Document 19802

Prostatitis
Prostatitis is an inflammation or infection of the prostate gland. It can affect men of any age. The most common
urological problem in men aged 50 and older, prostatitis is not contagious and is not transmitted during sex.
The prostate is a walnut-sized organ found only in men. Its main function is to produce semen, the fluid that
carries sperm during ejaculation. Part of the male urinary system, it lies next to the bladder. Prostatitis often causes
urinary symptoms because the prostate surrounds the urethra, the tube carrying urine out of the body.
Types
The four types of prostatitis are:
n C
hronic Pelvic Pain Syndrome (CPPS)–
affects about 90% of men with prostatitis
(Chronic Non-Bacterial Prostatitis)
n A
symptomatic inflammatory prostatitis –
patients don’t have symptoms but their
doctors find infection-fighting cells in the
semen when checking for other problems
such as prostate cancer or enlargement
n A
cute bacterial prostatitis – the least
common but easiest to treat
n C
hronic bacterial prostatitis – also not
common
Doctors are not entirely certain what causes
CPPS and in most cases no cause is found.
Possible contributing factors include:
n Infections not found during standard tests
n S
exually transmitted diseases (STDs)
n P
ersistent bladder infections
n P
elvic muscle spasm
n P
hysical activity such as biking or heavy
lifting when your bladder is full
Pubic bone
Bladder
Symptoms
Symptoms vary depending on the type of
prostatitis. Acute bacterial prostatitis comes
on suddenly and is often accompanied
by fever, severe burning during urination,
inability to empty the bladder, low back or
groin pain. You should seek immediate
medical care. If left untreated, acute
bacterial prostatitis may cause problems
with sterility, inability to urinate, and even
bacteremia (bacteria in your blood).
In chronic bacterial prostatitis, you
experience less intense symptoms but for
a longer period of time, and you may have
frequent urinary tract infections.
Men with CPPS may have many of the
same symptoms as bacterial prostatitis, but
without fever. Ejaculation may be painful.
CPPS is distinguished by pelvic pain
that can last months without evidence of
inflammation or bacterial infection. Bladder
and rectal pressure or pain is common.
Causes
Bacterial prostatitis is caused by bacteria
from infected urine that backs up into
the prostate ducts. Men who have had
catheterization, injury to the area or a recent
bladder infection are at greater risk.
Prostate
Urethra
Diagnosis
Diagnosing prostatitis involves ruling out
other problems such as prostate cancer
or an enlarged prostate, then determining
which type of prostatitis you have. Your
doctor will perform a history and physical
exam, including a digital rectal exam (DRE),
where your prostate is checked for size,
tenderness and the possibility of cancer by
inserting a gloved finger into the rectum.
Your doctor also may test your urine and
semen for infection. If you have an infection,
you will get a culture to identify which
bacteria is involved. Cystoscopy (viewing
the urethra, bladder and prostate with a tiny
telescope-like instrument) and urine flow
studies also may be ordered.
CPPS is diagnosed after other probable
causes have been eliminated and when
the prostatitis has lasted for three or more
months. Often, it is a diagnosis of exclusion.
Treatment
Acute and chronic bacterial prostatitis
can be treated effectively with antibiotics.
You must take the entire dose even if your
symptoms improve, to prevent re-infection.
Treatment can last several weeks to several
months.
Treatments that may help relieve
CPPS symptoms:
n A
lpha blockers such as Flomax may
improve urinary symptoms by relaxing
bladder muscles.
n M
uscle relaxants
n P
ain relievers such as ibuprofen or
naproxen
n H
erbal remedies such as Quercetin or bee
pollen
n P
hysical therapy, including pelvic exercises
or biofeedback
n W
arm baths and relaxation techniques
n D
ietary changes - discontinue caffeinated,
spicy and acidic foods and beverages
n Experimental treatments with heat
(microwave) therapy are being evaluated.
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