PROSTATITIS

Prostatitis is an infection or inflammation of the prostate gland. The prostate is a walnut sized gland located below the bladder in males. The urethra runs through the middle of the prostate gland. The prostate produces fluid that nourishes the sperm.

Acute bacterial prostatitis has a rapid onset and local symptoms such as voiding difficulty, pelvic pain, and low back pain. Some patients may experience systemic symptoms such as fever, chills, muscle aches, and fatigue. Occasionally sepsis can occur. This requires treatment with antibiotics.

Chronic bacterial prostatitis has a slower onset and the symptoms can wax and wane. Systemic symptoms are not usually associated with this chronic condition. Local symptoms such as pelvic pain, low back pain, testicular pain, and upper leg pain can occur. This also requires treatment with antibiotics.

There is another chronic condition of the prostate called nonbacterial prostatitis. The symptoms can be similar to the chronic bacterial prostatitis. Urine cultures are typically not positive. It is speculated that urine metabolites such as urate can reflux into the prostate gland causing a chemical irritation of the prostate.

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 surgery 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. 

SYMPTOMS

  • Pain or burning sensation when urination (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 symptoms (with bacterial prostatitis) 

TREATMENT

Treatment includes anti-inflammatory medications to reduce inflammation and allopurinol to dissolve urates.