When a man’s prostate becomes swollen, tender and inflamed, he may have a condition called prostatitis. Prostatitis is not cancer and it is not the same thing as having an enlarged prostate (also known as benign prostatic hyperplasia). Most men are familiar with these two conditions, and they may suspect one or the other when first experiencing certain symptoms. But a lesser known—and less talked about—problem that affects up to one in six men at some point during their life is prostatitis. This inflammation of the prostate gland (anything word ending in “itis” means inflammation) sends more than two million men to their doctors’ offices annually.
Symptoms of prostatitis
When the prostate gland becomes inflamed, a whole host of symptoms can result:
- Burning or painful urination
- Urgent need to urinate
- Trouble voiding
- Difficult or painful ejaculation
- Pain in the area between the scrotum and rectum known as the perineum
- Lower back pain
The symptoms are very similar and can occur at the same time to what many men experience with benign prostatic hyperplasia or BPH, even though the two conditions are not the same. Both BPH and prostate cancer predominately affect older men whereas prostatitis can affect men of all ages.
Types of prostatitis
There are four types of prostatitis. Your doctor will determine which type you are experiencing, and therefore the best course of treatment, based on your set of symptoms. The variants of prostatitis are:
- Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)
- Chronic bacterial prostatitis
- Acute (sudden) bacterial prostatitis
- Asymptomatic inflammatory prostatitis
Causes of prostatitis
It is not completely understood what causes prostatitis, but it is usually caused by common strains of bacteria. One way an infection may start is when bacteria gets into the prostate when infected urine flows backwards from the urethra. Antibiotics are used to treat it, but if the bacteria is not completely eliminated with antibiotics, then the prostatitis may recur or be difficult to treat.
CP/CPPS may be caused by bacteria such as chlamydia, mycoplasma (which can be passed during sex), or ureaplasma. It is possible that prostatitis may occur if a man’s body reacts to an infection or injury that happened in the past.
Other possible causes of prostatitis include:
- Placement of a catheter (a tube to drain fluid from the body) or another instrument recently placed in the urethra
- An abnormality found in the urinary tract
- A recent bladder infection
Diagnosis of prostatitis
It’s best to seek help from a urologist who specializes in treating problems of the urinary system and male reproductive system when experiencing the symptoms of prostatitis. Some of the tests they may conduct to make a definitive diagnosis might include a digital rectal exam, a transrectal ultrasound, obtaining a fluid called expressed prostatic excretion (EPS) to check for signs of inflammation and infection, use of cystoscope to perform a cystoscopy, or a urine flow study to measure the strength of the urine flow and to check for blockages caused by the prostate, urethra, or pelvic muscles.
The best course for clearing the inflammation will depend on the type of prostatitis. Most types of prostatitis require treatment with an antibiotic, which needs to be taken on schedule and finished completely.
Other treatment methods for managing the pain during a bout of prostatitis may include:
- Anti-inflammatory drugs, pain medications, muscle relaxants or plant extracts
- Hot baths, hot water bottles, or a heating pad to ease discomfort
- Sitting on a donut pillow or inflatable cushion
- Avoiding irritating foods such as spicy or acidic foods, and caffeinated, fizzy or alcoholic drinks
- Abstaining from riding a bicycle
- In rare cases, surgery on either the urethra or prostate may be necessary