Prostatitis

Symptoms Of Prostatitis

The term 'prostatitis' is used to describe four different conditions that affect the prostate gland. Only two of these are related to urinary tract infections (UTIs).

The signs and symptoms of prostatitis vary depending on the cause. Moreover, many symptoms of prostatitis are common to those of other conditions. Based on the type of prostatitis, the symptoms which a person may experience are:

Type 1: Acute bacterial infection or acute bacterial prostatitis (ABP)

Type 1 prostatitis is an acute bacterial infection. Its signs & symptoms have an abrupt onset and it is caused by an ascending urinary tract infection. This means that the bacteria which cause the urinary tract infection travels up the urethra and infect the surrounding areas, including the prostate gland. 

The symptoms of type 1 prostatitis include:

• Fever
• Myalgia (muscle pain) 
• Malaise (generalized feeling of being unwell)
• Lower urinary tract symptoms (LUTS) like urgency, frequency, and dysuria (burning sensation)
• Nocturia (frequent urination during periods of sleep)
• Nausea and vomiting
• Pain, which may be severe, in or around your penis, testicles, anus, lower abdomen or lower back – pooing can be painful
• Pain when peeing, needing to pee frequently (particularly at night), problems starting or "stop-start" peeing, an urgent need to pee and, sometimes, blood in your urine
• Lower back pain and pain on ejaculation

Type 2: Chronic bacterial infection or chronic bacterial prostatitis (CBP)

The symptoms of type 2 prostatitis or CBP are similar to ABP (type 1), except the symptoms are chronic, recurrent, and less severe. It is caused by a bacterial infection, specifically by recurrent urinary tract infections and previous ABP. Often, if type 1 prostatitis is not appropriately treated, it develops into type 2 prostatitis. 

In this condition, the bacteria may form a biofilm that helps them adhere to tissues of the prostate gland. This gelatinous film also protects the bacteria from antibiotics and immune system attacks.  

The symptoms of type 2 prostatitis include:

• Pain during and after ejaculation
• Sexual dysfunction
• Infertility
• A weak or an interrupted urine stream
• Urinary blockage
• An enlarged or tender prostate on rectal examination
• Sexual problems such as erectile dysfunction or pelvic pain after sex

Type 3: Chronic sterile inflammation/chronic pelvic pain syndrome

Type 3 prostatitis is the most common prostatitis. It is called sterile prostatitis because it is not caused by bacterial infection, and so it does not have type 1 and type 2 symptoms like increased urgency and frequency of urination. 

Chronic sterile inflammation is caused by the obstruction of the urinary bladder outlet or by reflux of urine within the prostate gland due to enlarged prostate or some stone in the way.

Symptoms are similar to type 2 prostatitis but also include:

• Chronic pelvic pain may affect the penis, scrotum, and perineum areas  
• Urinary retention
• Difficulty in passing urine
• A weak or an interrupted urine stream

Type 4: Asymptomatic inflammatory prostatitis

Type 4 prostatitis is asymptomatic, i.e., it has no condition indicating symptoms. There may be some mild inflammation within the prostate gland.

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Causes Of Prostatitis

Prostatitis is more often caused by a bacterial infection resulting from a UTI or procedures like catheter insertion, prostate biopsy, or other urological intervention. 

Bacterial prostatitis is generally more difficult to treat than a simple urinary tract infection and often requires a prolonged course of antibiotics. 

In certain cases, the underlying cause of prostatitis may not be found, and it may be a reflection of inflammatory changes around the nerves causing pain arising from the pelvis.

In such a situation, treatment often requires a more multidisciplinary approach involving physicians, urologists, and microbiologists, who try to understand the individual’s condition in-depth and ensure that it's adequately treated.

The common cause for bacterial or nonbacterial prostatitis are:

1. Inflammation of the genitourinary system 

2. Chronic pelvic floor tension

3. Muscle dysfunction

4. Autoimmune diseases

5. Pelvic floor muscle spasms

6. Stress

7. Bladder infections or bladder stones

8. Surgery or biopsy requiring the use of a urinary catheter

9. Prostate stones

10. Urinary retention (not emptying the bladder)

11. Urinary tract infections (UTIs)

12. Sexually transmitted infection (STI)

Another problem that could occur in the prostate is prostate enlargement, which is:

1. Most often non-cancerous (also referred to as benign prostatic hyperplasia or BPH)

2. In some patients, enlargement of the prostate is cancerous (prostate cancer)

3. Likely related to hormonal changes in testosterone and estrogen levels. 

Benign prostatic hyperplasia or BPH is the most common form of an enlarged prostate. The prevalence of BPH increases with:

1. Increasing age, on an estimate 50 to 60% of male patients in their 60s are affected by BPH, and these rates increase as the patient gets older. 

2. There is an increased risk in individuals with metabolic syndrome and obesity. 

BPH is a medical condition that commonly occurs in older men. Read more about its causes, symptoms and treatment.
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Risk Factors For Prostatitis

The prostate is around the size of a walnut and is located near the base of the penis. It encircles the urethra (the tube that urine comes from). 

For unknown causes, the prostate continues to get larger as a man ages, which is the source of urinary problems that affect half of the men by the age of 60 and practically all men by the age of 80.

The exact cause of prostatitis isn’t confined to one thing, but the following are some more risk factors for the development of prostatitis:

1. Having experienced prostatitis in the past

2. Having had a recent bladder infection

3. Infections of the bladder or the tube that carries sperm and urine to the penis (urethra)

4. Having pelvic trauma, such as a bike or horseback riding accident

5. Using the tube inserted into the urethra to empty the bladder (urinary catheter)

6. Infection with HIV/AIDS

7. Enlarged prostate gland

8. Having undergone a prostate biopsy

9. Eating a lot of spicy, marinated food

10. Injury to the lower pelvis (often as a result of cycling, lifting weights, etc.)

Diagnosis Of Prostatitis

The symptoms will be examined, and a physical exam will be performed by your healthcare professional to rule out the presence of prostatitis.

Less invasive prostatitis testing may include:

1. Urinalysis: A urinalysis and urine culture are performed to look for bacteria and UTIs.

2. Urine culture and sensitivity: Finds which bacteria is causing the infection and the best medicine to treat it.

3. Sexually transmitted infections testing: Some STIs can be confirmed with a urine sample.

4. Complete blood count (CBC): A blood test detects PSA, a protein produced by the prostate gland. High levels may suggest prostatitis, BPH, or prostate cancer.

5. Digital rectal exam: Your doctor inserts a gloved, lubricated finger into the rectum to assess discomfort and inflammation in the prostate gland. This examination may include a prostate massage to get a sample of seminal fluid.

6. Prostate-specific antigen (PSA): The PSA test determines the level of prostate-specific antigen (PSA) in your blood. PSA is a protein made by the prostate gland. High PSA levels indicate prostatitis.

7. CT imaging to assess prostatic abscesses: If the patient is immunocompromised, the doctor may request a CT scan of the urinary system and prostate and a prostate ultrasonography. CT scan pictures reveal more than standard X-rays. The visual image created by ultrasound is known as a sonogram.

8. 2-glass and 4-glass tests: The 2-glass pre-massage and post-massage test and the Meares-Stamey 4-glass test are done to detect and identify pathogens causing chronic prostatitis/chronic pelvic pain syndrome.

9. Urine flow studies (urodynamics): Your urologist may also order urine flow studies or urodynamics. These help measure the strength of your urine flow. These tests also spot any blockage caused by the prostate, urethra, or pelvic muscles.

10. Transrectal ultrasound: Examine for abnormalities in the rectum and surrounding tissues, particularly the prostate. Also known as endorectal ultrasound (ERUS) and transrectal ultrasound (TRUS). An ultrasound probe is inserted into the rectum to examine the prostate.

11. Cystoscopy: A cystoscopy can detect various urinary tract issues but cannot confirm prostatitis. To examine within the bladder and urethra, your physician will use a cystoscope (a pencil-sized lighted tube with a camera at its end).  

Prevention Of Prostatitis

Prostatitis is a harmless condition (not cancerous). It does not raise your chances of developing prostate cancer. However, prostatitis-induced inflammation raises the level of prostate-specific antigens (PSA) in the blood, precisely as prostate cancer does. Additional testing can be used to discover what is causing the increased PSA levels.

Prostatitis is a condition that doctors aren't always clear about. The most common causes vary based on whether the condition is acute or chronic, infectious or inflammatory. 

An infection in your urinary tract is sometimes to blame. Sometimes, it's because of an injury or nerve damage. In many situations, doctors are unable to discover the root problem.

As a result, treating prostatitis might be difficult. It might take months, if not years, for some patients to recover.

1. Maintain good hygiene: To avoid infection, keep your pelvic area and the surrounding around it clean.

2. Stand up when possible: Extended durations of sitting put pressure on your prostate gland, which can cause inflammation over time. 

3. Move a lot: Make it a habit to exercise at least three times every week. Take regular walks, stretch, or go to the gym for a cardio class to get your blood flowing. Physical exercise can help lower anxiety, which has been related to some kinds of prostatitis.

4. Stay hydrated: Some kinds of prostatitis are caused by bacteria in the urinary tract that invades and infects the prostate gland. Drink plenty of fluids to keep urine diluted and the bladder flushed. If you have a medical condition such as chronic renal disease or congestive heart failure, consult your doctor to know about additional precautions you should follow.

5. Eat more fruits and green vegetables: Fruits and vegetables are high in nutrients to maintain health and fight infections and inflammation.

6. Limit or avoid caffeine and alcohol: Tea, coffee, carbonated drinks, and alcoholic beverages can irritate the urinary system and bladder. 

7. Manage stress: Men who experience high stress levels at work or home are more prone to develop prostatitis. Consult with a doctor to manage your emotions. Meditation and relaxation to release the tension of the body and mind may also help.  

8. Practice safe sex: Prostatitis can be caused by sexually transmitted infections (STIs). Bacterial infection can be caused by oral, vaginal, or anal intercourse with an infected partner without using a condom. 

9. Maintain healthy body weight: Being obese puts pressure on the prostate gland. Try to lose weight by eating a good diet, being athletic, and getting adequate rest.

10. See your doctor: Consult with your doctor if you notice signs like increased urinary frequency or painful urination, constipation, or painful bowel movements. These are indicators of bad prostate health.

Urinary tract infections (UTIs) should be treated as soon as possible to prevent the infection from spreading to the prostate gland and preventing prostatitis. Consult the doctor if you get discomfort in your perineum (an area extending from behind the scrotum to the anus) when sitting. You can address this issue before it progresses to chronic pelvic pain syndrome.

Here’s more on who is the right expert to consult for male sexual and reproductive health problems.
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Specialist To Visit 

The signs and symptoms of an enlarged prostate become increasingly noticeable with age. However, the degree of these symptoms does not always correspond to the severity of the prostate enlargement. 

In reality, many men with severe prostate enlargement or prostatitis have relatively minor symptoms and vice versa. A doctor should be consulted as soon as the symptoms start showing. 

Throughout prostatitis diagnosis, treatment, and follow-up care, you might deal with many specialists such as:

• Urologist

• General surgeon

Understanding what these physicians do will help you get the right treatment at the right time for your ailment. A visit to the urologist is perhaps the most usual next step when your general practitioner detects an abnormality. Urologists are the most probable surgeons to undertake prostate surgery in most places, although there may be no urologists accessible in some remote areas. In such cases, general surgeons can perform prostate surgery.

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Treatment Of Prostatitis

Treatment for prostatitis varies based on the cause and type. Treatment is not required for asymptomatic inflammatory prostatitis.

Your healthcare practitioner may use a method called UPOINT to categorize symptoms of chronic pelvic pain syndrome (CPPS) and may utilize many treatments at the same time to address only the symptoms you're experiencing.

With the UPOINT method, the condition of over 80% of males with CPPS has improved. The method is focused on these symptoms and treatments:

• Urinary: Tamsulosin and alfuzosin are alpha blockers which relax the muscles around the prostate and bladder to increase urine flow.

• Psychosocial: Stress/anxiety management can be beneficial. Counseling or medicine for anxiety, depression, and negative thinking can help some men.

• Organ-specific: Quercetin may reduce prostate inflammation and may help to ease an inflamed prostate gland or prostatitis.

• Infection-related: Antibiotics medicines help kill infection-causing bacteria.

• Neurological: Prescription pain relievers such as amitriptyline, pregabalin, and gabapentin help treat neurogenic pain. This pain may involve fibromyalgia or pain that spreads into the legs, arms, or back.

• Tenderness: Gentle massage to ease tension on tight pelvic floor muscles. This treatment can help to lessen or eliminate muscular spasms.

To treat acute & chronic bacterial prostatitis

• Antibiotics like fluoroquinolones, macrolides & tetracyclines are recommended. The dose and duration of treatment depends on the type of prostatitis.

• Surgical drainage of abscesses can also help in case of inflammation and ease the symptoms.

• Alpha-blockers are also recommended as they help to relax the muscles around the prostate and the base of the bladder.

• Anti-inflammatory agents are non-steroidal drugs to reduce pain from inflammation in the prostate or muscles. These are pain medicines (aspirin, ibuprofen, etc.) and muscle relaxers.

Other treatments

You may also require one of the following therapies at some point:

1. Urinary catheter: If you cannot urinate, a nurse may help empty your bladder by inserting a flexible tube into your urethra (the tube that takes urine from your body).

2. Prostate massage: This helps remove fluid from your prostate ducts (tubes). Getting it done twice or three times a week may be beneficial. Frequent ejaculation (the release of semen during orgasm) may help just as much.

3. Pelvic floor physical therapy: Prostatitis can be linked to problems with your pelvic floor muscles. Pelvic floor physical therapy is a way to learn how to relax certain muscles in your pelvis. It is done with an expert to help you lessen tension in your pelvic floor muscles. These aid with sexual function and support your bladder and intestines.

4. Mental health therapy: Stress, depression, and a sense of helplessness may all play a role in some kinds of prostatitis. Speak with your mental health professional. They can teach you how to regulate your negative thoughts and therefore feel better. If your prostatitis disturbs your mood and you feel down, sad, or worried, your doctor may recommend antidepressant medication or send you to a counselor. Joining a support group and conversing with other people who have prostatitis might also improve your mood.

5. Treatments for sexual dysfunction: Speak with your doctor if your prostatitis creates issues in your sex life, such as trouble getting or maintaining an erection. There is help available, as well as ideas to try that may work well. Your doctor may, for example, prescribe sildenafil or tadalafil.

Home-care For Prostatitis

Natural home remedies for prostatitis, in addition to medical therapy, to relieve some of the symptoms of prostatitis at home are:

1. Soak in a warm bath (sitz bath) or apply a heating pad to your body.

2. Avoid or limit alcohol, caffeine, spicy or acidic meals, and other items that might upset your bladder.

3. Prolonged sitting or biking are two activities that might aggravate your prostate.

4. Consuming a lot of caffeine-free drinks will make you urinate more frequently, which will aid in the removal of germs from your bladder.

5. Prostate massage has been demonstrated in a few trials to ease the symptoms in certain people with chronic nonbacterial prostatitis.

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Complications Of Prostatitis

Prostatitis complications can include:

1. Bacterial infection of the blood (bacteremia)

2. Inflammation of the coiled tube connecting to the back of the testicle (epididymitis)

3. Prostate cavity filled with pus (prostatic abscess)

4. Infertility and sperm abnormalities can arise as a result of chronic prostatitis

5. Pyelonephritis (UTI where one or kidneys get infected)

6. Renal damage

7. Sepsis (spread of bacteria through the bloodstream)

8. Bladder outlet obstruction/urinary retention

There is no concrete evidence that prostatitis can lead to prostate cancer. Whether chronic inflammation of the prostate can lead to cancer is still under research.

Alternative Therapies For Prostatitis

Many men find that complementary treatments help them manage their symptoms and the day-to-day effect of prostatitis, giving them a sense of control. Some men report feeling more comfortable and confident in themselves and their treatment.

Complementary therapies are typically utilized in addition to, rather than in place of, medical treatments. Some complementary remedies have adverse effects, while others may interfere with your therapy for prostatitis. Inform your doctor or urologist about any complementary therapies you are receiving or considering using.

Here are some alternative treatments that have shown some potential in decreasing prostatitis symptoms include:

1. Biofeedback: A biofeedback professional utilizes signals from monitoring equipment to teach you how to manage specific body functions and responses such as muscular relaxation.

2. Acupuncture: This procedure entails putting extremely small needles into your skin at varying depths at various places on your body.

3. Herbal remedies and supplements: Some herbal therapies for prostatitis include ryegrass (cernilton), a substance found in green tea, onions, and other plants (quercetin), and saw palmetto plant extract. However, these lack any scientific backing whether they improve prostatitis or not.

Living With Prostatitis

Prostatitis is accompanied by pain which might make you feel uncomfortable and make you want to do nothing. Some of the following suggestions may be useful to you. They may make you feel more at ease and in control of your pain. Follow these tips to live at ease with prostatitis:

1. Find methods to relax: Stress or anxiety can trigger a flare-up or worsen symptoms. If this is an issue for you, try these relaxation techniques to help you feel more in control such as deep breathing or meditation, having a warm bath, or listening to music are all options.

2. Divert your attention: Take a break from the pain by listening to music, reading, watching T.V, or speaking with somebody. This may appear to be a simple solution, yet it may be quite beneficial.

3. Watch what you consume: Consume plenty of fluids - 6 to 8 glasses of water every day. Reduce your intake of carbonated drinks, artificial sweeteners, alcohol, and caffeine-containing beverages (tea, coffee, and cola), since these might irritate the bladder and aggravate some urinary disorders. There is some evidence that spicy meals might aggravate the symptoms of chronic pelvic pain syndrome (CPPS).

4. Avoid cycling: Cycling, for example, is a good example of an activity that puts pressure on the region between your back passage and testicles (perineum). But they have the potential to exacerbate symptoms. If you want to keep cycling, you may try a different saddle, such as a gel saddle.

5. Keep a journal: This might help you identify items that aggravate your symptoms and can be a great approach to show your doctor what you're going through. Keep track of everything you eat and drink, how much you exercise, how stressed you are, and your symptoms.