Prostatitis - Types, Symptoms, Causes, Diagnosis, Treatment, and Complications

Introduction:

The swelling (inflammation) of the prostate gland, a gland present below the bladder in men, is called prostatitis. This walnut-sized gland’s primary function is to produce semen, which nourishes and transports sperms. When this gland gets swollen, it causes pain during urination, groin pain, pain in the pelvic area and genitals, and flu-like symptoms.

Prostatitis commonly affects men 50 years old or younger but can occur at any age. Various causes can result in the inflammation of the prostate gland, including bacterial infection. The swelling and symptoms can occur suddenly or gradually, which depends on the cause. Some cases of prostatitis improve quickly on their own, and some might need treatment.

What Are the Types of Prostatitis?

The two main types of prostatitis are:

• Acute Prostatitis: This type develops suddenly and is usually temporary. It lasts from a few days to weeks and responds well to initial treatments.

• Chronic Prostatitis: This type develops gradually and lasts for months or years. If the prostatitis symptoms are present for over three months, they come under this type. This type does not respond to initial treatment recommendations.

The other subtypes of prostatitis include:

• Acute Bacterial Prostatitis - It is when a sudden bacterial infection results in the inflammation of the prostate. The symptoms occur suddenly and are severe. This condition must be treated immediately with intravenous antibiotics, pain relievers, and fluids. Otherwise, it can lead to complications like sepsis (bacteria spreads to the bloodstream) and death.

• Chronic Bacterial Prostatitis - This is when the prostate gets inflamed due to repeated bacterial urinary tract infections. The symptoms are less severe but last for a long time. This type of prostatitis is difficult to treat as it is challenging to identify the causative bacteria in the urine, and patients need a prolonged course of antibiotics.

• Chronic Pelvic Pain Syndrome or Chronic Nonbacterial Prostatitis - It is the most common type, as 90 % of cases of prostatitis are this type. It causes pain in the pelvic region, stomach, and genitals, pain and burning sensation during urination, and erectile dysfunction.

• Asymptomatic Prostatitis - In this type, the prostate is inflamed, but the patient might not have any symptoms. This type of prostatitis is accidentally diagnosed during a prostate biopsy or semen analysis.

What Are the Symptoms of Prostatitis?

The common symptoms of acute prostatitis are:

• Fever.

• Chills.

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• Pelvis pain.

• Blood in the urine.

• Genital or rectal pain.

• Frequent urination.

• Increased urge to urinate.

• Pain during ejaculation.

• Foul-smelling urine.

• Blood in the semen.

• Incomplete bladder voiding.

• Difficulty initiating a stream of urine.

The common symptoms of chronic prostatitis are:

• A need to empty the bladder several times at night.

• Pain while urinating.

• Difficulty urinating.

• Pain after sex.

• Frequent urge to urinate.

• Lower back, rectum, and genital pain.

• Pain during ejaculation.

• Problems with ejaculating.

What Are the Causes of Prostatitis?

Acute prostatitis is most commonly caused by a bacterial infection. When urine leaks into the prostate, it results in such infection. If bacteria become resistant to antibiotics or the antibiotic course is not completed, the infection recurs and becomes difficult to treat, resulting in chronic bacterial prostatitis. Nonbacterial prostatitis can result from nerve damage from surgery or trauma to the prostate.

What Are the Risk Factors of Prostatitis?

• Men who are younger than 50 years.

• History of prostatitis.

• Immunocompromised conditions (HIV or AIDS).

• Getting a prostate biopsy.

• Infection of the bladder or urethra (the tube that transports semen and urine).

• Pelvic injury (horseback riding or cycling).

• Urinary catheter.

How Is Prostatitis Diagnosed?

The doctor will diagnose this condition after ruling out other conditions that cause similar symptoms. After getting a complete medical and family history, the doctor will conduct a digital rectal examination. Then they might suggest you get the following tests done:

• Urinalysis - Your urine sample is checked for signs of infection. And they try to find the causative bacteria or organism in the urine responsible for the infection through urine culture.

• Blood Tests - To check for any other infection.

• Post-prostatic Massage - The prostate is massaged, and the secretions are tested.

• Ultrasound - To visualize the prostate and bladder.

• CT (Computed Tomography) Scan - To get a detailed image of your urinary tract system.

How Is Prostatitis Treated?

The treatment options include:

Medications:-

• Antibiotics - As prostatitis mostly occurs due to bacterial infections, antibiotics are most commonly prescribed. Depending on the results of the urine culture, the doctor will choose the right antibiotic. In cases of severe infection, antibiotics need to be administered intravenously. Antibiotics are usually prescribed for four to six weeks for acute prostatitis, but in chronic prostatitis, it might be longer.

• Alpha-Blockers - These drugs are used to relax the bladder neck and muscles where the prostate joins the bladder. This helps in relieving symptoms such as painful urination.

• Anti-inflammatory Drugs - Nonsteroidal anti-inflammatory drugs (NSAIDs) are prescribed for reducing pain and inflammation.

Home Remedies:-

• Sitz Bath - Sit in a warm water bath or use a heating pad.

• Avoid or limit alcohol consumption.

• Avoid prolonged sitting or cycling.

• Drink a lot of water.

• Avoid eating spicy and acidic foods.

• Do not drink caffeinated beverages like coffee.

What Are the Complications of Prostatitis?

The possible complications of prostatitis are:

• Epididymitis - Inflammation of a coiled tube in the testis.

• Prostatic Abscess - Pus-filled abscess can form in the prostate.

• Infertility.

• Semen abnormalities.

• Sepsis - Bacteria spreading to the bloodstream.

How Is the Prognosis of Prostatitis?

The severity and symptoms of chronic prostatitis vary in different men. To reduce pain and discomfort, take your medicines exactly as your doctor prescribes. With proper medication and care, most men with chronic prostatitis lead a normal life. It does not affect your sexual life, as it is not contagious. And there is no evidence to suggest that prostatitis increases the risk of prostate cancer or kidney disease. Nevertheless, go for regular prostate examinations even after your symptoms get better.

Conclusion:

Although various home remedies help ease prostatitis, researchers have found nothing about diet’s role in preventing prostatitis. But, excess water intake and reduced intake of bladder-irritant substances have shown results. However, consult a doctor immediately when you have symptoms such as blood in the urine, urinary incontinence, pain in the lower abdomen, fever, and chills. It is always crucial to get tested and treated when such symptoms appear to prevent serious complications.