What it is prostatitis?
It is a general term used to describe an "inflammation" or infection of the prostate. Prostatitis can appear suddenly (acute prostatitis) or remain dormant for months or even years without causing symptoms (chronic prostatitis).
Causes
It may be related to a bacterial infection. This type of prostatitis is most often caused by bacteria found in the urinary tract or large intestine, such as Escherichia coli, which are the most frequent agents of bacterial prostatitis.
Other times, the cause is unknown. Many theories exist to explain the possible cause of this inflammation, but none are certain and many are not well understood. Among them are:
- sexual activity: young men who are sexually active and have urethral inflammation (urethritis) or a sexually transmitted disease (STD), such as gonorrhea or chlamydia, are more likely to develop non-bacterial prostatitis
- other infectious agents: the inflammation may be related to an infectious agent that current tests cannot yet detect
- anxiety and stress: this condition may cause spasms of the urinary sphincter muscle and irritate the prostate gland or cause fluids from the urethra to flow back into the prostate, irritating internal tissues
In general, the risk of prostatitis increases in people who:
- have recently had a medical instrument inserted into the urethra
- engage in anal sex
- have some abnormality in the urinary tract
- have had or currently have frequent bladder infections
- have developed benign prostatic hyperplasia (BPH)
Incidence
At some point in their lives, 50% of men will experience an episode of prostatitis. It rarely occurs in young men, is more common in adult men, and its incidence increases with age. It accounts for about 25% of men’s annual medical visits.
Symptoms
If prostatitis appears suddenly as a result of a bacterial infection (acute prostatitis), the symptoms are usually severe. The patient may require emergency care. Due to the inflammatory process, the prostate swells and compresses the urethral canal. Symptoms may include: chills, fever, intense burning during urination, and even inability to empty the bladder. There may also be a burning sensation or the presence of pus-like material in the urine.
When prostatitis is chronic, the symptoms are similar but do not include fever. In addition to a burning sensation during urination, the patient may feel: pain in the area below the scrotal sac (perineal), pain in the testicles, penis, or bladder area, and painful ejaculation. Chronic prostatitis symptoms may come and go, which makes diagnosis more difficult.
Diagnosis
When examining the prostate gland, the urologist will perform a digital rectal exam. If the patient has prostatitis, this exam may cause temporary pain or discomfort. If prostatitis is suspected, the doctor may request a urine test. In some cases, prostate secretion is collected during the rectal exam. The doctor gently presses the prostate, causing prostatic fluid to be released through the penile urethra, which is then collected. Both the urine and prostatic secretion are analyzed to detect infection. This can help the urologist determine the appropriate treatment.
Treatment
It will depend on the diagnosis. Acute bacterial prostatitis will be treated with antibiotics. The duration of medication is at least two weeks, with the possibility of extending to 4 or 12 weeks. It is very important for the patient to continue taking the antibiotics prescribed by the doctor, even if the symptoms have disappeared.
Bacteria in the prostate can be difficult to eliminate and kill. Even if only a few remain alive, they can multiply and symptoms may return.
Other types of medication may also be used to relieve pain and uncomfortable symptoms. Medications called alpha-blockers relax the muscles of the bladder and prostate, which can help the patient urinate more easily. Anti-inflammatory drugs may also be prescribed to reduce inflammation. Some additional measures that may help include:
- taking warm baths
- avoiding spicy foods
- avoiding acidic and caffeinated beverages (such as coffee and carbonated drinks)
- avoiding biking, horseback riding, and other activities that may put pressure on the prostate
Prognosis
Acute prostatitis treated with the appropriate antibiotics for the correct duration, especially when started early in the course of symptoms, generally leads to full recovery without lasting effects. Chronic prostatitis is more difficult to treat and requires more frequent monitoring. In cases where infectious factors persist, new courses of antibiotics may be necessary. Despite all efforts, many patients experience changes in fertility—a feared complication of the disease.
Prevention
Simple hygiene habits can be essential in preventing prostatitis. Every man over the age of 40 or 50 should regularly visit a urologist to evaluate the prostate and check for any potential cancerous focus and/or its growth, known as benign prostatic hyperplasia (BPH). This is the main cause of prostate enlargement, which can lead to narrowing of the urethral canal and, as a result, residual urine after urination. Urine retained in the bladder is an excellent culture medium for infection.