Prostatitis: Types, Causes, Symptoms, Diagnosis, Treatment, Diet

What Is Prostatitis?

Prostatitis is a pathological condition of the genitourinary system in which the prostate and at times the areas surrounding it get inflamed. Prostatitis can be classified into many types with their own set of symptoms, namely bacterial prostatitis, nonbacterial prostatitis, and chronic prostatitis. Some individuals with this disease have excruciating pain in the pelvic region whereas in some cases the affected individual may not feel any symptoms of pain, although Prostatitis tends to affect the life of the affected individual quite significantly.


What Are The Different Types Of Prostatitis?

The different types of Prostatitis are as follows:

  • Acute Bacterial Prostatitis: This type of Prostatitis is quite rare, but tends to get diagnosed easily. This type of Prostatitis tends to be caused due to some sort of a bacterial infection affecting the prostate gland. The infection can be diagnosed easily by its inherent symptoms of urinary tract infection, in accompaniment with high-grade fever and chills sometimes requiring an emergency room visit. This type of Prostatitis can be found in people of all age groups. The individual affected with Acute Bacterial Prostatitis will experience pain with urination, incomplete emptying, low back pain, pain in the abdomen or the pelvic regions, high-grade fever accompanied by chills.
  • Chronic Bacterial Prostatitis: This type of Prostatitis is quite similar to Acute Bacterial Prostatitis but the symptoms caused by this type of Prostatitis tend to develop over time and is not severe. This type of Prostatitis is quite common in young individuals.
  • Nonbacterial Prostatitis: This is by far the most common type of Prostatitis. How this condition is caused is still a matter of study, although studies suggest that this could be caused due to frequent infections or muscle spasms in the pelvic regions. At times, Prostatitis remains asymptomatic. Some of the symptoms experienced by the affected individual are severe pain in the genitals, pain with urination, and at times pain after sexual intercourse.
  • Asymptomatic Prostatitis: This is a type of Prostatitis which does not cause any symptoms. This condition is usually diagnosed when the individual is being screened for some other medical condition and is an incidental finding.

What Are The Causes Of Prostatitis?

The exact cause of Prostatitis is still not known, although researchers have comes up with several suggestions as to the cause of this disease. Some cases of Prostatitis are clearly associated with bacterial infections. This infection reaches the prostate due to backflow of the infected urine into the prostate. It should be made clear that Bacterial Prostatitis is not a sexually transmitted disease and cannot be passed from an individual to individual.

Some other factors that can lead to development of Bacterial Prostatitis are catheter insertion to the urethra leading to bacterial infections, a urinary tract abnormality or infection, or an infection of the bladder.

Chronic forms of Prostatitis or Nonbacterial Prostatitis are usually caused due to organisms like chlamydia or mycoplasma, which can be transmitted due to unprotected sexual activity. It can also be caused due to some previous injury or infection to the prostate gland.

What Are The Symptoms Of Prostatitis?

The symptoms of Prostatitis are dependent on the type of Prostatitis that an individual has. In some cases an affected individual may experience some symptoms whereas in some cases the disease can be completely asymptomatic. In cases of Acute Bacterial Prostatitis, the symptoms develop quite suddenly and consist of pain in the genitals, painful urination, burning with urination, and incomplete bladder emptying.

In cases of Chronic Bacterial Prostatitis, the symptoms develop gradually and over time although the symptoms are quite similar to those of Acute Bacterial Prostatitis to include pain in the genitals, burning with urination, increased urinary frequency, testicular pain, and pain with sexual intercourse. This condition tends to come and go with its periods of recurrence and flare-ups

Chronic Prostatitis has symptoms of pain with urination, perineal pain, pain in the testes, and problems and pain with sexual activity.

How Is Prostatitis Diagnosed?

In cases of Prostatitis, an accurate diagnosis is of utmost importance, as treatment for different forms of Prostatitis is different. Additionally, the treating physician needs to make sure that the symptoms the individual is experiencing are not caused by some other disease condition like cystitis or an enlarged prostate. To help make an accurate diagnosis, several types of examinations are useful.

The first method that the treating physician uses to accurately diagnose Prostatitis is a questionnaire that needs to be filled out by the individual. This questionnaire is called as National Institute of Health Prostatitis Symptom Index. This questionnaire consists of a list of questions for the individual inquiring about the symptoms experienced by the individual, the frequency of the symptoms, and the impact it has had on the life of the individual. Filling out the questionnaire is important as it will give the physician an idea about what exactly the individual is suffering from and the best way to treat the condition.

Next, the treating physician will perform what is called as Digital Rectal Examination in order to assess the prostate gland to look for any signs of any enlargement of the prostate or any lumps present. It will also give the physician a know how as to how much discomfort the individual is suffering from by deeply palpating the prostate gland and come up with a diagnosis.

If further investigation is required, then the physician will perform what is called as transrectal ultrasound to closely visualize the prostate gland looking for signs of inflammation. If there is a cancer risk suspected then a PSA level may also be obtained.

Once the treating physician suspects Prostatitis, then the individual will be referred to a urologist for confirmatory diagnosis of Prostatitis. The urologist may perform repeat examinations of the prostate and additionally will collect a little bit of prostatic fluid for analysis. This goes a long way in helping the physician pinpoint an exact diagnosis for the symptoms experienced.

Additionally, the urologist may also perform a cystoscopy examining in detail the bladder, urethra, and the prostate and confirm the diagnosis of Prostatitis.

What Are Treatments For Prostatitis?

What Are The Treatments For Prostatitis?

Again, Prostatitis treatments are dependent on the type of Prostatitis the individual is suffering from.

Treatment For Acute Bacterial Prostatitis: For this form of Prostatitis, the affected individual will have to be on a minimum of a 14 day course of oral antibiotics to eliminate the bacteria causing the inflammation. In severe cases, antibiotics may also have to be administered in a hospital setting intravenously. At times, a Foley catheter is inserted for problems with urination. Majority of cases of Acute Bacterial Prostatitis are treated with the above mentioned treatments. The choice of antibiotics depends upon the response of the individual. If the patient is not responsive to certain classes of antibiotics then the physician will change the antibiotics for better response. It should be noted here that the individual should be diligent with the prescribed course of medications and should not discontinue taking medications if the symptoms fade off since the condition may recur if the bacteria is not eliminated entirely from the system.

Treatment For Chronic Bacterial Prostatitis: For treatment of this form of Prostatitis, the duration of the course of antibiotics is more than that of Acute Bacterial Prostatitis. The course of antibiotics is for a period of about 10-12 weeks. Majority of cases of this form of Prostatitis are treated with diligent use of antibiotics and following the entire treatment course. In case if the above treatment is not beneficial, then long term antibiotic therapy may be required. In rare cases, urethral or prostate surgery is recommended for treatment but the main indication for the procedure is the presence of a specific anatomic abnormality like scar tissues in order for the surgery to be effective in treating Prostatitis.

Treatment For Chronic Nonbacterial Prostatitis: In this form of Prostatitis, antibiotics are not required. It is tough to differentiate between a bacterial and a nonbacterial Prostatitis due to difficulty in obtaining adequate specimen of the prostatic fluid. Since it is difficult to confirmatively diagnose nonbacterial Prostatitis, it is also treated initially with antibiotics but once a confirmed diagnosis of nonbacterial prostatitis is made the treatment regimen is changed. The preferred treatment for this form of Prostatitis is utilization of alpha-blockers to relax the muscles around the prostate and to help with any spasms that may be present causing pain with urination. Usually, antiinflammatory medications, pain medications, muscle relaxants, herbal extracts like bee pollen is used. Prostatic massages done on a relatively frequent basis also help in relieving the pressure on the prostate.

Another way of relieving discomfort on the prostate is by using hot sitz baths and other heat therapies like heating pads to help with the discomfort. If the affected individual finds it difficult to sit comfortably then it is advised that he uses a cushion or a pillow for comfort. Biofeedback is yet another way to help with the symptoms of Prostatitis.

Diet For Prostatitis

It is advisable for individuals with any form of Prostatitis to eat foods rich in fiber like fruits, vegetables, breads, and cereals. Adequate amount of water should be consumed to prevent constipation. It is strictly recommended that the individual abstain from alcohol, avoid caffeine as much as possible, avoid spicy foods, or foods that has pepper or chilly in them. It is also recommended to avoid eating pickles since they may worsen the symptoms of Prostatitis.

Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:January 18, 2019

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