Prostate Infection (Prostatitis)
Pelvic Pain Or Inflammation? Start Here.
Prostatitis is a condition of the prostate/pelvis associated with either inflammation, infection, or pain in the prostate/pelvic area.
What is Prostatitis?
The prostate is a small gland in the male reproductive system located below the bladder and surrounding the urethra. Prostatitis is the inflammation or infection of the prostate and is diagnosed as one of three types: acute bacterial prostatitis, chronic bacterial prostatitis, or chronic non-bacterial prostatitis.
What are the symptoms of Prostatitis?
You may experience the following symptoms
- Pelvic pain
- Burning with urination
- Urinary frequency/urgency
- Weak urinary stream
- Blood in the urine
- Pain in the lower back, the lower abdomen or in the area between the scrotum and the anus
- Tender or swollen prostate
- Painful ejaculation
What causes Prostatitis?
Prostatitis may be associated with a prostate infection, urinary tract infection, inflammation, pelvic muscle dysfunction, enlarged prostate, or a chronic pelvic pain syndrome.
The cause of chronic non-bacterial prostatitis/chronic pelvic pain syndrome is unknown but is thought to be a variant of Interstitial cystitis (a chronic inflammatory disease of the bladder).
How is Prostatitis diagnosed?
What to know before your visit to MidLantic Urology in Philadelphia and surrounding counties:
During your visit, your doctor will ask you questions regarding your medical history, surgical history, medications, and will perform an exam with focused attention to the groin and genitalia. A digital rectal exam may often be performed.
Tests that may be performed during or after your visit:
- Digital rectal exam: The physician inserts a finger into your rectum to check for the size of your prostate and to evaluate for any abnormalities.
- Urine studies: Evaluates for any blood in the urine or infection.
- Post-void residual: The physician will often ask you to void and then check to make sure you are emptying your bladder.
- Urine flow: The physician may have you urinate in a funnel to assess the speed of your urinary stream.
- Prostatic fluid analysis: The prostate gland is massaged to produce a fluid sample for microscopic evaluation.
- Cystoscopy: This is a procedure performed in the office where the physician inserts a small scope into the penis to assess the urethra for any scar tissue and evaluate the prostate for any evidence of obstruction.
- Imaging: An ultrasound of the prostate, kidneys/bladder, or a CT scan of the abdomen and pelvis may be performed in follow-up.
How is Prostatitis treated?
- Prostatitis associated with infection:
- Anti-inflammatories: Ibuprofen is typically utilized to reduce inflammation. For mild cases, this may be the only treatment.
- Antibiotics: If there is concern for acute or chronic infection then a course of antibiotics may be utilized. It is possible that a longer course of antibiotics may be necessary (i.e. 4-12 weeks).
- In patients with fevers or worsening symptoms on antibiotics, hospitalization and IV antibiotics may be necessary.
- Prostatitis associated with chronic pain:
- Behavioral changes: Dietary changes may be useful (i.e., avoiding or decreasing spicy foods, caffeine, diet sodas, artificial sweeteners, acidic foods that contain vitamin D, alcohol and tea). Avoiding constipation is also helpful.
- Lifestyle changes: Non-bacterial prostatitis may be helped with heat (soaking in a warm bath), regular exercise, and stress reduction.
- Pelvic floor physical therapy: Techniques utilized to relax/stretch the pelvic muscles (similar to physical therapy in other parts of the body. This may improve symptoms because chronic pelvic pain may be due to excessive contraction of the pelvis muscles and not a prostatic specific problem.
- Alpha blockers: Relaxes the prostatic urethra and bladder neck, making urination less difficult.
- Quercetin: An anti-inflammatory medication
- Tadalafil (Cialis)
- A pain specialist may be necessary for significant or atypical pain OR if there is no improvement with 1st line therapy
- Transurethral resection of prostate (TURP): This involves a scope in the urethra (tip of penis) with resection and removal of prostatic tissue. This is often necessary in those with recurrent prostatitis or severe infections associated with a prostatic abscess.