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Definition
Prostatitis is an inflammation of the prostate gland.
Causes
-
Bacteria such as escherichia
coli, pseudomonas, proteus,
Chlamydia,
Gonorrhea, and
many others can cause inflammation of the
prostate.
Bacteria may cause both acute
and the chronic forms.
-
A narrowing or stricture of the
urethra can cause the urine to back up (reflux)
and cause
Prostatitis.
Prostate Cancer
or enlargement can block the neck of the bladder,
causing urine to leak around and result in
Prostatitis.
Damage to the nerves that
supply the prostate (i.e.,
Herniated Disc)
and tension in muscles around the prostate can
cause Prostatitis.
Immune system -- body's natural
defense system may play role in the inflammation
of prostate.
Risk Factors
Urinary Tract
Infections
Acute
Prostatitis is a
risk factor for chronic form.
Prostate stones
Epididymitis --
inflammation of the ducts that drain the testicles.
Urethritis -- inflammation of
urethra
Manipulation or inserting devices
in the urethra ( Cystoscopy
and catheter)
Infections in other body parts
(e.g., rectum)
High
Uric acid
levels
Symptoms
-
Frequent urination
-
A feeling of having to push the
urine out
-
Decreased urinary stream
(amount of urine)
-
Inability to completely empty
the bladder
-
Fever
-
Chills
-
Pain or burning during
urination (dysuria)
-
Frequent urination at night (nocturia)
-
Painful ejaculation
-
Lower back pain
-
Pain in the lower abdomen
-
Pain with bowel movement
-
Blood in the
Urine or semen
-
Pain in the testicles
-
Symptoms may be mild or absent.
-
Symptoms similar to acute form.
-
In non-bacterial form, fever
and chills may be absent.
Screening and
Diagnostics
-
Symptoms -- how long, how
severe.
-
Illnesses -- injuries, etc.
-
Surgeries -- recent
Cystoscopy
Habits -- sexual habits
Family
Medications
Allergies
-
May or may not have fever
-
May reveal a warm, swollen,
tender mass when the doctor inserts his index
finger into the rectum in order to reach and
examine the prostrate (rectal exam).
-
The groin area may have tender
lumps known as inguinal lymph nodes.
Urine cultures
(clean catch sample) is collected and sent to the
laboratory where in 24-48 hours the offending
bacteria (and its sensitivity to antibiotic agents)
is identified.
Blood samples may also be done
for cultures.
Prostate massage is helpful in
bringing out the discharge containing the bacteria
(this is not done until antibiotics have been
started).
In chronic bacterial and
non-bacterial causes, the U/A may show white blood
cells and cells containing fatty droplets (oval fat
bodies), but bacteria may be absent. In both
conditions, urine, urine in the bladder, and
prostate secretions must be sent for bacterial
cultures.
In non-bacterial form, the
cultures are negative and no bacteria found.
Treatment
-
Bed rest
-
Fluids
-
Cranberry juice may help
-
Painkillers -- Tylenol or Advil
-
Stool softeners
-
Sitz baths will help with pain
and spasms.
-
Antibiotics such as Septra help
with acute form.
-
Ciprofloxacin daily for periods
(over 3 months) are often given for the chronic
form.
-
In Non-bacterial forms --
antibiotics are also tried
-
If antibiotics do not heal,
surgical resection of the prostate or thermotherapy
(heat) using microwaves may be an option for
non-acute forms of
Prostatitis.
Avoid spicy foods, alcohol, and
caffeine.
Prognosis
The majority of men who are accurately diagnosed with
acute prostatitis become symptom-free after treatment.
Patients who have had acute prostatitis are prone to
recurrence and are likely to develop chronic
prostatitis.
Complications
Chronic prostatitis can develop. Urinary retention may
occur as a result of the swollen prostate occluding
the urethra.
Prevention
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. |
