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6055 harbour park drive
midlothian, va. 23112
chesterfield
urology
web:
e-mail:
phone: 804.639.7777
fax:
804.739.1021
www.chesterfieldurology.com
[email protected]
Prostatitis
Prostatitis is an inflammation or infection of the prostate gland. It can affect men of any age. The most
common urological problem in men aged 50 and older, prostatitis is not contagious and is not
transmitted during sex. The prostate is a walnut-sized organ found only in men. Its main function is to
produce semen, the fluid that carries sperm during ejaculation. Part of the male urinary system, it lies
next to the bladder. Prostatitis often causes urinary symptoms because the prostate surrounds the
urethra, the tube carrying urine out of the body.
Types of Prostatitis
The four types of prostatitis are:
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Chronic Pelvic Pain Syndrome (CPPS) - affects about 90% of men with prostatitis (Chronic NonBacterial Prostatitis)
Asymptomatic inflammatory prostatitis - patients don't have symptoms but their doctors find
infection-fighting cells in the semen when checking for other problems such as prostate cancer
or enlargement
Acute bacterial prostatitis - the least common but easiest to treat
Chronic bacterial prostatitis - also not common
Symptoms
Symptoms vary depending on the type of prostatitis. Acute bacterial prostatitis comes on suddenly and
is often accompanied by fever, severe burning during urination, inability to empty the bladder, low back
or groin pain. You should seek immediate medical care. If left untreated, acute bacterial prostatitis may
cause problems with sterility, inability to urinate, and even bacteremia (bacteria in your blood).
In chronic bacterial prostatitis, you experience less intense symptoms but for a longer period of time,
and you may have frequent urinary tract infections.
Men with CPPS may have many of the same symptoms as bacterial prostatitis, but without fever.
Ejaculation may be painful. CPPS is distinguished by pelvic pain that can last months without evidence
of inflammation or bacterial infection. Bladder and rectal pressure or pain is common.
Causes
Bacterial prostatitis is caused by bacteria from infected urine that backs up into the prostate ducts. Men
who have had catheterization, injury to the area or a recent bladder infection are at greater risk.
Doctors are not entirely certain what causes CPPS and in most cases no cause is found. Possible
contributing factors include:
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Infections not found during standard tests
Sexually transmitted diseases (STDs)
Persistent bladder infections
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Pelvic muscle spasm
Physical activity such as biking or heavy lifting when your bladder is full
Diagnosis
Diagnosing prostatitis involves ruling out other problems such as prostate cancer or an enlarged
prostate, then determining which type of prostatitis you have. Your doctor will perform a history and
physical exam, including a digital rectal exam (DRE), where your prostate is checked for size,
tenderness and the possibility of cancer by inserting a gloved finger into the rectum.
Your doctor also may test your urine and semen for infection. If you have an infection, you will get a
culture to identify which bacteria is involved. Cystoscopy (viewing the urethra, bladder and prostate
with a tiny telescope-like instrument) and urine flow studies also may be ordered.
CPPS is diagnosed after other probable causes have been eliminated and when the prostatitis has
lasted for three or more months. Often, it is a diagnosis of exclusion.
Treatment
Acute and chronic bacterial prostatitis can be treated effectively with antibiotics. You must take the
entire dose even if your symptoms improve, to prevent re-infection. Treatment can last several weeks
to several months.
Treatments that may help relieve CPPS symptoms:
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Alpha blockers such as Flomax may improve urinary symptoms by relaxing bladder muscles.
Muscle relaxants
Pain relievers such as ibuprofen or naproxen
Herbal remedies such as Quercetin or bee pollen
Physical therapy, including pelvic exercises or biofeedback
Warm baths and relaxation techniques
Dietary changes - discontinue caffeinated, spicy and acidic foods and beverages
Experimental treatments with heat (microwave) therapy are being evaluated