The prostate is part of the male reproductive system and while it usually goes unnoticed, it can become inflamed causing some discomfort. Urologist Brian Le, MD, UnityPoint Health, explains a condition known as prostatitis.
Types of Prostatitis
Dr. Le says prostatitis is an inflammatory condition of the prostate that may or may not be associated with infection. He says there are four different types.
- Acute bacterial prostatitis
- Chronic bacterial prostatitis
- Chronic non-bacterial prostatitis (chronic pelvic pain syndrome)
- Asymptomatic prostatitis (usually diagnosed from a biopsy)
“Acute bacterial prostatitis is the most worrisome, as patients can get very sick and possibly septic (severe infection that spreads to the blood stream),” Dr. Le says. “They can be unable to urinate, and it may be associated with high fevers.”
In the United States, prostatitis is most common in older men, above age 60.
Dr. Le says the cause of prostatitis is not completely understood. There are certain bacterial causes that lead to infection, but Dr. Le says that only makes up a minority of cases. Some sources also suggest it can be caused by excessive bike riding or pressure, certain foods, viruses, reflux of urine (urine that flows backwards) or immune disorders.
“We don’t think sexual intercourse causes prostatitis, though some patients report having symptoms shortly after a high-risk sexual encounter. It is unclear if that link is real or perceived due to anxiety. Sometimes, sexual activity can relieve symptoms of prostatitis,” Dr. Le says.
It’s hard to determine how many men have had prostatitis because many cases go undiagnosed. However, Dr. Le says it is common enough to be considered if there is a sudden, significant change in urinary symptoms or pain. The condition has a wide range of symptoms from severe to mild.
- More frequent and/or urgent urination
- Difficulty emptying the bladder
- Pain in the groin
- Pain in the perineum, area between the anus and scrotum
- Pain in the penis
- Fevers (severe cases)
- Inability to urinate (severe cases)
- Severe burning (severe cases)
If you notice any of these symptoms, contact your UnityPoint Health provider for a discussion.
Prostatitis Diagnosis and Prostatitis Treatment
There is no specific test to diagnose prostatitis, but a provider can come to the conclusion from a patient’s explanation of symptoms. In order to make the prostatitis diagnosis, Dr. Le says urine samples, cultures and secretions from the prostate may help eliminate other conditions.
While making the diagnosis, a provider may tell a patient he has a boggy prostate. The term is what your provider may use to describe how the prostate feels in comparison to a normal prostate.
“It means the prostate feels soft and spongy, which may be a sign of inflammation. Sometimes, the prostate can be very tender on examination,” Dr. Le says.
Once a diagnosis is reached, treatment depends on the determined cause. Dr. Le says treating chronic prostatitis or frequent cases can be challenging.
“If we suspect there is a good chance of a bacterial or infectious cause, your doctor may put you on an extended course of antibiotics. The longer dose allows for adequate tissue penetration, as shorter doses are unable to get in the prostate at sufficient quantities to get rid of any infection. You may also be told to use anti-inflammatories or pain medications. Also, for urinary symptoms, you may be placed on an alpha-blocker medication to help. For patients with major pain symptoms and no clear infectious cause, pelvic floor physical therapy can sometimes be helpful,” Dr. Le says.
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