An Overview of Prostatitis: Symptoms and Treatment

All men have a gland in their reproductive system called the prostate. The prostate is located below the bladder and in front of the rectum, and its responsibility is to create semen—the fluid that contains sperm. If the prostate swells or becomes inflamed, however, a condition known as prostatitis can develop.

This can cause painful urination or trouble urinating, and several other pain- or discomfort-related symptoms. It has several different causes and can be either temporary or recurring. Here’s what you need to know.

Symptoms and Complications

Symptoms vary depending on its cause, and they can include:

Dysuria: Pain or burning sensation during urination
Nocturia: Frequent urination, particularly during the night
Bloody or cloudy urine
Trouble urinating
Feelings of an urgent need to urinate
Pain: Could be present in the abdomen, groin, lower back, perineum (area between scrotum and rectum), penis, testicles or during ejaculation
Flu-like symptoms: These are only present in bacterial prostatitis

In cases of pelvic pain, difficulty or pain during urination, or painful ejaculation, see a doctor as soon as possible. Other complications include:

• Epididymitis: Inflammation of a tube attached at the back of the testicles
Prostatic abscess: A pus-filled cavity inside the prostate
Bacteremia: Bacterial infection in the blood
In cases of chronic prostatitis, infertility and semen abnormalities are possible

Causes and Risk Factors

Common strains of bacteria can cause acute bacterial prostatitis, one of a few different types of the condition, and this type can be treated with antibiotics—if these are ineffective, this could signal chronic bacterial prostatitis. In other cases, nerve damage in the urinary tract can contribute to types that aren’t related to a bacterial infection.

There are also several factors that raise your risk level:

Age: Prostatitis is more common in men ages 50 and under
Previous prostatitis infection
Infection in the bladder or urethra
Presence of a urinary catheter (a tube inserted into the urethra)
Pelvic trauma
Presence of HIV/AIDS
Past prostate biopsy

Diagnosis and Types

Part of the diagnosis process includes ruling out other conditions that might be causing your symptoms. This includes a basic medical history and physical exam, which often includes a digital rectal examination. It may also include one of several tests.

Based on the results of the exam and any tests performed, your doctor may inform you that you have one of the following types of prostatitis:

Acute bacterial prostatitis: Generally caused by common strains of bacteria, this condition leads to flu-like symptoms and usually starts suddenly.
Chronic bacterial prostatitis: This condition is defined by recurring infections due to the ineffectiveness of antibiotics used on acute bacterial prostatitis. People with chronic bacterial prostatitis will see flare-ups with noticeable symptoms in addition to down periods with no symptoms or very limited symptoms.
Chronic prostatitis/chronic pelvic pain syndrome: This is the most common type and is not caused by bacteria. Causes often can’t be specifically identified. Symptoms remain constant in some cases, or ebb and flow through cycles in other cases.
Asymptomatic inflammatory prostatitis: This type does not cause symptoms, and often is only found while undergoing tests for outside conditions. This type does not require treatment.

Prostatitis Treatment

Treatments can include the following, depending on the cause:

Antibiotics: The most common form of treatment
Alpha blockers: Medications that relax the bladder neck and the fibers where the prostate and the bladder connect
Anti-inflammatory medications: To ease comfort
Alternative measures: Alternative therapies such as biofeedback, acupuncture and herbal remedies or supplements have had success in reducing prostatitis symptoms in some cases