What are the symptoms of prostatitis? What causes prostatitis? How is prostatitis diagnosed and treated? Get the answers to these questions and more in this comprehensive guide.

Understanding Prostatitis

Prostatitis is an inflammation of the prostate gland, a walnut-sized gland located just below the bladder in men. This condition can cause a range of unpleasant symptoms, including pain, difficulty urinating, and sexual dysfunction. Prostatitis can be caused by bacterial infections, chronic pelvic pain syndrome, or other underlying conditions.

Symptoms of Prostatitis

The symptoms of prostatitis can vary depending on the type of prostatitis, but common signs and symptoms include:

• Pelvic pain or pressure
• Difficulty or pain with urination
• Frequent or urgent need to urinate
• Pain during or after ejaculation
• Fever, chills, and flu-like symptoms (in cases of acute bacterial prostatitis)

Causes of Prostatitis

Prostatitis can be caused by several factors, including:

1. Bacterial infections: Acute and chronic bacterial prostatitis are caused by bacterial infections, often from common strains of bacteria.
2. Chronic pelvic pain syndrome: This type of prostatitis is not caused by a bacterial infection and the exact cause is often unknown.
3. Other underlying conditions: Prostatitis can also be associated with other conditions, such as urethral strictures, pelvic floor muscle dysfunction, or even trauma to the prostate.

Diagnosing Prostatitis

Diagnosing prostatitis involves a comprehensive evaluation by a healthcare provider. This may include:

• Medical history and physical examination, including a digital rectal exam
• Urine tests to check for signs of infection
• Blood tests to look for signs of inflammation or infection
• Imaging tests, such as a CT scan or ultrasound, to evaluate the prostate gland

Treating Prostatitis

The treatment for prostatitis will depend on the underlying cause. Common treatment approaches include:

1. Antibiotics: These are the primary treatment for bacterial forms of prostatitis.
2. Alpha-blockers: These medications can help relax the bladder neck and prostate muscles, improving urinary symptoms.
3. Anti-inflammatory medications: Over-the-counter or prescription anti-inflammatory drugs can help reduce pain and inflammation.
4. Lifestyle modifications: Relaxation techniques, warm baths, and avoiding irritants like caffeine and alcohol can also help manage prostatitis symptoms.
5. Alternative therapies: Some men may find relief from prostatitis symptoms through therapies like biofeedback or acupuncture, though the evidence for their effectiveness is limited.

Preparing for Your Appointment

When seeing a healthcare provider for prostatitis, be sure to bring the following information:

• A detailed description of your symptoms, including when they started and how they have progressed
• A list of any medications or supplements you are currently taking
• Any relevant medical history, including previous infections or conditions related to the urinary tract or prostate

Your provider will use this information, along with the results of any diagnostic tests, to determine the best course of treatment for your prostatitis.

Preventing Prostatitis

While prostatitis can’t always be prevented, there are some steps you can take to reduce your risk:

• Maintain good hygiene, including proper cleaning of the genital area
• Avoid activities that can irritate the prostate, such as prolonged sitting or bicycling
• Manage any underlying conditions, such as diabetes or urinary tract infections, that may increase your risk of prostatitis
• Discuss any concerns about prostatitis with your healthcare provider, who can provide personalized guidance on prevention and management.

Remember, if you’re experiencing symptoms of prostatitis, it’s important to seek medical attention. With the right diagnosis and treatment, most men with prostatitis can find relief from their symptoms and prevent complications.

Prostatitis – Diagnosis and treatment

Diagnosis

Diagnosing prostatitis involves ruling out other conditions as the cause of your symptoms and determining what kind of prostatitis you have. Your doctor will ask about your medical history and your symptoms. He or she will also do a physical exam, which will likely include a digital rectal examination.

Initial diagnostic tests might include:

• Urine tests. Your doctor might have a sample of your urine analyzed to look for signs of infection in your urine (urinalysis). Your doctor might also send a sample of your urine to a lab to determine if you have an infection.
• Blood tests. Your doctor might examine samples of your blood for signs of infection and other prostate problems.
• Post-prostatic massage. In rare cases, your doctor might massage your prostate and test the secretions.
• Imaging tests. In some cases, your doctor might order a CT scan of your urinary tract and prostate or a sonogram of your prostate. CT scan images provide more detailed information than plain X-rays do. A sonogram is the visual image produced by an ultrasound.

Based on your symptoms and test results, your doctor might conclude that you have one of the following types of prostatitis:

• Acute bacterial prostatitis. Often caused by common strains of bacteria, this type of prostatitis generally starts suddenly and causes flu-like signs and symptoms, such as fever, chills, nausea and vomiting.
• Chronic bacterial prostatitis. When antibiotics don’t eliminate the bacteria causing prostatitis, you can develop recurring or difficult-to-treat infections. Between bouts of chronic bacterial prostatitis, you might have no symptoms or only minor ones.
• Chronic prostatitis/chronic pelvic pain syndrome. This type of prostatitis — the most common — isn’t caused by bacteria. Often an exact cause can’t be identified. For some men, symptoms stay about the same over time. For others, the symptoms go through cycles of being more and less severe.
• Asymptomatic inflammatory prostatitis. This type of prostatitis doesn’t cause symptoms and is usually found only by chance when you’re undergoing tests for other conditions. It doesn’t require treatment.

Treatment

Prostatitis treatments depend on the underlying cause. They can include:

• Antibiotics. Taking antibiotics is the most commonly prescribed treatment for prostatitis. Your doctor will choose your medication based on the type of bacteria that might be causing your infection.

  If you have severe symptoms, you might need intravenous (IV) antibiotics. You’ll likely need to take oral antibiotics for four to six weeks but might need longer treatment for chronic or recurring prostatitis.

• Alpha blockers. These medications help relax the bladder neck and the muscle fibers where your prostate joins your bladder. This treatment might ease symptoms, such as painful urination.
• Anti-inflammatory agents. Nonsteroidal anti-inflammatory drugs (NSAIDs) might make you more comfortable.

Lifestyle and home remedies

The following might ease some symptoms of prostatitis:

• Soak in a warm bath (sitz bath) or use a heating pad.
• Limit or avoid alcohol, caffeine, and spicy or acidic foods, which can irritate your bladder.
• Avoid activities that can irritate your prostate, such as prolonged sitting or bicycling.
• Drink plenty of caffeine-free beverages. This will cause you to urinate more and help flush bacteria from your bladder.

Alternative medicine

Alternative therapies that show some promise for reducing symptoms of prostatitis include:

• Biofeedback. A biofeedback specialist uses signals from monitoring equipment to teach you to control certain body functions and responses, including relaxing your muscles.
• Acupuncture. This involves inserting very thin needles through your skin to various depths at certain points on your body.
• Herbal remedies and supplements. There’s no evidence that herbs and supplements improve prostatitis, although many men take them. Some herbal treatments for prostatitis include rye grass (cernilton), a chemical found in green tea, onions and other plants (quercetin) and extract of the saw palmetto plant.

Discuss your use of alternative medicine practices and supplements with your doctor.

Preparing for your appointment

You might start by seeing your primary care provider. Or you might be referred immediately to a specialist in urinary tract and sexual disorders (urologist).

Here’s some information to help you get ready for your appointment.

What you can do

Make a list of:

• Your symptoms, including any that might seem unrelated to the reason for your appointment, and when they began
• Key personal information, including major stresses or recent illnesses
• All medications, vitamins or other supplements you take, including doses
• Questions to ask your doctor

Take a family member or friend along, if possible, to help you remember the information you’re given.

For prostatitis, questions to ask your doctor include:

• What is likely causing my symptoms?
• What other conditions could be causing my pain?
• What kinds of tests will I need?
• What treatment do you recommend?
• Are there other treatment options?
• Are there brochures or other printed materials I can have? What websites do you recommend?

Don’t hesitate to ask other questions.

What to expect from your doctor

Your doctor is likely to ask you questions, such as:

• When did you begin having symptoms?
• How severe are your symptoms?
• Have your symptoms been continuous, or do they come and go?
• Were you recently diagnosed with a urinary tract infection?
• Have you had frequent urinary tract infections in the past?
• Have you had a recent injury to your groin?
• What, if anything, seems to improve your symptoms?

Jan. 17, 2020

Show references

1. Meyrier A, et al. Acute bacterial prostatitis. http://www.uptodate.com/home. Accessed Oct. 11, 2016.
2. Meyrier A, et al. Chronic bacterial prostatitis. http://www.uptodate.com/home. Accessed Oct. 11, 2016.
3. Prostatitis. Prostate Cancer Foundation. https://www.pcf.org/about-prostate-cancer/what-is-prostate-cancer/prostate-gland/prostatitis/. Accessed Jan. 9, 2020.
4. Prostatitis: Inflammation of the prostate. National Kidney and Urological Diseases Information Clearinghouse. https://www.niddk.nih.gov/health-information/health-topics/urologic-disease/prostate-problems/Pages/facts.aspx/. Accessed Oct. 14, 2016.
5. Pontari M. Chronic prostatitis/chronic pelvic pain syndrome. http://www.uptodate.com/home. Accessed Oct. 14, 2016.
6. Sharp VJ, et al. Prostatitis: Diagnosis and treatment. American Family Physician. 2010;82:397.
7. Castle EP (expert opinion). Mayo Clinic, Scottsdale/Phoenix, Ariz. Oct. 26, 2016.
8. AskMayoExpert. Prostatitis (adult). Mayo Clinic; 2019.

Related

Associated Procedures

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Recurrent prostate infection: What are the treatment options?

What are the treatment options for a recurrent prostate infection?

Answer From Patricio C. Gargollo, M.D.

A recurring prostate infection is usually treated with antibiotics. Also known as chronic bacterial prostatitis, this infection is caused by bacteria in the prostate gland.

A prostate infection may come back because antibiotics weren’t able to get deep enough into the prostate tissue to destroy all of the bacteria. Or it’s possible that the original antibiotic wasn’t effective against the specific bacterium causing the infection.

To treat a prostate infection that keeps coming back, you might need to:

• Try a different antibiotic. One type of antibiotic might work better than another for your infection.
• Take a longer course of an antibiotic. You might need a course of antibiotics that lasts six weeks or longer.
• Use additional medications to help relieve bothersome symptoms. For example, drugs called alpha blockers can relieve urinary symptoms and anti-inflammatory medications such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve) can ease pain.

If you’re prescribed antibiotics, take them exactly as instructed, even if you begin to feel better. Missing doses or not taking the full course of antibiotics may interfere with the antibiotic’s ability to completely kill the bacteria.

If you have recurring prostate infections that don’t improve with treatment, see a doctor who specializes in men’s urinary and reproductive health (urologist). You might need to have fluid taken from your prostate to determine the bacterium causing the problem and the antibiotic that is likely to work best. It’s also possible you may have a form of prostatitis that isn’t caused by a bacterium.

You might need a CT scan or a procedure used to see inside your urinary bladder and urethra (cystoscopy) to look for other causes for your symptoms. A urologist can look for any underlying problems, such as a blockage, that would prevent treatment from being effective or make you more vulnerable to infection.

With

Patricio C. Gargollo, M.D.

Sept. 04, 2021

Show references

1. AskMayoExpert. Prostatitis (adult). Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2019.
2. Prostatitis: Inflammation of the prostate. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/urologic-diseases/prostate-problems/prostatitis-inflammation-prostate. Accessed May 13, 2019.
3. Mayrier A, et al. Chronic bacterial prostatitis. https://www.uptodate.com/contents/search. Accessed May 13, 2019.
4. Gill BC, et al. Bacterial prostatitis. Current Opinion in Infectious Diseases. 2016;29:86.

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Prostatitis (Prostate Infection): Causes, Symptoms, Treatments

The prostate is a walnut-sized gland that all men have. It’s found below your bladder and in front of your rectum. The job of the prostate is to make fluid that contains sperm (semen). This fluid protects the sperm when they travel toward a female’s egg.

If your prostate becomes swollen, tender, and inflamed, you have a condition called “prostatitis.” This isn’t cancer, and it’s different from having an “enlarged prostate.”

Symptoms of Prostatitis

There are four types of prostatitis. Each has its own set of symptoms and causes. These include:

Acute bacterial prostatitis. Your urinary tract is made up of your kidneys, bladder, and the tubes that pass between them. If bacteria from here finds its way into your prostate, you can get an infection.

This type of prostatitis comes on quickly. You might suddenly have:

• Urgent need to pee but only a little comes out, or you have to get to the toilet quickly to prevent an accident 
• High fever
• Chills
• Trouble peeing
• Pain around the base of your penis or behind your scrotum
• Cloudy urine 

Acute bacterial prostatitis is a severe condition. If you notice these symptoms, seek medical care right away.

Chronic bacterial prostatitis. This is more common in older men. It’s a milder bacterial infection that can linger for several months. Some men get it after they’ve had a urinary tract infection (UTI) or acute bacterial prostatitis.

The symptoms of chronic bacterial prostatitis often come and go. This makes them easy to miss. With this condition, you might sometimes have:

• An urgent need to pee, often in the middle of the night
• Painful urination
• Pain after you ejaculate (release semen at orgasm)
• Lower back pain
• Rectum pain
• A “heavy” feeling behind your scrotum
• Blood in your semen
• Urinary blockage (difficulty peeing or a weak urine stream)

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). This is the most common type of prostatitis. It shares many of the same signs as bacterial prostatitis. The difference is that when tests are run, no bacteria are present with this type.

Doctors aren’t sure what causes CP/CPPS. Triggers include stress, nearby nerve damage, and physical injury. Chemicals in your urine or a UTI you had in the past may play a role. CP/CPPS has also been linked to immune disorders like chronic fatigue syndrome and irritable bowel syndrome (IBS).

The main symptom of CP/CPPS is pain that lasts more than 3 months in at least one of these body parts:

• Penis (often at the tip)
• Scrotum
• Between your scrotum and rectum (the perineum)
• Lower abdomen

You may also have pain when you pee or ejaculate. You might not be able to hold your urine, or you may have to pee more than 8 times a day. A weak urine stream is another common symptom of CP/CPPS.

Asymptomatic prostatitis. Men who have this type of prostatitis have an inflamed prostate but no symptoms. You may only learn you have it if your doctor does a blood test that checks your prostate health. Asymptomatic prostatitis doesn’t need any treatment, but it can lead to infertility.

Prostatitis Risk Factors

You’re more likely to have problems with your prostate if:

• You’ve had a UTI
• You’ve had a groin injury
• You use a urinary catheter
• You’ve had a prostate biopsy
• You have HIV/AIDS
• You have an enlarged prostate or voiding symptoms
• You’ve had prostatitis before

An inflamed or infected prostate gland is common in men of all ages.

If you have prostatitis, your doctor can help you find ways to manage your symptoms and control your pain. if it is an infection, your treatment will include antibiotics.Researchers are also trying to better understand what causes it. This will allow them to find more treatments that work.

Prostatitis: What It Is, How to Cure It

Please note: This information was current at the time of publication. But medical information is always changing, and some information given here may be out of date. For regularly updated information on a variety of health topics, please visit familydoctor. org, the AAFP patient education website.

Information from Your Family Doctor

 

Am Fam Physician. 2000 May 15;61(10):3025-3026.

 
See related article on prostatitis.

What is prostatitis?

Prostatitis is common and affects many men at some time. Prostatitis is an inflammation of the prostate gland. When part of your body is inflamed, it is red, hot and sore. Prostatitis can cause many symptoms. It can make it difficult or painful to urinate. It can make you have to urinate more often. It can also give you a fever, low-back pain or pain in your groin (the area where the legs meet your body). It may make you less interested in having sex or unable to get an erection or keep it. Prostatitis is easy to confuse with other infections in the urinary tract.

What is the prostate gland?

The prostate is a gland that lies just below a man’s urinary bladder. It surrounds the urethra like a donut and is in front of the rectum. The urethra is the tube that carries urine out of the bladder, through the penis and out of the body. Your doctor may check your prostate by putting a finger into your rectum to feel the back of your prostate gland.

The prostate gland makes a fluid that provides nutrients for sperm. This fluid makes up most of the ejaculate fluid. We do not yet know all of the ways the prostate gland works.

What causes prostatitis?

Prostatitis is divided into categories based on cause. Two kinds of prostatitis, acute prostatitis and chronic bacterial prostatitis, are caused by infection of the prostate. Some kinds of prostatitis might be caused when the muscles of the pelvis or the bladder don’t work right.

How is prostatitis treated?

The treatment is based on the cause. Your doctor may do a rectal exam and test urine samples to find out the cause.

An antibiotic is used to treat prostatitis that is caused by an infection. Some antibiotics that might be used are trimethoprim-sulfamethoxazole, doxycycline, ciprofloxacin, norfloxacin and ofloxin. You might have to take antibiotics for several weeks or even a few months. If prostatitis is severe, you might have to go to a hospital for treatment with fluids and antibiotics.

What if my prostatitis is not caused by infection?

Because we do not understand what causes prostatitis without infection, it can be hard to treat. Your doctor might try an antibiotic to treat a hidden infection. Other treatments are aimed at making you feel better. Nonsteroidal anti-inflammatory medicines, such as ibuprofen or naproxen, and hot soaking baths may help you feel better. Some men get better by taking medicines that help the way the bladder or prostate gland work. These medicines include oxybutynin, doxazosin, prazosin, tamsulosin and terazosin.

Can prostatitis be passed on during sex?

Sometimes prostatitis is caused by a sexually transmitted organism, such as chlamydia. However, most cases are caused by infections that are not sexually transmitted. These infections can’t be passed on to sexual partners.

Can prostatitis come back?

Men who have had prostatitis once are more likely to get it again. Antibiotics may not get into the prostate gland well. Small amounts of bacteria might “hide” in the prostate and not be killed by the antibiotic. Once you stop taking the antibiotic, the infection can get bad again. If this happens, you might have to take antibiotics for a long time to prevent another infection. Prostatitis that is not caused by infection is often chronic. If you have this kind of prostatitis, you might have to take medicine for a long time.

Should I have my prostate gland taken out if I have prostatitis?

Prostatitis can usually be treated with medicine. Most of the time, surgery is not needed.

Does prostatitis cause cancer?

Although prostatitis can cause you trouble, it does not cause cancer. There is a blood test some doctors use for prostate cancer called the prostate-specific antigen test (called the PSA, for short). If you have prostatitis, your PSA level might go up. This does not mean you have cancer. Your doctor will treat your prostatitis and may check your PSA level again.

Types, Symptoms, Causes, Diagnosis & Treatment

Overview

Chronic Prostatitis: State-of-the-art diagnosis and treatment.

What is prostatitis?

Prostatitis refers to four different conditions that affect the prostate gland. Two types of prostatitis are linked to urinary tract infections (UTIs). Other types are not. Men with prostatitis may have infection, inflammation and/or pain. Adult men of any age can get prostatitis.

Many men who are told they have prostatitis are misdiagnosed and actually have a different condition. There’s a lot of outdated information about prostatitis. It’s important to see a healthcare provider who is up to date on the latest prostatitis research, diagnostic tests and treatments.

What is the prostate gland?

The prostate gland is part of the male reproductive system. It sits below your bladder, in front of the rectum. The urethra (tube that carries urine and semen out of the body) runs through the center of the gland.

How common is prostatitis?

Half of all men have symptoms of prostatitis at some point in their lives. It’s the most common urinary tract issue in men younger than 50. In men over 50, it’s the third most common. More than two million men see a healthcare provider every year for prostatitis symptoms.

What are the types of prostatitis?

Types of prostatitis include:

• Acute bacterial prostatitis (category 1): A UTI causes an infection in the prostate gland. Symptoms include fever and chills. You may experience painful and frequent urination or have trouble urinating. Acute bacterial prostatitis requires immediate medical treatment.
• Chronic bacterial prostatitis (category 2): Bacteria become trapped in the prostate gland, causing recurrent UTIs that are difficult to treat.
• Chronic pelvic pain syndrome, or CPPS (category 3): CPPS is the most common prostatitis type. Prostate gland inflammation occurs in approximately 1 out of 3 men. As the name implies, this type causes chronic pain in the pelvis, perineum (the area between the scrotum and rectum) and genitals.
• Asymptomatic inflammatory prostatitis (category 4): This condition causes prostate gland inflammation but no symptoms. You may learn you have this condition after getting tests to find the cause of other problems. For example, a semen analysis for infertility may detect asymptomatic inflammatory prostatitis. This type doesn’t need treatment.

Is prostatitis a sign of prostate cancer?

Prostatitis is benign (not cancerous). It doesn’t increase your risk of prostate cancer. However, inflammation from prostatitis sometimes raises the level of prostate-specific antigens (PSA) in blood — just like prostate cancer does. Further tests can help determine what’s causing elevated PSA levels.

What are the complications of prostatitis?

Men with acute bacterial prostatitis may develop sepsis. This widespread inflammation can be life-threatening. It requires immediate medical treatment.

Antibiotics can cause an upset stomach. Men with chronic bacterial prostatitis may need lots of antibiotics to treat recurring infections. Some people develop antibiotic resistance, making treatment ineffective.

Asymptomatic inflammatory prostatitis can lower sperm count, affecting fertility.

Symptoms and Causes

What causes prostatitis?

Different types of prostatitis have different causes. Risk factors for chronic pelvic pain syndrome (CPPS), the most common type, aren’t clear. Potential contributors to CPPS include:

• Autoimmune diseases.
• Pelvic floor muscle spasms.
• Stress.

Potential causes of bacterial forms of prostatitis include:

• Bladder infections or bladder stones.
• Surgery or biopsy requiring use of a urinary catheter.
• Prostate stones.
• Urinary retention (not emptying the bladder completely).
• UTIs.

What are the symptoms of prostatitis?

Prostatitis symptoms vary depending on the type and cause. People with asymptomatic inflammatory prostatitis don’t have any symptoms.

Men with chronic pelvic pain syndrome or chronic bacterial prostatitis may experience:

• Pain in the penis, testicles or perineum (area between the testicles and rectum). The pain may radiate to the lower back.
• Frequent urge to urinate.
• Painful urination (dysuria).
• Weak urine flow or urine stream that starts and stops.
• Painful ejaculation or pain during intercourse.
• Blood in semen (hematospermia).
• Erectile dysfunction.

Acute bacterial prostatitis causes a fever and chills.

Diagnosis and Tests

How is prostatitis diagnosed?

Your healthcare provider will assess your symptoms and perform a physical exam.

Less invasive tests for prostatitis may include:

• Digital rectal exam: Your provider inserts a gloved, lubricated finger into the rectum to check the prostate gland for pain and swelling. This exam may include prostate massage to collect a sample of seminal fluid.
• Urinalysis: A urinalysis and urine culture check for bacteria and UTIs.
• Blood test: A blood test measures PSA, a protein made by the prostate gland. High levels may indicate prostatitis, BPH or prostate cancer.

More invasive tests for prostatitis include:

• Cystoscopy: A cystoscopy can look for other urinary tract problems but does not diagnose prostatitis. Your provider uses a cystoscope (a pencil-sized lighted tube with a camera or viewing lens on the end) to view inside the bladder and urethra.
• Transrectal ultrasound: Men with acute bacterial prostatitis or chronic bacterial prostatitis that doesn’t improve with antibiotics may get a transrectal ultrasound. A slender ultrasound probe inserted into the rectum uses sound waves to produce images of the prostate gland. This test can show prostate gland abnormalities, abscesses or stones.

Management and Treatment

How is chronic pelvic pain syndrome (CPPS) managed or treated?

Prostatitis treatments vary depending on the cause and type. Asymptomatic inflammatory prostatitis doesn’t require treatment.

For chronic pelvic pain syndrome (CPPS), your healthcare provider may use a system called UPOINT to classify symptoms into six categories. Your provider uses multiple treatments at the same time to treat only the symptoms you’re experiencing.

Approximately 80% of men with CPPS improve with the UPOINT system. The system focuses on these symptoms and treatments:

• Urinary: Medications, such as tamsulosin (Flomax®) and alfuzosin (Uroxatral®), relax muscles around the prostate and bladder to improve urine flow.
• Psychosocial: Stress management can help. Some men benefit from counseling or medications for anxiety, depression and catastrophizing (over-reaction to minor stresses common in people with chronic pain).
• Organ: Quercetin and bee pollen supplements may relieve a swollen, inflamed prostate gland.
• Infection: Antibiotics kill infection-causing bacteria.
• Neurologic: Prescription pain medicines, such as amitriptyline (Elavil®) and gabapentin (Gralise®), relieve neurogenic pain. This pain can include fibromyalgia or pain that extends into the legs, arms or back.
• Tenderness: Pelvic floor physical therapy may include myofascial release (gentle massage to ease tension on tight pelvic floor muscles). This therapy can reduce or eliminate muscle spasms.

How are bacterial forms of prostatitis managed or treated?

Antibiotics can kill bacteria that cause bacterial types of prostatitis. Men with acute bacterial prostatitis may need 14 to 30 days of antibiotics, starting with IV antibiotics in the hospital. Rarely, men need surgery to drain an abscess on the prostate.

Treating chronic bacterial prostatitis is challenging. You may need up to three months of antibiotics to sterilize the prostate. If the prostate can’t be sterilized, low-dose antibiotics can be used long term to prevent recurrences. Some men need surgery to remove prostate stones or scar tissue in the urethra. Rarely, surgeons remove part or all of the prostate gland (prostatectomy).

Prevention

How can I prevent prostatitis?

Prompt treatment for UTIs may keep the infection from spreading to the prostate. If you have pain in your perineum when sitting, see a provider. You can take steps to address this problem before it leads to chronic pelvic pain syndrome.

Outlook / Prognosis

What is the prognosis (outlook) for people who have prostatitis?

Antibiotics can cure acute bacterial prostatitis. These medications also ease chronic bacterial prostatitis symptoms in approximately 30% to 60% of men. Up to 80% of men with chronic pelvic pain syndrome feel better after receiving appropriate treatments for their symptoms using the UPOINT system. Men with asymptomatic inflammatory prostatitis don’t need treatment.

Living With

When should I call the doctor?

You should call your healthcare provider if you experience:

• Blood in your urine or semen.
• Difficulty urinating.
• Frequent urination (incontinence).
• Pain during urination or intercourse.

What questions should I ask my doctor?

You may want to ask your healthcare provider:

• What type of prostatitis do I have?
• What is the best treatment for this type of prostatitis?
• What are the treatment risks and side effects?
• How can I avoid getting prostatitis again?
• What type of follow-up care do I need after treatment?
• Should I look out for signs of complications?

A note from Cleveland Clinic

Prostatitis is a common problem that affects many men. Unfortunately, there’s a lot of confusion about the disease. People (including some healthcare providers) use the word prostatitis to describe four different conditions. There isn’t a one-size-fits-all treatment for prostatitis, which is why an accurate diagnosis is so important.

Prostatitis: Inflammation of the Prostate

What is prostatitis?

Prostatitis is a frequently painful condition that involves inflammation of the prostate and sometimes the areas around the prostate.

Scientists have identified four types of prostatitis:

• chronic prostatitis or chronic pelvic pain syndrome
• acute bacterial prostatitis
• chronic bacterial prostatitis
• asymptomatic inflammatory prostatitis

Men with asymptomatic inflammatory prostatitis do not have symptoms. A health care provider may diagnose asymptomatic inflammatory prostatitis when testing for other urinary tract or reproductive tract disorders. This type of prostatitis does not cause complications and does not need treatment.

What is the prostate?

The prostate is a walnut-shaped gland that is part of the male reproductive system. The main function of the prostate is to make a fluid that goes into semen. Prostate fluid is essential for a man’s fertility. The gland surrounds the urethra at the neck of the bladder. The bladder neck is the area where the urethra joins the bladder. The bladder and urethra are parts of the lower urinary tract. The prostate has two or more lobes, or sections, enclosed by an outer layer of tissue, and it is in front of the rectum, just below the bladder. The urethra is the tube that carries urine from the bladder to the outside of the body. In men, the urethra also carries semen out through the penis.

The prostate is a walnut-shaped gland that is part of the male reproductive system.

What causes prostatitis?

The causes of prostatitis differ depending on the type.

Chronic prostatitis or chronic pelvic pain syndrome. The exact cause of chronic prostatitis/chronic pelvic pain syndrome is unknown. Researchers believe a microorganism, though not a bacterial infection, may cause the condition. This type of prostatitis may relate to chemicals in the urine, the immune system’s response to a previous urinary tract infection (UTI), or nerve damage in the pelvic area.

Acute and chronic bacterial prostatitis. A bacterial infection of the prostate causes bacterial prostatitis. The acute type happens suddenly and lasts a short time, while the chronic type develops slowly and lasts a long time, often years. The infection may occur when bacteria travel from the urethra into the prostate.

How common is prostatitis?

Prostatitis is the most common urinary tract problem for men younger than age 50 and the third most common urinary tract problem for men older than age 50.¹ Prostatitis accounts for about two million visits to health care providers in the United States each year.²

Chronic prostatitis or chronic pelvic pain syndrome is

• the most common and least understood form of prostatitis.
• can occur in men of any age group.
• affects 10 to 15 percent of the U.S. male population.³

Who is more likely to develop prostatitis?

The factors that affect a man’s chances of developing prostatitis differ depending on the type.

Chronic prostatitis/chronic pelvic pain syndrome. Men with nerve damage in the lower urinary tract due to surgery or trauma may be more likely to develop chronic prostatitis/chronic pelvic pain syndrome. Psychological stress may also increase a man’s chances of developing the condition.

Acute and chronic bacterial prostatitis. Men with lower UTIs may be more likely to develop bacterial prostatitis. UTIs that recur or are difficult to treat may lead to chronic bacterial prostatitis.

What are the symptoms of prostatitis?

Each type of prostatitis has a range of symptoms that vary depending on the cause and may not be the same for every man. Many symptoms are similar to those of other conditions.

Chronic prostatitis/chronic pelvic pain syndrome. The main symptoms of chronic prostatitis/chronic pelvic pain syndrome can include pain or discomfort lasting 3 or more months in one or more of the following areas:

• between the scrotum and anus
• the central lower abdomen
• the penis
• the scrotum
• the lower back

Pain during or after ejaculation is another common symptom. A man with chronic prostatitis/chronic pelvic pain syndrome may have pain spread out around the pelvic area or may have pain in one or more areas at the same time. The pain may come and go and appear suddenly or gradually. Other symptoms may include

• pain in the urethra during or after urination.
• pain in the penis during or after urination.
• urinary frequency—urination eight or more times a day. The bladder begins to contract even when it contains small amounts of urine, causing more frequent urination.
• urinary urgency—the inability to delay urination.
• a weak or an interrupted urine stream.

Acute bacterial prostatitis. The symptoms of acute bacterial prostatitis come on suddenly and are severe. Men should seek immediate medical care. Symptoms of acute bacterial prostatitis may include

• urinary frequency
• urinary urgency
• fever
• chills
• a burning feeling or pain during urination
• pain in the genital area, groin, lower abdomen, or lower back
• nocturia—frequent urination during periods of sleep
• nausea and vomiting
• body aches
• urinary retention—the inability to empty the bladder completely
• trouble starting a urine stream
• a weak or an interrupted urine stream
• urinary blockage—the complete inability to urinate
• a UTI—as shown by bacteria and infection-fighting cells in the urine

Chronic bacterial prostatitis. The symptoms of chronic bacterial prostatitis are similar to those of acute bacterial prostatitis, though not as severe. This type of prostatitis often develops slowly and can last 3 or more months. The symptoms may come and go, or they may be mild all the time. Chronic bacterial prostatitis may occur after previous treatment of acute bacterial prostatitis or a UTI. The symptoms of chronic bacterial prostatitis may include

• urinary frequency
• urinary urgency
• a burning feeling or pain during urination
• pain in the genital area, groin, lower abdomen, or lower back
• nocturia
• painful ejaculation
• urinary retention
• trouble starting a urine stream
• a weak or an interrupted urine stream
• urinary blockage
• a UTI

What are the complications of prostatitis?

The complications of prostatitis may include

• bacterial infection in the bloodstream
• prostatic abscess—a pus-filled cavity in the prostate
• sexual dysfunction
• inflammation of reproductive organs near the prostate

When to Seek Medical Care

A person may have urinary symptoms unrelated to prostatitis that are caused by bladder problems, UTIs, or benign prostatic hyperplasia. Symptoms of prostatitis also can signal more serious conditions, including prostate cancer.

Men with symptoms of prostatitis should see a health care provider.

Men with the following symptoms should seek immediate medical care:

• complete inability to urinate
• painful, frequent, and urgent need to urinate, with fever and chills
• blood in the urine
• great discomfort or pain in the lower abdomen and urinary tract

How is prostatitis diagnosed?

A health care provider diagnoses prostatitis based on

• a personal and family medical history
• a physical exam
• medical tests

A health care provider may have to rule out other conditions that cause similar signs and symptoms before diagnosing prostatitis.

Personal and Family Medical History

Taking a personal and family medical history is one of the first things a health care provider may do to help diagnose prostatitis.

Physical Exam

A physical exam may help diagnose prostatitis. During a physical exam, a health care provider usually

• examines a patient’s body, which can include checking for
  • discharge from the urethra
  • enlarged or tender lymph nodes in the groin
  • a swollen or tender scrotum
• performs a digital rectal exam

A digital rectal exam, or rectal exam, is a physical exam of the prostate. To perform the exam, the health care provider asks the man to bend over a table or lie on his side while holding his knees close to his chest. The health care provider slides a gloved, lubricated finger into the rectum and feels the part of the prostate that lies next to the rectum. The man may feel slight, brief discomfort during the rectal exam. A health care provider usually performs a rectal exam during an office visit, and the man does not need anesthesia. The exam helps the health care provider see if the prostate is enlarged or tender or has any abnormalities that require more testing.

Many health care providers perform a rectal exam as part of a routine physical exam for men age 40 or older, whether or not they have urinary problems.

Digital rectal exam

Medical Tests

A health care provider may refer men to a urologist—a doctor who specializes in the urinary tract and male reproductive system. A urologist uses medical tests to help diagnose lower urinary tract problems related to prostatitis and recommend treatment. Medical tests may include

• urinalysis
• blood tests
• urodynamic tests
• cystoscopy
• transrectal ultrasound
• biopsy
• semen analysis

Urinalysis. Urinalysis involves testing a urine sample. The patient collects a urine sample in a special container in a health care provider’s office or a commercial facility. A health care provider tests the sample during an office visit or sends it to a lab for analysis. For the test, a nurse or technician places a strip of chemically treated paper, called a dipstick, into the urine. Patches on the dipstick change color to indicate signs of infection in urine.

The health care provider can diagnose the bacterial forms of prostatitis by examining the urine sample with a microscope. The health care provider may also send the sample to a lab to perform a culture. In a urine culture, a lab technician places some of the urine sample in a tube or dish with a substance that encourages any bacteria present to grow; once the bacteria have multiplied, a technician can identify them.

Blood tests. Blood tests involve a health care provider drawing blood during an office visit or in a commercial facility and sending the sample to a lab for analysis. Blood tests can show signs of infection and other prostate problems, such as prostate cancer.

Urodynamic tests. Urodynamic tests include a variety of procedures that look at how well the bladder and urethra store and release urine. A health care provider performs urodynamic tests during an office visit or in an outpatient center or a hospital. Some urodynamic tests do not require anesthesia; others may require local anesthesia. Most urodynamic tests focus on the bladder’s ability to hold urine and empty steadily and completely and may include the following:

• uroflowmetry, which measures how rapidly the bladder releases urine
• postvoid residual measurement, which evaluates how much urine remains in the bladder after urination

Cystoscopy. Cystoscopy is a procedure that uses a tubelike instrument, called a cystoscope, to look inside the urethra and bladder. A urologist inserts the cystoscope through the opening at the tip of the penis and into the lower urinary tract. He or she performs cystoscopy during an office visit or in an outpatient center or a hospital. He or she will give the patient local anesthesia. In some cases, the patient may require sedation and regional or general anesthesia. A urologist may use cystoscopy to look for narrowing, blockage, or stones in the urinary tract.

Transrectal ultrasound. Transrectal ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure. The health care provider can move the transducer to different angles to make it possible to examine different organs. A specially trained technician performs the procedure in a health care provider’s office, an outpatient center, or a hospital, and a radiologist—a doctor who specializes in medical imaging—interprets the images; the patient does not require anesthesia. Urologists most often use transrectal ultrasound to examine the prostate. In a transrectal ultrasound, the technician inserts a transducer slightly larger than a pen into the man’s rectum next to the prostate. The ultrasound image shows the size of the prostate and any abnormalities, such as tumors. Transrectal ultrasound cannot reliably diagnose prostate cancer.

Biopsy. Biopsy is a procedure that involves taking a small piece of prostate tissue for examination with a microscope. A urologist performs the biopsy in an outpatient center or a hospital. He or she will give the patient light sedation and local anesthetic; however, in some cases, the patient will require general anesthesia. The urologist uses imaging techniques such as ultrasound, a computerized tomography scan, or magnetic resonance imaging to guide the biopsy needle into the prostate. A pathologist—a doctor who specializes in examining tissues to diagnose diseases—examines the prostate tissue in a lab. The test can show whether prostate cancer is present.

Semen analysis. Semen analysis is a test to measure the amount and quality of a man’s semen and sperm. The man collects a semen sample in a special container at home, a health care provider’s office, or a commercial facility. A health care provider analyzes the sample during an office visit or sends it to a lab for analysis. A semen sample can show blood and signs of infection.

How is prostatitis treated?

Treatment depends on the type of prostatitis.

Chronic prostatitis/chronic pelvic pain syndrome. Treatment for chronic prostatitis/chronic pelvic pain syndrome aims to decrease pain, discomfort, and inflammation. A wide range of symptoms exists and no single treatment works for every man. Although antibiotics will not help treat nonbacterial prostatitis, a urologist may prescribe them, at least initially, until the urologist can rule out a bacterial infection. A urologist may prescribe other medications:

• silodo
• sin (Rapaflo)
• 5-alpha reductase inhibitors such as finasteride (Proscar) and dutasteride (Avodart)
• nonsteroidal anti-inflammatory drugs—also called NSAIDs—such as aspirin, ibuprofen, and naproxen sodium
• glycosaminogly
• cans such as chondroitin sulfate
• muscle relaxants such as cyclobenzaprine (Amrix, Flexeril) and clonazepam (Klonopin)
• neuromodulators such as amitriptyline, nortriptyline (Aventyl, Pamelor), and pregabalin (Lyrica)

Alternative treatments may include

• warm baths, called sitz baths
• local heat therapy with hot water bottles or heating pads
• physical therapy, such as
  • Kegel exercises—tightening and relaxing the muscles that hold urine in the bladder and hold the bladder in its proper position. Also called pelvic muscle exercises.
  • myofascial release—pressing and stretching, sometimes with cooling and warming, of the muscles and soft tissues in the lower back, pelvic region, and upper legs. Also known as myofascial trigger point release.
• relaxation exercises
• biofeedback
• phytotherapy with plant extracts such as quercetin, bee pollen, and saw palmetto
• acupuncture

To help ensure coordinated and safe care, people should discuss their use of complementary and alternative medical practices, including their use of dietary supplements, with their health care provider. Read more at www.nccih.nih.gov.

For men whose chronic prostatitis/chronic pelvic pain syndrome symptoms are affected by psychological stress, appropriate psychiatric treatment and stress reduction may reduce the recurrence of symptoms.

To help measure the effectiveness of treatment, a urologist may ask a series of questions from a standard questionnaire called the National Institutes of Health (NIH) Chronic Prostatitis Symptom Index. The questionnaire helps a urologist assess the severity of symptoms and how they affect the man’s quality of life. A urologist may ask questions several times, such as before, during, and after treatment.

Acute bacterial prostatitis. A urologist treats acute bacterial prostatitis with antibiotics. The antibiotic prescribed may depend on the type of bacteria causing the infection. Urologists usually prescribe oral antibiotics for at least 2 weeks. The infection may come back; therefore, some urologists recommend taking oral antibiotics for 6 to 8 weeks. Severe cases of acute prostatitis may require a short hospital stay so men can receive fluids and antibiotics through an intravenous (IV) tube. After the IV treatment, the man will need to take oral antibiotics for 2 to 4 weeks. Most cases of acute bacterial prostatitis clear up completely with medication and slight changes to diet. The urologist may recommend

• avoiding or reducing intake of substances that irritate the bladder, such as alcohol, caffeinated beverages, and acidic and spicy foods
• increasing intake of liquids—64 to 128 ounces per day—to urinate often and help flush bacteria from the bladder

Chronic bacterial prostatitis. A urologist treats chronic bacterial prostatitis with antibiotics; however, treatment requires a longer course of therapy. The urologist may prescribe a low dose of antibiotics for up to 6 months to prevent recurrent infection. The urologist may also prescribe a different antibiotic or use a combination of antibiotics if the infection keeps coming back. The urologist may recommend increasing intake of liquids and avoiding or reducing intake of substances that irritate the bladder.

A urologist may use alpha blockers that treat chronic prostatitis/chronic pelvic pain syndrome to treat urinary retention caused by chronic bacterial prostatitis. These medications help relax the bladder muscles near the prostate and lessen symptoms such as painful urination. Men may require surgery to treat urinary retention caused by chronic bacterial prostatitis. Surgically removing scar tissue in the urethra often improves urine flow and reduces urinary retention.

How can prostatitis be prevented?

Men cannot prevent prostatitis. Researchers are currently seeking to better understand what causes prostatitis and develop prevention strategies.

Eating, Diet, and Nutrition

Researchers have not found that eating, diet, and nutrition play a role in causing or preventing prostatitis. During treatment of bacterial prostatitis, urologists may recommend increasing intake of liquids and avoiding or reducing intake of substances that irritate the bladder. Men should talk with a health care provider or dietitian about what diet is right for them.

Clinical Trials

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and other components of the National Institutes of Health (NIH) conduct and support research into many diseases and conditions.

What are clinical trials, and are they right for you?

Clinical trials are part of clinical research and at the heart of all medical advances. Clinical trials look at new ways to prevent, detect, or treat disease. Researchers also use clinical trials to look at other aspects of care, such as improving the quality of life for people with chronic illnesses. Find out if clinical trials are right for you.

What clinical trials are open?

Clinical trials that are currently open and are recruiting can be viewed at www.ClinicalTrials.gov.

References

[1] Nickel JC. Prostatitis and related conditions, orchitis, and epididymitis. In: Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 10th ed. Philadelphia: Saunders; 2012: 327–356.

[2] Barry MJ, Collins MM. Benign prostatic hyperplasia and prostatitis. In: Goldman L, Schafer AI, eds. Goldman’s Cecil Medicine. 24th ed. Philadelphia: Saunders; 2011: 805–810.

[3] Murphy AB, Macejko A, Taylor A, Nadler RB. Chronic prostatitis: management strategies. Drugs. 2009;69(1):71–84.

Prostatitis | Cedars-Sinai

Not what you’re looking for?

What is prostatitis?

Prostatitis is inflammation of the prostate gland and sometimes the area around it.
It is not cancer.

Only men have a prostate gland. It
sits in front of the rectum and below the bladder. The gland wraps around the urethra,
the tube that carries urine out of the body. The prostate makes the fluid part of
semen.

Types of prostatitis

• Chronic prostatitis. This is the most common type of prostatitis. Symptoms may
  get better and then come back without warning. Healthcare providers do not know
  why this happens. There is no cure, but you can manage symptoms.
• Acute bacterial prostatitis. This is the least common type of prostatitis. It happens
  in men at any age. It often starts suddenly and causes severe symptoms. It’s
  important to get treatment right away. You may find urination difficult and very
  painful. Other symptoms include fever, chills, lower back pain, pain in the
  genital area, frequent urination, burning during urination, or urinary urgency at
  night. You may also have aches and pains all over your body.
• Chronic bacterial prostatitis. This type is fairly uncommon. It is an infection that
  comes back again and again, and it is hard to treat. Symptoms are like a mild form
  of acute bacterial prostatitis. But they last longer. Often you have no
  fever.
• Asymptomatic inflammatory prostatitis. This is prostatitis with no symptoms.
  Your healthcare provider often diagnoses it during an exam for another health
  problem. They may diagnose it if you have infection-fighting cells in your
  prostate fluid or semen.

What causes prostatitis?

Prostatitis is most often caused by bacteria. They spread from the rectum or from
infected urine.

You can’t get prostatitis from
another person. It is not an STD. But it can result from several STDs.

Who is at risk for prostatitis?

You can get prostatitis at any age.
But some things raise your risk:

• Recent bladder or urinary tract infection, or other infection in the body
• Injury to the area between the scrotum and the anus
• Abnormal urinary tract anatomy
• Enlarged prostate
• Recent test where a catheter or scope was put into the urethra

What are the symptoms of prostatitis?

These are the most common symptoms of prostatitis:

• Need to urinate often
• Burning or stinging while urinating
• Pain when urinating
• Less urine when you urinate
• Rectal pain or pressure
• Fever and chills (often only with an acute infection)
• Pain in your lower back or pelvis
• Discharge through the urethra during bowel movements
• Erectile dysfunction or loss of sex drive
• Throbbing sensations in the rectal or genital area

The symptoms of prostatitis may
look like other health conditions or problems. Always see your healthcare provider
for a
diagnosis.

How is prostatitis diagnosed?

Your healthcare provider will
review your past health and sexual history. They will also do a physical exam. Other
tests may include:

• Urine culture. This test collects prostatic fluid and
  urine. They are checked for white blood cells and bacteria.
• Digital rectal exam (DRE). In this test, the healthcare provider puts a gloved finger
  into the rectum to check the part of the prostate next to the rectum. This is done
  to
  look for swelling or tenderness.
• Prostate massage. The healthcare provider massages your prostate gland to drain
  fluid into the urethra. This fluid is then checked under a microscope to look for
  inflammation or infection. This test is often done during a digital rectal exam
  (DRE).
• Semen culture. A semen sample is tested in the lab for
  bacteria and white blood cells.
• Cystoscopy. A
  thin, flexible tube and viewing device is put into the penis and through the urethra.
  Your healthcare provider uses the device to look at your bladder and urinary tract
  for structure changes or blockages.
• Transrectal ultrasound. A small, hand-held device
  (transducer) is inserted into the rectum next to the prostate to show images of the
  prostate.
• CT scan. This is an imaging test that uses X-rays and a
  computer to make detailed images of the body. A CT scan shows details of the bones,
  muscles, fat, and organs.

How is prostatitis treated?

Treatment will depend on your symptoms, age, and general health. It
will also depend on how severe the condition is.

Treatment depends on what type
of prostatitis you have.

Chronic prostatitis

You may take antibiotics until infection can be ruled out. Depending on the symptoms,
other treatments may include:

• Medicines to help relax the muscles around the prostate and bladder, decrease inflammation,
  and ease pain
• Prostate massage to release the fluid that is causing pressure in the prostate
• Heat from hot baths or a heating pad to help ease discomfort

Chronic bacterial prostatitis

Treatment often means taking
antibiotics for 4 to 12 weeks. This type of prostatitis is hard to treat, and the
infection may come back. If antibiotics don’t work in 4 to 12 weeks, you may need
to
take a low dose of antibiotics for a while. In rare cases, you may need surgery to
remove part or all of the prostate. This may be done if you have trouble emptying
your bladder.

Acute bacterial prostatitis

For this type of prostatitis,
you often take antibiotics for 2 to 4 weeks. It’s important to take the full course
of antibiotics, even when you don’t have symptoms. This is to stop the growth of
antibiotic-resistant bacteria. You may also need pain medicines. You may be told to
drink more fluids. In severe cases, you may need to stay in the hospital.

Always see your healthcare provider for more information about the treatment of prostatitis.

Key points about prostatitis

• Prostatitis is inflammation of the
  prostate gland caused by infection. It can be one of several types.
• Prostatitis is not contagious and is
  not an STD.
• Prostatitis can happen at any age.
  Symptoms of prostatitis may include urinating more often, burning or stinging during
  urination, pain during urination, and fever and chills.
• Your healthcare provider often
  diagnoses prostatitis by your symptoms and by checking your urine and semen for signs
  of infection.
• Antibiotics are used to treat
  prostatitis. In rare cases, you may need surgery.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.
• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells
  you.
• At the visit, write down the name of a
  new diagnosis and any new medicines, treatments, or tests. Also write down any new
  instructions your provider gives you.
• Know why a new medicine or treatment
  is prescribed and how it will help you. Also know what the side effects are.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if you do not take the medicine or have the test or procedure.
• If you have a follow-up appointment, write down the date, time, and purpose for that
  visit.
• Know how you can contact your provider
  if you have questions.

Medical Reviewer: Marc Greenstein MD

Medical Reviewer: Raymond Turley Jr PA-C

Medical Reviewer: Raymond Kent Turley BSN MSN RN

© 2000-2021 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional’s instructions.

Not what you’re looking for?

90,000 treatment of acute prostatitis, diagnostics, treatment methods, prices for operations in the SOYUZ clinic.

Methods of treatment of prostatitis in the clinic “SOYUZ”

There is no single answer to the question of how prostatitis is treated. Since each patient has his own characteristics, and the disease manifests itself differently in everyone, there is no specific treatment regimen for prostatitis.

Currently, a wide range of drugs and medical procedures are used for the treatment of prostatitis.However, the disease cannot be cured only by taking pills – you can only relieve the symptoms for a short time. As a rule, therapy for prostatitis is complex. As a result of the complex application of various procedures and medicines, the causes of prostatitis are eliminated and the body is restored.

For the successful treatment of prostatitis, first of all, the qualifications of the doctor and strict adherence to his recommendations are extremely important.

Massage for prostatitis

According to most men, prostate massage is the most unpleasant procedure that one will have to face with this disease.However, if this procedure is performed by a qualified doctor, the patient will hardly experience any discomfort.

In this disease, massage is one of the most effective methods. It improves blood circulation in the prostate gland (and good blood circulation is one of the key conditions for its normal functioning), increases muscle tone, restores duct patency, enhances the effect of antibiotic therapy and ultimately helps relieve inflammation.

In addition, massage of the lumbosacral region is effective for the treatment of prostatitis. Before carrying out it, it is recommended to perform general massage sessions or perform gymnastic exercises that promote better blood circulation.

There are also sets of exercises for prostatitis, which the patient can perform independently.

How to treat prostatitis

Today’s drug market offers a large selection of drugs for treatment. We list those medicines that are used most often.

Vitaprost . This drug is used in the treatment of chronic prostatitis, and is also prescribed after operations on the prostate gland. It improves metabolism in the prostate gland, normalizes its functions, and is a corrector of urodynamics.

Prostanorm. This drug improves blood microcirculation in the prostate gland, relieves inflammation, reduces pain.

Prostamol Uno. The drug is prescribed not only for this disease, but also for other urinary disorders associated with inflammation of the prostate gland.The tool normalizes the functioning of the genitourinary system, improves reproductive function.

In addition to the listed preparations, biologically active additives are also widely used. With the bacterial forms of this disease, not only drugs for prostatitis are prescribed, but also various antibiotics.

Never prescribe medication yourself! If you want your treatment to really be successful, see your doctor. The specialist will prescribe a course of drugs based on your physical condition and the severity of your illness.

Antibiotics for prostatitis

The cost of treating prostatitis, depending on the severity of the case, may vary. This is due to the fact that it consists of the price of drugs and the cost of the procedures prescribed by the doctor.

The use of antibiotics for bacterial prostatitis is inevitable, as it is required to eliminate the infection.

The effectiveness of antibiotic treatment will be effective in the case of a thorough diagnosis of the patient’s condition and the appointment of the optimal dose, duration of treatment and the method of taking drugs.

No less important is the spectrum of antimicrobial action of medicines. So, if prostatitis is a consequence of an infectious disease (such as, for example, tuberculosis, gonorrhea, chlamydia), antibiotics with an appropriate spectrum of action are prescribed.

When prescribing antibiotics, the doctor must also take into account the presence of allergic reactions, renal failure. As a rule, along with antibiotics, drugs are prescribed that normalize the intestinal microflora.

It is important to remember that antibiotics are used only to treat bacterial prostatitis.Prostatitis caused by viruses is treated with antiviral drugs.

Surgical intervention

Contrary to popular belief, surgery is rarely prescribed for prostatitis. Surgical intervention is an extreme measure and is used when other methods of treatment do not lead to a positive result.

Surgical intervention consists in removing the inflamed area of ​​the prostate gland. The likelihood of a complete cure is very low.In addition, various complications are inevitable, up to a complete loss of potency.

Surgical intervention, in particular, is prescribed in the case of stones in the prostate gland that cannot be removed, and deep sclerosis of the prostate. In all other cases, even if the duration and cost of treatment are high, other methods are used. 90,005 90,000 causes, symptoms and treatment. Treatment of prostatitis in men at the A-Media clinic.

Description of the disease

The most common male health disorder is prostatitis.This medical term hides a disease familiar to at least a third of the male population. Inflammation of the prostate gland, in other words, prostatitis affects men of any age, and after 50 years, every second person suffers from it. The danger of the disease lies in the fact that, flowing unnoticed for a long time, it can become chronic and lead to serious complications.

Causes of the disease

Due to the onset of prostatitis is divided into two types:

• infectious;
• stagnant.

Infectious inflammation can occur as a result of a bacterial, viral or fungal infection that enters the prostate gland from the urethra, bladder or intestines. Painful microflora can spread through the circulatory and lymphatic systems.

The cause of stagnant (non-infectious, non-bacterial) prostatitis is most often: stagnation of blood in the pelvic area, stagnation of prostate secretions, hypothermia, trauma, alcohol abuse.Blood stagnation occurs most often in people who spend a long time in a sitting position. No wonder they say that prostatitis is an occupational disease of drivers and office workers.

If you wear tight underwear, then drastically reduce blood circulation and increase the risk of prostatitis. The secretion stagnation is explained by irregular sex life and long intervals in sexual activity.

Symptoms

Disease in the early stages may not even manifest itself in any way.If you are attentive to your health, you should be alerted by any of the following classic manifestations of prostatitis:

• pain of slight intensity in the lower abdomen, perineum, in the genital area and rectum;
• Difficulty, frequent, to varying degrees of painful urination;
• discharge from the urethra.

Progressive inflammation of the prostate gland is accompanied by a gradual deterioration of erection, which is associated with damage to the nerve endings that pass through the prostate and are responsible for erectile function.

Diagnostics

At your request, the doctor of our clinic can prescribe examinations that will help to make an accurate diagnosis and choose the optimal treatment. If the doctor, based on the symptoms, has reasonable assumptions that the patient has prostatitis, then he will recommend passing:

If necessary, a prostate biopsy may be required.

Treatment

The most modern equipment, extensive experience and the highest qualifications of the urologists of our clinic allow, after the diagnosis is made, to choose the optimal and most effective treatment.The complex of therapeutic measures includes:

• drug therapy using antibacterial and antiviral drugs;
• physiotherapy procedures to improve blood circulation;
• therapeutic exercises and massage;
• Strengthening the immune system.

The duration of the course of treatment depends on the neglect of the disease at the time of treatment, but rarely is more than 20 days.

How to avoid prostatitis?

Weakened immunity, regular and prolonged stress, alcohol abuse, smoking, sexually transmitted infections, a sedentary lifestyle, irregular sex life with periods of high activity and periods of prolonged abstinence – these are all factors that can be overcome to significantly reduce the risk of you have prostatitis.

If you have any symptoms that accompany prostatitis, you should immediately consult a doctor. Our clinic in St. Petersburg employs specialists in men’s health of the highest level. With timely treatment, they will definitely help you get rid of prostatitis forever and prevent possible complications.

See also : Visiting a urologist.

Chronic prostatitis: treatment of the disease | Clinic Rassvet

Fast passage

Chronic (bacterial) prostatitis is characterized by persistent or recurrent urogenital symptoms with confirmed bacterial infection in the prostate gland.

Prostatitis of this category occurs infrequently, in about 10% of all cases of prostatitis. The question – can atypical pathogens, such as ureaplasma (ureaplasma urealiticum), provoke inflammation of the prostate – is being discussed. They can be present in a man’s body without any signs of inflammation or complaints.

Causes of chronic prostatitis

The causes of chronic prostatitis are basically similar to those of acute bacterial prostatitis.The ingress of microorganisms into the prostate in most cases occurs through the urethra – as a result of the throwing of urine into the ducts of the prostate gland (intraprostatic reflux of urine).

Chronic bacterial prostatitis develops as a result of inadequate treatment or a short course of treatment for acute bacterial prostatitis.

Symptoms

• Discomfort or pain – in the perineum, lower abdomen, groin, scrotum, penis, during ejaculation
• Changes in urination – difficulty urinating, frequent urination in small portions, a feeling of incomplete emptying of the bladder.

A patient may complain about a number of symptoms or a symptom in isolation. An increase in body temperature is uncharacteristic (or insignificant).

Important:

Many men associate erectile dysfunction with prostatitis. This is often facilitated by unprofessional publications in the media and advertising of dubious drugs. The fact that an erection can persist even with complete removal of the prostate (due to the presence of a malignant tumor of the organ) suggests that it itself does not play a role in maintaining an erection.

According to many respected urologists, erectile dysfunction in patients with chronic prostatitis is due to psychogenic and neurotic problems.

Diagnostics

For the initial assessment, the NIH-CPSI questionnaire is used – the index of symptoms of chronic prostatitis. It can be used to objectify the patient’s complaints.

The standard method for diagnosing prostatitis is to perform a 4-glass Meares-Stamey test. This is a microscopic and bacteriological examination of urine samples obtained from different parts of the genitourinary tract and prostate secretions.However, the 4-glass sample method is rather laborious, and currently modifications of the Meares-Stamey samples are more often used: 3-glass or 2-glass sample. A possible alternative is the delivery of the ejaculate (sperm) for microscopic and bacteriological examination, since the ejaculate partially (at least 1/3) consists of the secretion of the prostate gland. This method is more comfortable for patients, especially if they categorically refuse a rectal examination or diagnostic massage of the prostate gland in order to obtain prostate secretions.However, the delivery of ejaculate has a lower information content and reliability in comparison with a 3-glass or 2-glass sample.

The delivery of ejaculate for bacteriological examination is included in the diagnostic algorithm for infections of the male genital organs and when examining a man for infertility.

The results of laboratory tests (general urine analysis, general blood analysis, biochemical blood test, spermogram and other general clinical tests) are not informative in the case of chronic prostatitis.Most likely, these analyzes will show “normal”.

During rectal examination, changes indicating an inflammatory process in the prostate are not always observed in patients with chronic prostatitis. That is, it is impossible to rely on the result of a rectal examination for the diagnosis of chronic prostatitis.

The same is true for ultrasound diagnostics: it is incorrect to diagnose chronic prostatitis, focusing only on ultrasound data. The European and American Urological Association does not recommend performing ultrasound for the diagnosis of prostatitis.The type of execution in this case is not important – transabdominal (through the anterior abdominal wall – the lower abdomen) or transrectally (TRUS – through the rectum). Writing in the conclusion of ultrasound examination “chronic prostatitis”, “ultrasound signs of chronic prostatitis”, “signs of congestive prostatitis” is wrong. The prerogative of establishing this diagnosis is only with the urologist, who determines it on the basis of complaints, anamnesis, laboratory tests and – only after – an ultrasound scan.

The most frequent ultrasound symptom by which chronic prostatitis is diagnosed is the so-called diffuse changes in the prostate gland associated with the postponed inflammatory process or other changes in the prostate parenchyma.This is a kind of fibrotic process, replacement of the normal parenchyma of the prostate with scar tissue. However, there is no correlation between the number of fibrotic changes in the prostate and the presence of complaints. . With age, the chances of the appearance of such “scars” in the organ increase, but a man can live his whole life without feeling any discomfort in the perineum or pubic area. Nevertheless, as soon as the ultrasound reveals these changes, some “specialists” will diagnose prostatitis. And some men will have a feeling that they are really seriously ill, they will begin to listen to themselves, they will feel all the symptoms described on the Internet.

In many men over the age of 30, ultrasound may show diffuse changes in the prostate gland. However, the fibrotic process does not indicate the presence of prostatitis.

The diagnosis of chronic prostatitis is established on the basis of exclusion of other diseases of the genitourinary system – primarily urethritis, prostatic hyperplasia, urethral stricture, neurogenic urinary disorders, prostate cancer, and bladder cancer.

There is no specific pattern for chronic prostatitis on routine examination.

Treatment of chronic prostatitis

Antibiotics of the fluoroquinolone group (Ciprofloxacin, Levofloxacin) are optimal antimicrobial drugs for the treatment of chronic bacterial prostatitis. The recommended course of antibiotic therapy is 4 to 6 weeks. Such a long course is justified by scientific data indicating a decrease in the likelihood of relapse of the disease.

In case of identified sexually transmitted infections (STIs), such as chlamydia trachomatis, an antibiotic of the macrolide group (Azithromycin, Clarithromycin) is prescribed.

There is evidence of decreased relaxation of the bladder neck in patients with chronic prostatitis, which leads to reflux of urine into the prostatic ducts in the urethra and causes inflammation of the prostate tissue and pain. Such patients are recommended to prescribe alpha-blockers (Tamsulosin, Silodosin).

When treating chronic prostatitis, it is advisable for patients to refrain from tempting offers for the use of herbal medicine. A feature of dietary supplements and herbal supplements is the instability of herbal components in a portion of the substance, they may differ even in the preparation of the same manufacturer.In addition, from an evidence-based medicine perspective, the benefits of herbal medicine do not hold water.

Prostate massage, which was used as the basis of therapy in the middle of the 20th century, today, thanks to new scientific approaches and the Meares-Stamey classification, remains an important tool for diagnosing prostatitis, but not for its treatment. It is not necessary to use prostate massage as a therapeutic procedure (the effect has not been proven). There are suggestions that frequent ejaculation is similar in its properties to sessions of therapeutic massage of the prostate.

Other methods that have been proven effective in just one or a few studies or are still being investigated include:

• Pelvic Floor Muscle Training – Some evidence suggests that specific exercises are effective in reducing symptoms of chronic prostatitis and chronic pelvic pain syndrome;

90,073 Acupuncture – Few studies indicate the benefit of acupuncture over placebo in patients with chronic prostatitis;

• extracorporeal shock wave therapy – based on the effect of significant amplitude acoustic impulses on connective and bone tissue, is widely used in the treatment of diseases of the musculoskeletal system, has recently been used in urology, its effectiveness is under study;
• Behavioral therapy and psychological support – Since chronic prostatitis is associated with poor quality of life and the development of depression, these methods can improve the patient’s psychological well-being and help reduce some of the symptoms of the disease.

We should also mention asymptomatic (asymptomatic) chronic prostatitis . The diagnosis is most often established by the results of a histological report – after a prostate biopsy performed or after surgical treatment of the prostate. The frequency of detecting inflammation in the tissues of the prostate varies from 44% (with prostate biopsy) to 98-100% (after surgical treatment of the prostate). Scientists suggest that the inflammatory changes identified in this way are nothing more than an age-related physiological feature.Nobody is specifically engaged in diagnostics of this category of prostatitis, this is a kind of accidental find. It does not need treatment, it does not require any further action on the part of the doctor and the patient.

How is chronic prostatitis treated at the Rassvet clinic?

Over the past 10 years, 47 monographs have been published in Russia and 64 candidate and doctoral dissertations on prostatitis have been defended. Not to mention the various “popular” publications, which colorfully describe the causes, diagnosis and various methods of treating the disease.What does this mean? The fact that the topic of prostatitis raises a lot of questions, and some, unfortunately, still have no clear answer. There are a large number of modern drugs, the effect of which has been proven. However, there are no fewer patients diagnosed with chronic prostatitis.

That is why, when diagnosing and treating prostatitis, Rassvet urologists are trying to get the most complete picture. They ask the patient in detail about the signs and symptoms, study the results of previous examinations, pay attention not only to the clinical signs of the disease, but also to other aspects of health, including the neurological and psychological state of the patient – since it can provoke the onset of characteristic manifestations.At the same time, unnecessary tests and studies are not prescribed. If surgical treatment is required, our urologists perform a surgical operation on the territory of the Rassvet partner clinic.

Author:

90,000 why the disease occurs in young people and how to treat it

The prostate is a small, walnut-sized gland located just below the bladder in men and surrounding the urethra, the hollow tube that drains urine from the bladder.The prostate gland produces a secretion that increases the volume of semen and makes it more fluid. This is important because sperm diluted with prostate secretions increases the chances of a successful conception.

Prostatitis is a disease of the prostate gland in which the patient complains of frequent, difficult urination, pain in the perineum, scrotum or penis. These symptoms can occur after using the toilet or during ejaculation. But some patients with prostatitis may not even be aware of their illness, since they may not have any unpleasant symptoms.In this case, the disease is discovered by chance, when the patient turns to the urologist for some other reason, for example, because of infertility.

Three facts about prostatitis

According to various estimates, prostatitis occurs in 2.2-9.7% of men. This is comparable to the incidence of coronary heart disease and diabetes mellitus.

Prostatitis can be contracted at any age, but men aged 30-50 are more likely to suffer.

For some people, prostatitis symptoms go away on their own over time.However, this does not mean that the disease can be ignored and left untreated. After a while, prostatitis may return, worsen or become chronic – in this situation, the disease lasts for months, and its symptoms recur again and again.

Why does prostatitis occur

Inflammation of the prostate gland is bacterial and abacterial (that is, not associated with the effects of bacteria).

Bacterial prostatitis

The disease is caused either by pathogenic microbes that most often affect the genitourinary tract, such as E. coli, Proteus or Klebsiella.In addition, sexually transmitted infections can lead to the development of bacterial prostatitis, for example, chlamydia – causative agents of chlamydia, ureaplasma – causative agents of ureaplasmosis, Trichomonas – causative agents of trichomoniasis and neisseria – causative agents of gonorrhea.

Bacterial prostatitis is acute, when the disease begins suddenly, with severe symptoms such as severe pain and fever, or chronic, when symptoms of the disease appear or disappear within three or more months.

Abacterial prostatitis

Abacterial prostatitis is considered today as one of the variants of chronic pelvic pain syndrome. The reasons for this condition are varied. According to some reports, the problem may be associated with incomplete relaxation of the urinary sphincter – because of this, pressure in the bladder increases. As a result, part of the urine enters the prostate and provokes an inflammatory reaction there. Even more often, “prostatitis-like” symptoms are caused by stimulation of the pelvic nerves as a result of problems in the lumbosacral spine (for example, with a herniated disc) – as a result, we are dealing with chronic pelvic pain without inflammation.

In addition, it is believed that stress can also increase the risk of developing this condition.

Prostatitis, especially bacterial, can be found in any man. At the same time, there are factors that increase the risk of developing the disease:

• in the past, the patient has already suffered from prostatitis;

90,073 a person was diagnosed with a urinary tract infection;

90,073 the patient had a pelvic injury, recently had a prostate biopsy or had a urinary catheter inserted;

• the patient has weak immunity, for example, against the background of HIV or AIDS.

How to recognize prostatitis

Symptoms of prostatitis depend on what form of the disease is found in the patient. So, among the symptoms of acute bacterial prostatitis may be the following:

• feeling unwell, fever, chills – similar to the flu;
• Pain in the perineum, during ejaculation, in the scrotum, in the anus, in the lower abdomen and sometimes in the muscles;
• often want to go to the toilet, especially at night, while urinating is painful, difficult or impossible at all;
• Urine may be cloudy or bleeding.

In chronic bacterial prostatitis, symptoms are similar, but are usually milder and last at least three months. The main symptom of abacterial inflammatory prostatitis is pelvic pain, including with ejaculation. Sometimes it is difficult for a person to go to the toilet. Although pain is usually less severe than with acute bacterial prostatitis, the disease still significantly impairs quality of life.

It is difficult to independently distinguish bacterial from non-bacterial prostatitis.However, patients do not need to do this – a doctor must make an accurate diagnosis. It is enough to remember three signs of prostatitis: pelvic pain, difficult or painful urination, and painful ejaculation. If these symptoms appear, you should see a doctor as soon as possible.

How is prostatitis treated

The tactics of treating prostatitis depends on the cause of the development of the disease. To distinguish bacterial from non-bacterial prostatitis, before starting treatment, the doctor will prescribe a general analysis and culture of prostate secretions or urine obtained immediately after prostate massage and containing prostate secretions.In some cases, there is also a blood test for the level of prostate-specific antigen (PSA). These tests can detect signs of an inflammatory process. In addition, urologists often prescribe tests for sexually transmitted infections, because their pathogens can also cause prostatitis.

In some cases, urologists and urologists prescribe additional tests, such as computed tomography of the urinary tract, ultrasound examination (US) of the prostate, or cystoscopy, in order to differentiate with other diseases that have symptoms similar to prostatitis.In this procedure, a doctor examines a patient’s urinary tract using a cystoscope, an instrument that looks like a long, thin tube.

Konstantin Lokshin, urologist-andrologist, GMS Hospital:

Bacterial prostatitis is treated with antibiotics and drugs that improve urination. The duration of treatment is usually 2 to 4 weeks.

Other therapies don’t work. For example, these days prostatitis is no longer treated with prostate massage.Many of the physiotherapy procedures, in general, also do not have any evidence base, so it is useless to do them.

Treatment of prostatitis, which is not associated with a bacterial infection, usually focuses on eliminating the unpleasant symptoms of the disease – that is, reducing pain, discomfort, and inflammation. For each patient, therapy must be selected individually.

How to avoid the development of prostatitis

Konstantin Lokshin, urologist-andrologist, GMS Hospital:

There are three ways to avoid prostatitis:

• Have sex regularly.A harmonious intimate life is the most reliable way of prevention.
• Use a condom. This primarily applies to people who have many sexual partners. A condom is needed so as not to get infected with sexually transmitted diseases, due to which the disease most often develops.
• Avoid severe hypothermia, which also contributes to bacterial prostatitis.

What in the end

Prostatitis is a disease of the prostate gland in which the patient complains of pelvic pain, difficulty or painful urination, and / or painful ejaculation.If you develop any of these three symptoms, you should see your doctor as soon as possible.

Bacterial prostatitis is treated with antibiotics and drugs that improve urination. The duration of treatment is usually 2 to 4 weeks. The effectiveness of prostate massage and physical therapy has not been proven.

To avoid prostatitis, you need to strive to have a regular sex life, do not forget about condoms and avoid severe hypothermia.

Treatment of infectious prostatitis in Moscow

Infectious prostatitis is caused by penetration of pathogens into the gland structures and their active reproduction. The disease is diagnosed in men of any age. Pathology is acute and chronic. Acute infectious process begins with pronounced symptoms such as painful urination, pulling pain in the lower abdomen, an increase in body temperature. Chronic infectious prostatitis develops for a long time, can be triggered by an untreated acute form, is characterized by stages of remission and exacerbations.Treatment of infectious prostatitis in men should be comprehensive and carried out under the constant supervision of a urologist. If there is no therapy, serious complications develop, up to impotence, infertility, and prostate cancer. At the Medline Medical Center you can use the professional services of experienced urologists who will quickly determine an accurate diagnosis and select the most effective treatment that will help prevent any complications.

What is infectious prostatitis

Infectious prostatitis – inflammation of the prostate gland provoked by pathogenic microflora, which include:

• bacteria;

90,073 viruses;

• fungi.

The disease is more often diagnosed in mature men over the age of 45. The routes of infection to the prostate gland are different:

• through the urethra;
• blood flow from other foci of infection;
• through the bladder.

After the penetration of the pathogen into the same prostate, an acute infectious process develops, accompanied by pronounced symptoms. The characteristic signs of infectious prostatitis are as follows:

• pulling, aching pains radiating to the lower abdomen, perineum, anus;
• increased urge to urinate;
• feeling of incomplete emptying of the bladder;
• the presence of pathological inclusions in urine and semen: mucus, pus;

90,073 problems in sexual life: lack of erection, untimely ejaculation, inability to achieve orgasm;

• swelling and redness of the mucous membrane of the penis.

Abnormal symptoms such as:

• increase in body temperature;
• deterioration in general health;

90,073 muscle pain;

• causeless fever, chills.

If for 3 – 4 days the pathological symptoms persist, and the causes of its occurrence are not clarified, it is necessary to urgently consult a doctor and take tests. The earlier the problem is identified, the easier and faster it will be possible to get rid of it.

Prostatitis infections in men

The root cause provoking infectious prostatitis is an infection that has penetrated the tissue of the gland. If the immune system works smoothly, it destroys pathogens, preventing them from actively multiplying. But at the slightest failure, the immunity ceases to fully perform its functions, as a result of which the infection almost unhindered penetrates the body and affects the target organs.

Factors that can trigger the progression of the inflammatory process are:

• the presence of chronic foci of infection prone to frequent relapses;

90,073 promiscuous sex, unprotected sex;

• non-observance of personal hygiene rules;
• hormonal and endocrine imbalance;
• congenital or acquired immunodeficiency;
• hypothermia;
• stress, physical and psycho-emotional overwork;
• an inactive lifestyle, which leads to stagnant processes in the pelvic organs;
• abuse of bad habits: alcohol, cigarettes, illegal substances.

Classification

Depending on what type of infection provoked the disease, the following types of prostatitis are distinguished:

• Viral. It occurs against the background of human infection with the herpes virus in the presence of the papilloma virus. The disease is almost impossible to diagnose in the early stages, due to the lack of timely treatment, it turns into a chronic form that cannot be completely cured. During the period of remission, the pathogen is in a latent state without causing any symptoms.But at the time of relapse and activation of the infection with prostatitis in men, itchy vesicles appear on the penis, the prostate gland becomes inflamed, the composition of its secretion changes, which can be detected in laboratory research.
• Bacterial. There are infectious nonspecific, specific and polymicrobial. Infectious nonspecific is most often caused by E. coli, staphylococcus, streptococcus. The pathogen joins and develops in already damaged structures of the gland, therefore it is considered a secondary factor provoking inflammation.Infectious specific prostatitis develops against the background of damage to the tissues of the gland by such pathogens as Trichomonas, ureplasma, gonococcus, mycoplasma, tubercle bacillus, syphilis. With polymicrobial, specific and nonspecific pathogens are combined.
• Fungal. Prostatitis of this variety is mainly caused by yeast fungi of the genus Candida, less often the gland is affected by other types of fungus – Aspergillus, Blastomycetes, Histoplasma capsulatum. Fungal infection refers to a conditionally pathogenic microflora that robs the body of any healthy person.The growth and activity of the pathogen is controlled by the immune system, but at the slightest malfunction, the fungi are activated, causing acute inflammation. External signs of fungal prostatitis are redness, swelling, itching, white bloom on the mucous membrane of the penis.

Taking into account the nature of the course, acute and chronic infectious prostatitis are distinguished. The acute form occurs suddenly, manifests itself with characteristic clinical signs, with timely diagnosis, it can be successfully treated. Chronic infectious prostatitis can develop asymptomatically for years, destroying the structure of the gland and leading to irreversible consequences.The relapsing form cannot be completely cured, but correctly selected drug therapy and adherence to the rules of prevention will help prolong remission for many years

Features of the course of the disease

Prostatitis, occurring in the acute stage, is characterized by a pronounced clinical picture:

• pain in the groin and lower back;

90,073 frequent and painful urination;

90,073 discomfort during intercourse and ejaculation;

• traces of blood in the urine;

90,073 increase in body temperature;

• chills, fever, general malaise.

If treatment is not started promptly, individual lobules of the prostate are affected. In advanced cases, inflammation spreads to the entire tissue of the gland, which leads to an abscess and death of the patient.

In chronic course, periods of remission are replaced by exacerbations. At the time of relapse, symptoms resemble an acute course:

• aching, pulling pains in the groin, radiating to the lower back, inner thigh, pubic area;
• Frequent, difficult urination;
• decreased potency;
• impaired fertility caused by a decrease in sperm quality;
• pathological inclusions in urine: blood, mucus, pus particles;

90,073 increase in body temperature.

Diagnosis of infectious prostatitis

The diagnosis and treatment of infectious prostatitis is monitored by a urologist. It is to him that you need to make an appointment for a consultation if suspicious symptoms bother you. At the initial appointment, the doctor will listen to complaints, collect all the necessary information, conduct a digital rectal examination, with which you can quickly obtain information about the state of the prostate gland. If the prostate is enlarged and causes acute pain on palpation, it means that inflammation is progressing in its tissues.

To confirm the diagnosis and determine the type of infectious agent, a referral is given for an additional diagnostic examination, including the following procedures:

• general clinical analysis of urine for leukocytes, protein and bacteria;
• microscopic examination of the ejaculant;
• study of prostate secretion, urethral smear for leukocytes and the presence of pathogens;
• cytological and bacteriological examination of a urine sample;
• determination of the level of PSA – a specific prostatic protein;
• transrectal ultrasound examination;
• cystoscopy.

Based on the test results, the doctor determines the diagnosis, finds out the type of infectious prostatitis, and then selects an individual therapy regimen.

Infectious prostatitis treatment – cost

The cost of treating prostatitis of an infectious nature depends on the degree of neglect of the disease, the therapeutic methods used, the presence of concomitant complications, etc. Broad-spectrum antibiotics are prescribed for the treatment of bacterial prostatitis:

• fluoroquinolones;
• macrolides;
• tetracyclines.

If the inflammation of the prostate gland is caused by a fungal infection, drug therapy is based on the use of antifungal drugs:

• Fluconazole;
• Intraconazole;
• “Amphotericin”.

Treatment of viral prostatitis is based on the use of antiviral drugs:

• “Acyclovir”;
• “Gerpevir”;
• Zovirax.

In the treatment of all forms of infectious prostatitis, immunomodulators are necessarily prescribed, which restore the protective functions of the body and increase resistance to pathogens.To combat immunodeficiency, the following drugs are used:

• Interferon;
• “Immunofan”;
• Galavit.

In addition, preparations of the group of non-steroidal anti-inflammatory drugs are prescribed, which have anti-inflammatory, analgesic, antipyretic properties:

• Nurofen;
• “Ibuprofen”;
• Nimesil.

In order to accelerate recovery and recovery, it is recommended to undergo a course of physiotherapy procedures as an adjunct to the main drug therapy, such as:

• electrophoresis;
• UHF;
• laser or magnetic therapy;
• ultrasound;
• inductothermy;
• mud baths;
• manual massage of the prostate gland;
• hirudotherapy;
• acupuncture.

After the condition is completely normalized, it is important to adhere to the rules of prevention, which will help prevent re-inflammation of the prostate gland. to prevent infectious prostatitis, it is important to lead a regular, protected sex life, timely treat viral and infectious diseases, preventing their transformation into a chronic form, maintain immunity, and lead a healthy lifestyle.

Medical center “Medline” offers a wide range of services for the treatment of acute and chronic infectious prostatitis.Our urologists will provide professional medical care to any man who is faced with this unpleasant disease. The prices here are affordable and affordable for every patient. We work seven days a week and are ready to receive you any day. To clarify the cost and make an appointment with a specialist, call 7 (495) 236 96 48 or order a call back. As soon as our administrators see your request, they will immediately call you back and answer all your questions.

See also:

90,000 Prostatitis, chronic prostatitis.Prostatitis treatment – clinic Androcenter

One of the most common urological diseases in men is inflammation of the prostate gland (prostatitis). According to statistics, men under the age of 50 suffer from prostatitis. Most often, inflammation of the prostate gland is primarily chronic, that is, it appears without a visible acute onset.

Prostatitis is often characterized by severe pain symptoms, neurotization of the patient, the development of persistent disorders of urination, sexual disorders, infertility.Therefore, timely and reliable diagnosis, as well as complete treatment of prostatitis, is extremely important. There are several types of this disease.

Classification and criteria for prostatitis (NIDDK, 1995)

9079

leukocytes in the secretion of the prostate gland (> 10 in p / sp.microscope)

Category I
Acute bacterial prostatitis	Acute symptomatic bacterial infection
Category II	Recurrent prostatic infection
Category III
Chronic Pelvic Pain Syndrome (CPPS)	No overt infectious agents
Type IIIA
	Type IIIA
	Type IIIA
IIIB
Non-inflammatory type	Normal leukocyte count in the secretion of the prostate gland (> 10 in the field of microscope)
Category IV
No subjective symptoms. It is revealed by chance during a preventive examination

The so-called reflux (reflux) of urine into the prostatic ducts is recognized as the main mechanism of the onset of prostatitis.The ducts that drain the prostate glands enter the urethra horizontally or obliquely against the flow of urine. This feature can contribute to the throwing of urine into the ducts of the glands, impaired secretory function and infection. Urine causes increased mucus production and desquamation of cells. Due to the strong irritant effect and acidic reaction of urine, the viscosity of the prostatic secretion increases. Ultimately, “plugs” are formed in the prostate gland, containing dead cells, fibrin, leukocytes, urine salts, which is accompanied by a violation of the drainage and secretory functions of the organ and the formation of closed microcavities, where conditions are created for the long-term existence of pathogenic and opportunistic microflora.

Acute bacterial prostatitis

Acute bacterial prostatitis is caused mainly by aerobic gram-negative microorganisms. Most often – in 80% of cases – Escherichia coli is found. Pseudomonas aeruginosa, Serratia, Klebsiella and Proteus cause acute prostatitis in 10-15% of cases, enterococci are secreted in another 5-10%.

Clinical manifestations. Acute bacterial prostatitis is characterized by high fever and chills, severe pain in the rectum, perineum, lumbosacral region, severe urinary disorders.Swelling of the prostate gland can lead to acute urinary retention. The disease proceeds against the background of general malaise, pain in joints and muscles.

Diagnostics. The diagnosis of acute prostatitis is often made on the basis of characteristic symptoms, as well as the results of clinical and instrumental examination. Any diagnostic manipulations involving a mechanical effect on the prostate gland (four-glass test, secretion analysis) are contraindicated in order to avoid the spread of infection, as well as because of severe pain.

Treatment. Acute inflammatory process dictates the need for immediate prescription of antibiotic therapy until the results of bacteriological research are obtained. Antibiotics are prescribed empirically, often in combination, based on their effectiveness against gram-negative microorganisms and enterococci. As symptomatic agents, analgesics, antipyretics, laxatives, rehydration agents are prescribed, bed rest is recommended. Antibiotic therapy should be intense and long enough to avoid both suppuration and chronicity of the infectious process.

Chronic bacterial prostatitis

In chronic prostatitis, Escherichia coli (56%), enterococci (26%), Klebsiella (20%) Pseudomonas aeruginosa (8%) Proteus mirabilis (8%) are most often found. Recently, however, there has been a growing interest in the so-called atypical pathogens – chlamydia, mycoplasma, ureaplasma, viruses, trichomonads and fungi.

The penetration of microflora into the ducts of the prostate gland occurs mainly due to the above-mentioned urethro-prostatic reflux of urine.The pathways of infection through the blood and lymphatic vessels are also not excluded. In a significant number of patients, microcalcifications and prostate stones, often detected by ultrasound, are the source of the constant presence of infection.

Clinical manifestations. A combination of pain and urinary disorders is typical of chronic bacterial prostatitis. Painful sensations are noted by patients in the supra- and sub-pubic region, in the perineum, sacrum, sometimes accelerated and painful ejaculation is noted.Disorders of urination are manifested in its frequency, urination at night, a feeling of incomplete emptying of the bladder, an intermittent stream of urine.

Diagnostics. The diagnosis of chronic bacterial prostatitis is based on the results of examination of the patient, microscopic and bacteriological examination of the secretion of the prostate gland, ultrasound data.

Treatment. Chronic prostatitis is extremely difficult to treat. Antibacterial, anti-inflammatory, absorbable and antispasmodic agents are prescribed.In addition, one cannot speak of a quality treatment of chronic bacterial prostatitis without special physiotherapy. These are, first of all, finger massage of the prostate gland, vibration massage, the use of external and rectal electro- and phonophoresis of medicinal mixtures, centimeter, UHF and EHF-therapy, sinusoidal-modulated currents.

Chronic pelvic pain syndrome

Chronic pelvic pain syndrome is one of the most common and least studied types of prostatitis.The causes of this disease have not yet been convincingly established. Much attention is paid to the possible etiological role of chlamydia, ureaplasma and mycoplasma, herpes viruses. Another likely cause of chronic pelvic pain syndrome is persistent reflux of urine from the urethra into the prostate ducts. Another factor in the onset of chronic pelvic pain syndrome may be autoimmune processes. A sedentary lifestyle, irregular sex life, constant hypothermia, and rare urination can contribute to the development of this form of prostatitis.

Clinical manifestations. The clinical symptoms of chronic pelvic pain syndrome are similar to those of chronic bacterial prostatitis. Pains prevail in the perineum, testicles and penis. Disorders of urination are noted, manifested by frequent, sometimes imperative urges, weakening of the pressure of the urine stream. The disease is often accompanied by sexual dysfunctions.

Diagnostics. When examining the secretion of the prostate gland in patients with the inflammatory type of chronic pelvic pain syndrome, an increased content of leukocytes and macrophages is found.With a non-inflammatory type, pathological abnormalities are not detected. Bacteriological and molecular biological methods do not detect pathogenic microorganisms. Pronounced changes during ultrasound examination are also not noted.

Treatment. Good results are obtained by a combination of antibiotics with non-steroidal anti-inflammatory drugs and uroselective alpha-blockers. The effectiveness of treatment is significantly increased through the use of physiotherapy techniques.These are physiotherapy exercises, electrotherapy, medicinal electro- and phonophoresis, sedentary warm baths, microclysters, prostate massage. Electroneurostimulation, laser and magnetic therapy are increasingly used to relieve pain.

If you are interested in the question of how to treat prostatitis, you can get qualified advice by contacting Androcenter.

Prostatitis. Treatment of prostatitis.

Prostatitis. Treatment of prostatitis.

The word prostatitis is familiar to the absolute majority of men.Prostatitis is an inflammation of the prostate gland.
The main function of the prostate is to produce the liquid portion of the sperm, i.e. actually create conditions for the functioning of sperm, to prolong life. That is why, in case of dysfunction of the prostate gland, in addition to the actual symptoms of prostatitis, male infertility develops more and more often, as acidity increases, the hormonal and trace element composition of the secretion is disturbed, leukocytes and many other factors of inflammation appear.Sperm in such harsh conditions naturally lose their ability to fertilize.

Causes of prostatitis

It is a mistake to think that the main cause of prostatitis is infection. Of course, the infectious process is always present in the inflamed organs, but in the case of prostatitis –
infection is usually the trigger for the development of the disease. This explains the extremely low effectiveness of traditional treatment of prostatitis with antibiotics. In the future, inflammatory edema of the excretory ducts, stagnation of secretions in the gland are the main reasons for the maintenance of inflammatory phenomena.
Only an understanding of the mechanisms of development and maintenance of inflammation in each specific case can effectively cure such patients.
Other provoking factors include smoking, alcohol, physical inactivity, inaccuracies in nutrition, stress. But this, it seems to me, is already known to everyone.
Symptoms of prostatitis, according to the severity of certain manifestations of the disease, can be conditionally divided into three parts.
1. Pain (pain or discomfort, depending on the severity of the disease, may be
groin, pubic area, lower back, perineum, in the scrotum, in the penis, in the area
kidneys).
2. Violation of urination (difficulty in the flow of urine, night trips to the toilet, pain or
cramps when urinating, sometimes complete cessation of urination).
3. Sexual dysfunctions (erectile dysfunction, premature ejaculation, difficult ejaculation – up to complete cessation, decreased libido) Strictly speaking, the localization of pain sensations, as well as their intensity, are always individual and determined by the characteristics of a particular organism – the type of nervous activity, age, features of the innervation of the organ …In some cases, patients come with “non-painful” complaints – urination disorders, sexual problems.
The prostate gland is located just below the bladder and the urethra runs through the thickness of the prostate. The gland, as it were, covers the initial part of the urethra. Therefore, with inflammation of the prostate, swelling of the gland often occurs, which causes compression of the urethra. Hence, all sorts of symptoms of urinary disorders, the subsequent development of a neurogenic bladder.
With long-term inflammation, the sensitivity of the receptors to testosterone first changes. And then, at the next stage of the disease, the level of the male sex hormone itself, testosterone, decreases. What, in fact, causes these or those sexual disorders.
A decrease in testosterone levels seems to be a defensive reaction of nature, which limits the reproduction of sick individuals.

Now about the treatment of prostatitis.
Prostatitis can and should be treated.But for this you need to understand what is happening in the prostate gland. No matter how trite it may sound, each case is unique, how unique each of us is. And the standard schemes in this case do not lead to good. Of course, taking antibiotics will stop almost any inflammation. But then what? You can imagine what happens in the body with long-term intake of poisons. Serious changes take place, sometimes irreparable, which then for years and decades cause persistent changes in well-being and quality of life.