Alice,

What is prostatitis and what is the cure?

— Who knows?

Dear Who Knows?,

Simply put, prostatitis is characterized by inflammation or an infection of the prostate gland (a walnut-sized part of the male reproductive anatomy that’s connected to the urethra, just below the bladder). What’s not so simple about this condition is identifying the root cause (more on that in a bit). It’s good that you ask about the cure or treatment for the condition though, because being promptly diagnosed and treated can help folks steer clear of other, more serious conditions that can result, including epididymitis, bacterial infections of the blood, or an abscess in the prostate. Knowing more about the potential causes, risk factors, testing, and treatment options can help those who suspect there’s something up with their prostate get the medical attention — and relief — they seek!

First up: a discussion of potential causes. Figuring out what’s behind this condition can be a bit tricky. Cases are classified by a number of variables: whether they’re caused by a bacterial infection or not, if the condition is acute or chronic, if symptoms are present, and if the condition has induced an inflammatory response. Symptoms can vary depending on the classification and severity of the condition. Here’s a more detailed outline of the categories and related symptoms:

  • Acute bacterial prostatitis: This is a result of a bacterial infection (common pathogens include chlamydia, gonorrhea, Klebsiella, Proteus, and E.coli) that develops rapidly and is associated with more severe symptoms such as difficulty urinating, pelvic pain, fever, chills, and blood in the urine.
  • Chronic bacterial prostatitis: This type of prostatitis is also caused by a bacterial infection, but one that comes on more slowly and tends to recur. It’s also typically associated with less severe symptoms than in the acute bacterial cases. Often times, the infection becomes chronic because bacteria are not completely eradicated by antibiotics.
  • Chronic prostatitis or chronic pelvic pain syndrome: This is the most common type of prostatitis and often, a clear and specific cause cannot be identified. It’s not caused by a bacterial infection, but is associated with pain during ejaculation and possibly urinary irritation or obstruction. These cases may be further categorized as either inflammatory or non-inflammatory, depending upon the presence of inflammation in the prostate.
  • Asymptomatic inflammatory prostatitis: Lastly, there are some cases that go undetected and are without symptoms experienced. This type of prostatitis is typically discovered when a medical professional is examining the area for other reasons, such as a biopsy.

Who’s at a higher risk for a positive prostatitis diagnosis of any classification? Young and middle-aged males (or folks who have a prostate gland) are at a higher risk. Other factors can also increase the likelihood, such as stress, not being well hydrated, having unprotected sex, and certain other conditions (e.g., HIV/AIDS, bladder or urinary tract infections, trauma to the pelvic area, and previous bouts of prostatitis). What’s more, some folks are just genetically more susceptible to prostatitis.   

For those who suspect prostatitis may be causing their discomfort, the diagnostic process will likely entail a physical exam (including a rectal exam), medical history, and working with a health care provider to exclude other potential causes for their symptoms. Testing blood and urine samples may be in order to determine if there’s a bacterial infection present. Another test may be administered to see how well the bladder can empty and if the condition is making it more difficult to urinate.

Any necessary treatment depends, once again, on the identified cause. Acute bacterial infections are typically treated with antibiotics for about four weeks. Symptoms may also be addressed through the use of stool softeners, bed rest, getting enough fluids, and pain relief medication. A longer course of antibiotics may be necessary for chronic bacterial cases and overall treatment for them is based off of bacterial culture results. The use of muscle relaxers, medication to relax the bladder muscles that join up with the prostate (called alpha-blockers) to address painful urination, non-steroidal anti-inflammatory drugs (NSAIDs), and soaking in a warm bath may provide relief for chronic bacterial prostatitis as well. For chronic cases not associated with a bacterial infection, treatment can be challenging. In addition to the treatments suggested for bacterial prostatitis, some evidence suggests that prostate massage administered by a provider, acupuncture, and biofeedback (using thoughts to control the body’s response to stimuli) may be options to explore. In any case, communicating symptoms and sticking with a treatment plan are key to successful treatment, or with chronic cases, management of the condition (with the exception of the asymptomatic, non-bacterial variety — no treatment is necessary for those cases).

Hopefully, you’re now in possession of the prostatitis information you seek and can change the “who knows” regarding this condition to you know!

Alice!

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