Prostatitis (Prostate Infection)

Prostatitis is swelling and irritation of the prostate gland, often caused by a bacterial infection.

There are three types of prostatitis, each with a range of symptoms.

• Acute Bacterial Prostatitis: Usually caused by a sudden bacterial infection. The symptoms include painful urination; pain in the lower back, abdomen, groin or pelvic area; and fever and chills. A visit to a doctor or hospital is required.
• Chronic Bacterial Prostatitis: Symptoms are similar to acute bacterial prostatitis but develop gradually, are less severe, and do not produce a fever. The condition is caused by a bacterial infection. It can be episodic with flare-ups and remissions associated with treatment and subsequent recurrence.
• Chronic Nonbacterial Prostatitis/Chronic Pelvic Pain Syndrome: The symptoms can be indistinguishable from of chronic bacterial prostatitis, but tests for a bacterial infection are negative. Men with chronic nonbacterial prostatitis should be evaluated for interstitial cystitis/chronic pelvic pain syndrome.

To diagnose prostatitis, your doctor will ask you about your symptoms and may examine the prostate gland by inserting a lubricated, gloved finger into the rectum. Urine and prostate fluid may also be collected and evaluated for bacteria.

Treatment

Treatment depends on the type of prostate infection.

• For acute prostatitis, patients take antibiotics for 4 to 6 weeks.
• For chronic bacterial prostatitis, patients take antibiotics for 4 to 12 weeks. About 75 percent of all cases of chronic bacterial prostatitis clear up with this treatment. Sometimes the symptoms recur and antibiotic therapy needed again. For cases that do not respond to this treatment, long-term, low dose antibiotic therapy is recommended to relieve the symptoms.
• Treatment for nonbacterial prostatitis is difficult. The goal is to control symptoms because it is hard to cure this condition. Some doctors prescribed anti-inflammatory drugs, pain medications and muscle relaxants. Therapies used to treat interstitial cystitis or chronic pelvic pain syndrome may also be helpful.

Why do physicians have trouble diagnosing prostatitis?

With the exception of acute prostatitis, the diagnosis of prostatitis can be very difficult and sometimes quite frustrating for the patient and his physician. The symptoms are variable and there is much overlap in symptoms between the various types of prostatitis. Once the patient has been treated with antibiotics, it can be difficult to differentiate a bacterial prostatitis from chronic pelvic pain syndrome.

Why are some patients not cured after being treated for chronic bacterial prostatitis?

Patients with chronic bacterial prostatitis can have persistence of their infectious problem despite antibiotic use. This is because of the difficulty antibiotics have in penetrating the prostate gland to completely kill all the bacteria deep within the prostatic ducts.