Prostatitis
Your physician may have told you that you have prostatitis, which is an inflammation of the prostate. Because your prostate has probably not caused you any trouble until now, you may not know much about this organ

This portion of our web site is designed to answer your questions on prostatitis, as well as those about the prostate itself -- where it is, what it does

What Is the Prostate And What Does It Do?
The prostate is a gland of the male reproductive system. It is located in front of the rectum and just below the bladder, the organ that stores urine. The prostate is quite small - it weighs only about an ounce - and is nearly the same size and shape as a walnut. As shown below, the prostate wraps around a tube called the urethra, which carries urine from the bladder out through the tip of the penis.



The prostate is made up largely of muscular and glandular tissues. Its main function is to produce fluid for semen, which transports sperm. During the male orgasm (climax), muscular contractions squeeze the prostate's fluid into the urethra. Sperm, which are produced in the testicles, are also propelled into the urethra during orgasm. The sperm-containing semen leaves the penis during ejaculation.

Types of Prostatitis
There are three types of prostatitis:
  • acute infectious prostatitis
  • chronic infectious prostatitis
  • noninfectious prostatitis
Acute infectious prostatitis is caused by bacteria and is treated with antimicrobial medication. Acute infectious prostatitis comes on suddenly, and its symptoms - including chills and fever - are severe. Therefore, a visit to your doctor's office or the emergency room is essential, and hospitalization is frequently required.

Chronic infectious prostatitis is also caused by bacteria and requires antimicrobial medication. Unlike an acute prostate infection, the only symptoms of chronic infectious prostatitis may be recurring infectious cystitis (bladder infection).

Noninfectious prostatitis is not caused by bacteria - its cause is not known. Antimicrobial medications are not effective for this type of prostatitis. Treatments described later in this article may be helpful in some cases.

How Does Prostatitis Develop?
Despite their names, acute and chronic infectious prostatitis are not contagious and are not considered to be sexually transmitted diseases. Your sexual partner cannot catch this infection from you.

How then did you get it? The way in which the prostate becomes infected is not clearly understood. The bacteria that cause prostatitis may get into the prostate from the urethra by backward flow of infected urine into the prostate ducts or from rectal bacteria. However, it does not appear to be related to hygiene.

Certain conditions or medical procedures increase the risk of contracting prostatitis. You are at higher risk for getting prostatitis if you:
  • recently have had a medical instrument, such as a urinary catheter (a soft, lubricated tube used to drain urine from the bladder), inserted during a medical procedure
  • engage in rectal intercourse
  • have an abnormal urinary tract
  • have had a recent bladder infection
  • have an enlarged prostate
What Are the Symptoms Of Prostatitis?
The symptoms of prostatitis depend on the type of disease you have. You may experience no symptoms or symptoms so sudden and severe that they cause you to seek emergency medical care. Symptoms, when present, can include any of the following: fever, chills, urinary frequency, frequent urination at night, difficulty urinating, burning or painful urination, perineal (referring to the perineum, the area between the scrotum and the anus) and low-back pain, joint or muscle pain, tender or swollen prostate, blood in the urine, or painful ejaculation.

When to seek medical advice
See your doctor if you develop any of the signs and symptoms of prostatitis, such as persistent urinary discomfort and pain, blood-tinged urine or semen, or pain while ejaculating - especially if these signs and symptoms come on suddenly. When not treated, prostatitis can lead to more serious problems. It's also important to see your doctor to rule out other conditions that eventually may cause bladder or kidney damage.

If you're being treated for acute bacterial prostatitis, it's a good idea to see your doctor when you've finished your course of antibiotics to make sure the infection has cleared. This is also a good time to discuss what you can do to prevent a recurrence.

In addition, most men have a prostate checkup in conjunction with a regular physical exam. If your doctor doesn't perform a digital rectal exam when you have a routine physical, ask whether you should have one.

Key Facts on Prostatitis And Its Diagnosis
  • Prostatitis is an inflammation of the prostate.
  • The symptoms of prostatitis often mimic those of other urinary tract or prostate disorders.
  • The digital rectal examination is the first step in diagnosis of any prostate problem; it should also be performed yearly on every man over 40 to detect early, curable prostate cancer.
  • Another test that may be performed when prostatitis is suspected is prostate stripping - massaging the gland to get a fluid sample for microscopic evaluation.

Are the Symptoms Of Prostatitis Unique?
The symptoms of prostatitis resemble those of other infections or prostate diseases. Thus, even if the symptoms disappear, you should have your prostate checked. For example, benign prostatic hyperplasia (BPH), a non-cancerous enlargement of the prostate that is common in men over age 40, may produce urinary tract symptoms similar to those experienced with prostatitis.

Similarly, urethritis, an inflammation of the urethra (often caused by an infection), may also give rise to many of the symptoms associated with prostatitis.

Still another condition that mimics the symptoms of prostatitis - when prostatitis is not present - is prostatodynia (painful prostate). Patients with prostatodynia have pain in the pelvis or in the perineum. Such pain may result from a prostate problem, but the pain can have a variety of different causes including muscle spasms or other musculoskeletal conditions.

How is Prostatitis Diagnosed?
To help make an accurate diagnosis, several types of examinations are useful.

The prostate is an internal organ, so the physician cannot look at it directly. Because the prostate lies in front of the rectum, however, the doctor can feel it by inserting a gloved, lubricated finger into the rectum.

This simple procedure, called a digital rectal examination, is illustrated below. This examination allows the physician to estimate whether the prostate is enlarged or has lumps or other areas of abnormal texture. While this examination may produce momentary discomfort, it causes neither damage nor significant pain.


Because this examination is essential in detecting early prostate cancer, which usually causes no symptoms, the American Urological Association recommends a yearly prostate examination for every man over age 40 and an immediate examination for any man who develops persistent urinary symptoms.

If your physician suspects that you have prostatitis or another prostate problem, he or she may refer you to a urologist (a doctor who specializes in diseases of the urinary tract and the male reproductive system) to confirm the diagnosis.

The test that may be performed when prostatitis is suspected is prostate stripping (massaging), during which prostatic fluid is collected. While performing the digital rectal examination, your doctor may vigorously massage, or "strip," the prostate to force prostatic fluid out of the gland and into the urethra. Although prostate stripping is not particularly painful, you may feel some discomfort depending on the sensitivity of your prostate.



Why Is Correct Diagnosis So Important?
Because the treatment is different for the three types of prostatitis, the correct diagnosis is very important. Noninfectious prostatitis will not clear up with antimicrobial treatment, and infectious prostatitis will not go away without such treatment.

In addition, it is important to make sure that your symptoms are not caused by urethritis or some other condition that may lead to permanent bladder or kidney damage.

Treatment
How Is Prostatitis Treated?
Your treatment depends on the type of prostatitis you have.

If you have acute infectious prostatitis, you will usually need to take antimicrobial medication for 7 to 14 days. Almost all acute infections can be cured with this treatment. Analgesic drugs to relieve pain or discomfort and, at times, hospitalization may also be required.

If you have chronic infectious prostatitis, you will require antimicrobial medication for a longer period of time - usually 4 to 12 weeks. About 60 percent of all cases of chronic infectious prostatitis clear up with this treatment. For cases that don't respond to this treatment, long-term, low-dose antimicrobial therapy may be recommended to relieve the symptoms. In some cases, surgical removal of the infected portions of the prostate may be advised.

If you have noninfectious prostatitis, you do not need antimicrobial medication. Depending on your symptoms, you may receive one of a variety of treatments. If your condition responds to muscle relaxation, you may be given an alpha blocker, a drug that can relax the muscle tissue in the prostate and reduce the difficulty in urination.

You may find that tub baths or changes in your diet (for example, reduced caffeine intake) may help to alleviate your symptoms. Saw Palmetto (an herbal supplement) may also be used daily. While there is no scientific evidence proving that these "home remedies" are effective, they are not harmful and some people experience relief from symptoms while using them.

Treatment of Prostatitis
  • Correct diagnosis is crucial because each type of prostatitis is treated differently.
  • Infectious prostatitis is caused by bacteria and treated with antimicrobial medications.
  • Antimicrobial medications are not effective treatments for noninfectious prostatitis.
  • Prostatitis is not contagious; if you have it, you will not endanger your sexual partner.
  • The treatment regimen your doctor recommends should be followed even if you have no symptoms. With infectious prostatitis, for example, the symptoms may disappear before the infection has completely cleared.

Will Prostatitis Affect Me or My Lifestyle?
Prostatitis is a treatable disease. Even if the problem cannot be cured, you can usually get relief from your symptoms by following the recommended treatment.

Prostatitis is not a contagious disease. You can live your life normally and continue sexual relations without passing it on.

You should keep in mind the following ideas:
  • Correct diagnosis is key to management of prostatitis.
  • Treatment should be followed even if you have no symptoms.
Having prostatitis does not increase your risk of getting any other prostate disease. But remember, even if your prostatitis is cured, there are other prostate conditions, such as prostate cancer, that require prostate checkups at least once a year after age 40.

Prevention
Because traditional treatments aren't always effective for prostatitis, many men experiment with various lifestyle changes to control their symptoms. Although no scientific evidence proves these practices are beneficial, you may want to try one or more of the following suggestions:
  • Drink plenty of water.
  • Limit or avoid alcohol, caffeine and spicy foods.
  • Urinate at regular intervals.
  • Have regular sexual activity.
  • If you're a cyclist, use a "split" bicycle seat, which reduces the pressure on your prostate.
Eventually, many men with prostatitis learn to live with the disease by limiting the things that make their symptoms worse and emphasizing the things that make them feel better. Sometimes, finding what improves your condition may be up to you.