Prostatitis is a term used to describe inflammatory conditions of the Prostate gland. It is thought that most cases of prostatitis result from bacterial infection, but evidence of infection is not always found. An infected or inflamed prostate can cause painful urination and ejaculation, and if left untreated, serious complications.

Urinary System

There are four types of prostatitis:

Acute bacterial prostatitis Chronic bacterial prostatitis Nonbacterial prostatitis and Prostatodynia.

Acute bacterial prostatitis (ABP): It is inflammation of the Prostate gland caused by bacteria such as Escherichia coli and Klebsiella. Severe complications may develop if not promptly treated. ABP can be fatal if the bacterial infection is untreated and travels to the bloodstream (Sepsis). Chronic bacterial prostatitis (CBP): It is a recurrent infection and inflammation of the prostate and Urinary tract. Symptoms are less severe than those associated with acute bacterial prostatitis. Nonbacterial prostatitis: It is an inflamed prostate without bacterial infection. Prostatodynia: Sometimes called Chronic Pelvic Pain syndrome (CPPS), is the occurrence of prostatitis symptoms, without inflammation or bacterial infection.

Acute prostatitis often begins with chills and Fever, lower abdominal discomfort, perineal pain (pain in the area between the genitals and the anus), and burning with urination. Symptoms of more advanced prostatitis include a diminished urine stream and difficulty urinating. Prostatitis may occur in conjunction with epididymitis or Orchitis, especially if caused by an STD, in which case symptoms of the accompanying condition may also be present. Symptoms of acute prostatitis include the following:

Fever Chills Low Back Pain Abdominal pain (above the pubic Bone) Perineal pain (pelvic floor) Pain and burning with urination (dysuria) Urinary retention (inability to completely empty bladder) Pain with ejaculation Pain with bowel movement

Additional symptoms that may be associated with this condition:

Blood in the urine Increased Urinary frequency or urgency Difficulty urinating Decreased force of Urinary stream Testicle pain Blood in the semen Foul-smelling urine

Chronic Prostatitis has the following clinical features:

History of recurrent Urinary tract infections Low-grade or subtle symptoms may include:

Low Back Pain Perineal or pelvic floor pain Testicular pain Pain and burning with urination Pain with ejaculation Pain with bowel movement

Recurrent low-grade Fever Pain on urination Decreased Urinary stream Urinary hesitancy (delayed start of urination) Frequent urination Blood in the urine Incontinence

Your healthcare provider may perform a physical examination to assess the prostate (warm, soft, swollen, or tender), the groin lymph nodes (enlarged or tender), the Scrotum (swollen or tender), and the Urethra (discharge). Triple-void urine specimens may be collected for urinalysis and urine culture:

Initial stream Mid-stream After prostatic massage by examiner

Urinalysis may reveal increased white Blood cells (WBCs) and bacterial growth. Examination of prostatic secretions may also show increased levels of WBCs and concentrated bacterial growth upon culture. Prostatitis may also alter the results of the following tests:

CBC Urine analysis PSA Semen analysis

Prostatitis is treated with antibiotics. Because recurrence is common, some health care providers recommend even longer therapies 6 to 8 weeks to eliminate the infection. In severe cases, hospitalization and intravenous (IV) antibiotics may be required . Stool softeners may reduce the discomfort associated with bowel movements.

Surgery: Surgery or urethral instrumentation (Urinary catheterization or cystoscopy) are not recommended for patients with acute prostatitis.Transurethral resection of the prostate may be necessary if antibiotic therapy is unsuccessful or recurrence occurs frequently. This surgical treatment is usually not performed on younger men because it carries potential risks of sterility, Impotence, and incontinence. Other Therapy: Frequent and complete urination is recommended to decrease the symptoms of Urinary frequency and urgency.If the swollen prostate restricts the Urethra, it may be difficult to completely empty the bladder, and insertion of a suprapubic catheter (a drain that empties the bladder through the Abdomen) may be necessary.Warm baths may provide some relief of the perineal and lower Back Pain associated with acute prostatitis. Diet: Avoid substances that irritate the bladder, such as alcohol, caffeinated food and beverages, and citrus juices, and hot or spicy foods.Increasing the intake of fluids (64 to 128 ounces per day) encourages frequent urination that will help flush the bacteria from the bladder.

Not all types of prostatitis are preventable. Thorough hand washing after a bowel movement and prior to handling the Penis may prevent the transfer of bacteria from the rectal area to the genitourinary tract. Infections that are associated with STDs can be prevented by practicing safer-sex behaviors.

Most cases of acute prostatitis clear up completely with medication and slight modification of diet and behaviour. Recurrence of symptoms is common in Chronic Prostatitis.

Urinary retention may occur as a result of the swollen prostate occluding the Urethra. Scarring of the prostate and Urethra may result in permanent narrowing of the Urethra.