Prostatitis is an inflammation of the prostate gland. It is estimated that 50% of men experience symptoms of an inflamed prostate at one point in there lives. Although the symptoms are often the same, there can be different causes of prostatitis. Based on the cause, prostatitis can be classified into one of four categories:
- Acute bacterial prostatitis is inflammation of the prostate gland cause by bacteria such as E-Coli and Klebsiella. It is most common in men aged 40-60.
- Chronic bacterial prostatitis is when prostate infections keep coming back despite appropriate treatment. This is found most often in men aged 50-80.
- Nonbacterial prostatitis is when the prostate gets inflamed without an infection. This is most common in men aged 30-50.
- Prostatodynia, sometimes called chronic pelvic pain syndrome (CPPS), is the occurrence of prostatitis symptoms, without inflammation or bacterial infection.
To evaluate a patient for prostatitis the doctor will begin by obtaining a thorough medical history. A rectal exam may be done to determine the prostate surface, assess its size, shape and consistency, and evaluate for an abscess. A urinalysis will also be done to check the urine for the presence of leukocytes (white blood cells) which are often seen in the urine with prostate infections. If there is a concern about a urinary infection, urine may be further analyzed by a urine culture. The doctor may obtain a culture of prostatic secretions and may need to perform a prostate ultrasound in some men.
Acute Bacterial Prostatitis (ABP) is usually treated with antibiotics for 3-8 weeks and occasionally with medications that can relax the prostate and assist in allowing urine to drain.
Chronic Bacterial Prostatitis (CBP) may be treated with antibiotics but sometimes antibiotics are not enough. Other medications and even surgery (Transurethral Resection of the Prostate – TURP) may be necessary to remove the infected tissue .
Nonbacterial Prostatitis is inflammation of the prostate not caused by bacteria. Although bacteria are not the cause, antibiotics are often helpful to treat this. Other effective medications include anti-inflammatory agents and muscle relaxants. Many non-drug therapies can be effective in reducing the symptoms as well and include hot baths.
Prostatodynia usually has the same symptoms as prostatitis, but something outside the prostate is the cause. This can include a malfunction of the muscles that make up the pelvic floor, or a defect in the lining of the bladder. Therefore, treatment is directed at the cause and can vary from patient to patient.
Despite the relatively small size of the prostate, treating prostatitis can be difficult and often takes weeks to months. However, treatment is available and discussing your symptoms with a urologist is your first step towards finding the treatment that will get you on the road to recovery.