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Prostatitis is a general term for inflammation of the prostate gland.

Prostatitis is a general term for inflammation of the prostate gland. What is the prostate’s primary function? Main function is to produce semen, the fluid that helps transport sperm. Unfortunately, because of the prostate position and relations with other organs in this area- infections of the gland are quite common. Although not technically part of urinary system, it is proven that the prostate gland is important to urinary health because the prostate surrounds the top portion of the urethra. It is proven that an inflamed prostate can cause a variety of symptoms, including a frequent and urgent need to urinate and pain or burning when urinating — often accompanied by pelvic, groin or low back pain. Infection or inflammation can cause the gland to swell, squeezing the urethra and affecting your ability to urinate. Big problem is that it's not always possible to cure prostatitis, but in many cases symptoms can be controlled.

More about prostate

Every male patient should know that the prostate is a gland that lies just below a man's bladder- urine storage. It is positioned specifically to surrounds the urethra like a donut. It is just in front of the rectum. What exactly is urethra!? The urethra is the tube that carries urine out of the bladder, through the penis and out of the body. Beside urine- it also carries the sperm! Through one unpleasant examination called digito-rectal exam- doctor may check prostate by putting a finger into rectum to feel the back of prostate gland. Like it was been told- the prostate gland makes a fluid that provides nutrients for sperm. Sperm is thick and this fluid makes up most of the ejaculate fluid. What's also interesting- at birth, the prostate is about the size of a pea and then- it grows slightly during childhood and then undergoes a rapid growth spurt at puberty. It is proven that, after age 45, the prostate often begins to grow again more rapidly than normal.  

Possible causes of 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 correctly.

Type I — Acute bacterial prostatitis

Patient could assume from the name that signs and symptoms of this form of prostatitis usually come on suddenly. Acute prostatitis is a serious condition and should be reported and treated on time! Some of the most common sings may include:
  • Fever and chills
  • A flu-like feeling
  • Pain in the prostate gland, lower back or genital area
  • Urinary problems
  • Painful ejaculation

Type II — Chronic bacterial prostatitis

Good thing about this type of prostatitis is that the signs and symptoms of this type of prostatitis develop more slowly and usually aren't as severe as those of acute prostatitis. Some of the most common signs and symptoms of chronic bacterial prostatitis include:
  • A frequent and urgent need to urinate
  • Painful ejaculation
  • A slight fever
  • Recurring bladder infections
  • Pain or a burning sensation when urinating
  • Pain in the prostate
  • Excessive urination during the night
  • Pain in the lower back and genital area
  • Difficulty starting to urinate, or diminished urine flow
  • Occasional blood in semen or in urine

Type III — chronic nonbacterial prostatitis

Not too many people know that this type- chronic nonbacterial prostatitis, is the most common form of prostatitis. It is important to know that the signs and symptoms of nonbacterial prostatitis are similar to those of chronic bacterial prostatitis, although in most cases- it isn't accompanied with fever. Reasonably- the major difference is that tests won't detect any bacteria in urine or in fluid from prostate gland.

Type IV - Asymptomatic inflammatory prostatitis

Good thing is that this type doesn't require treatment.Problem is that the patient does not complain of pain or discomfort but has infection-fighting cells in his semen.  

Is it contagious?

Well, every patient should know that, sometimes prostatitis is caused by a sexually transmitted organism, such as chlamydia, which would mean that it can be passed via sexual contact! However- most cases are caused by infections that are not sexually transmitted. These infections can't be passed on to sexual partners.

Diagnosis of prostatitis

Every patient should know that diagnosis of prostatitis is a two-step process because doctor must first rule out any other conditions that may be causing signs and symptoms and then- focuses on determining what kind of prostatitis is case. Every diagnosis should start with taking a medical history and performing a physical exam which includes checking abdomen and pelvic area for tenderness.

Digital rectal exam

Digital rectal exam is still very powerful tool for diagnosis because it can help detect prostate cancer as well as prostatitis and other prostate disorders, although it is rather unpleasant! During a digital rectal exam, doctor manually examines prostate gland by gently inserting a lubricated finger into patient’s rectum. Everything is done with the gloves, of course! Because the prostate gland is in front of the rectum, doctor can feel the back surface of the gland this way.  

Lab tests

After digital rectal exam- doctor should evaluate samples of urine and semen for bacteria and white blood.

Medications

  • Antibiotics
Every patient should know that simple antibiotics are a first line of treatment for all forms of bacterial prostatitis. Every treatment should urgently start with some wide-specter antibiotic drug but, after the exact bacteria which is causing the infection is determined- treatment may switch to a different medication. Chronic bacterial prostatitis is more resistant to antibiotics and takes longer to treat. Sometimes patients need to continue taking medication for as long as six to 12 weeks. Bad thing is that, in some cases, the infection may never be eliminated. Although the cause of nonbacterial prostatitis is not a bacterial infection, some doctors may prescribe an antibiotic for a few weeks to see if symptoms improve.  
  • Alpha blockers
Important thing to know is that prostatitis sometimes causes several different urinating problems. In this case- doctor may prescribe an alpha blocker — an oral medication that helps relax the bladder and make urinating more bearable.  
  • Pain relievers
Reasonably- sometimes a pain reliever, such as aspirin or ibuprofen (Motrin, Advil, others) can make a patient more comfortable and relieve some pain! Only bad thing about these medications that taking too much can cause serious side effects including abdominal pain, intestinal bleeding or ulcers.
  • Muscle relaxants
Every patient should know that sometimes spasms of the pelvic muscles can accompany prostatitis. That’s why muscle relaxant medication may be helpful.
  • Other medications
Finasteride, a drug that lowers hormone levels in the prostate have been successful in treating some men, but scientific evidence can't really explain this. Quercetin has shown effective in a randomized placebo controlled trial in chronic prostatitis but the study has been criticized because of small numbers. Subsequent studies showed that Quercetin reduces inflammation and oxidative stress in the prostate. Bee Pollen has also been shown effective in small studies but the active therapeutic constituent has not been isolated.

Physical therapy

Good thing is that there are special exercises and relaxation techniques which can improve symptoms of prostatitis. Common techniques include:
  • Exercise
Although the precise mechanism is still unknown- several researches done in the past have shown that stretching and relaxing the lower pelvic muscles may help relieve prostatitis symptoms. These exercises could be also easily done at home.
  • Biofeedback
This technique teaches a patient how to control certain body responses, including relaxing muscles. Although this isn't to accomplish, doctor will help because, during a biofeedback session, he applies electrodes and other sensors to various parts of patient’s body. These electrodes are attached to a monitor that displays heart rate, blood pressure and degree of muscle tension.  
  • Sitz baths
Although not too many people know about these baths – they are not so uncommon. This type of bath simply involves soaking the lower half of body in a tub of warm water. Warm baths can relieve pain and relax the lower abdominal muscles.  
  • Prostate massage
The massage is performed using a gloved finger, similar to what is done during a digital rectal exam and many patients reported beneficial effects!

Surgical procedures

In some cases- doctor may recommend surgery to open blocked ducts if patient has a bacterial form of the disease. This is done only in case that -antibiotics couldn’t improve symptoms or patient’s fertility is severely affected. Surgery is not a treatment for nonbacterial prostatitis.

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