Conclusion

On the whole, prostatitis is treatable. The common, chronic types may last for months but will eventually be cured with treatment. Treatment however can be challenging as little is known about what causes it

In the case of acute prostatitis, whilst it can be life-threatening if not treated quickly enough, a course of antibiotics is usually sufficient to treat the infection present. There are a couple of conditions that may arise through this type of prostatitis, one being urinary retention. Painful urination may cause urine to build up in the bladder causing abdominal pain and the inability to urinate. If this happens, inserting a urinary catheter will relieve the situation.

In rare cases, the antibiotics will not clear up the infection and an abscess can develop in the prostate gland. If the antibiotics have not relieved the symptoms then the doctor may suspect this as being the problem and may order a CT scan of the prostate. If an abscess has formed it will require surgery to drain it