Prostate inflammation, also known as prostatitis, is a condition that occurs in men most commonly in their late teens and early twenties, or about the age of 60 and older. In young men, prostate infections are usually sexually transnitted, and occur after behaviors that night be politely described (this is a family site, after all) as adventurous. In older men, prostatitis is almost never a result of a sexually transmitted disease, and has more to do with wear and tear of various structures around and in the prostate.
In younger men, infectious prostatitis is typically caused by the same microorganisms that cause gonorrhea or chlamydia, or Trichomonas infections in female partners. Treating the infection clears up the problem. HIV can also cause prostate infections in younger men.
In older men, infectious prostatitis is most often caused by E. coli. This bacterium travels from the gut up the urethra into the prostate. It is transferred from underwear to the tip of the penis. It is is "sucked in" during retrograde ejaculation (a phenomenon more common in older men who have diabetes in which ejaculate flows up rather than out) or when there is mechanicl injury to the urethra. The prostate can also receive bacteria directly from the bloodstream if it is injured. Some microorganisms you would not readily expect to colonize the prostate can be the problem. Tuberculosis can travel from the kidneys to the prostate, and the fungus that causes "Valley fever" can find its way into the gland. Inflammation can also be caused by an autoimmune disease such as sarcoidosis. Nursing home residents may pick up an infection from urinary catheters.
Younger men typically experience burning urination and maybe blood in the urine. They may have erectile dysfunction and a smelly discharge. Their symptoms go away quickly if the infection can be treated. Younger men usually have acute prostatitis.
Older men typically experience urinary tract infections that come and go, and dysuria (inability to "go") that may come and go. They usually have chronic prostatitis. However, if the infection is uncontrolled, older men can develop an astonishing array of symptoms, including lower back pain, shortness of breath, severe fatigue, joint pain, fever, and chills, as well as erectile dysfunctiopn and spontaneous discharges from the tip of the penis. In older men with diabetes, prostate infections can lead to sepsis, the spread of infection throughout the body which is often fatal. When the discharge comes out in "chunks," the likelihood of sepsis is high.
Prostatitis usually is not diagnosed with a digital rectal exam, the so-called finger test. It's usually not a good idea to press against the prostate and spread the infection. PSA (prostate specific antigen) testing isn't used, either. PSA is more of a test for prostate cancer. Instead, the condition is diagnosed with blood and urine tests and computed tomography (CT) scans.
Men usually can't get over prostatitis on their own. "Heavy duty" antibiotics may be required, including some by IV. It's important to be followed by a physician who will offer immediate treatment in case the infection progresses to the kidneys or becomes sepsis.
Once the infection is brought under control, however, then there are some things men can do to keep it from coming back:
- Avoid dehydration. You always want to have enough urine to flush microorganisms away before they can attach themselves to the lining of the prostate.
- Avoid inflammation. A diet that contains at least a little "healthy" fat (but not too much even of the omega-3 and omega-6 essential fatty acids) and a bare minimum of sugars will reduce inflammation. Equally effective, however, is taking a baby Aspirin a day.
- Avoid reinfection. Men of all ages should use barrier protection (condoms) to avoid picking up infections during sexual intercourse of any kind.
Never quit taking your prescribed medication just because you feel better. Let it do its work.
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