Prostatitis: Causes, Symptoms, Diagnosis, Treatment, and Prevention
Prostatitis is an infection, inflammation, and pain problem of the prostate gland. It affects a wide range of men, but is most common among young and middle-aged men. The prostate gland is a part of the male reproductive system that produces the fluid that transports sperm during ejaculation.
Types of Prostatitis
There are four types of prostatitis, each with different causes and symptoms:
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Acute bacterial prostatitis: This is a sudden and severe infection of the prostate gland, usually caused by bacteria entering the urinary tract. A medical emergency, antibiotics and pain relievers are required immediately to treat this condition. Symptoms include fever, chills, muscle aches, frequent urination, difficulty urinating, blood in the urine, and difficulty urinating.
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A chronic bacterial prostatitis is caused by bacteria that have not been completely eliminated by previous treatments and recur again or persist. There are similar symptoms to acute bacterial prostatitis, but they are less severe and more variable. To relieve symptoms and prevent complications, antibiotics and other medications are used long-term.
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A chronic prostatitis/chronic pelvic pain syndrome (CPPS) is the most common form of prostatitis, but it is also the least understood. Rather than being caused by a bacterial infection, it may be caused by nerve damage, immune system dysfunction, hormone imbalance, or psychological stress, among others. This condition is characterized by chronic pelvic, perineal, genital, or lower back pain, as well as urinary problems that include urgency, frequency, or difficulty. In addition to medications, physical therapy, biofeedback, acupuncture, and lifestyle changes, treatment is based on the individual's symptoms.
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The prostate gland is inflamed but does not show any symptoms of asymptomatic inflammatory prostatitis. Unless it causes complications, such as urinary tract infections or kidney stones, it does not require treatment and is usually detected by chance during tests for other conditions like infertility or prostate cancer.
Diagnosis of Prostatitis
The diagnosis of prostatitis is based on the patient’s medical history, physical examination, and laboratory tests. The physical examination may include a digital rectal exam, where the doctor inserts a finger into the rectum to feel the prostate gland. The laboratory tests may include:
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Urine tests: To check for signs of infection or inflammation in the urine.
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Blood tests: To check for signs of infection or inflammation in the blood.
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Prostate-specific antigen (PSA) test: To measure the level of a protein produced by the prostate gland, which may be elevated in prostatitis or prostate cancer.
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Semen analysis: To check for signs of infection or inflammation in the semen.
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Prostatic fluid culture: To collect and grow bacteria from the prostatic fluid, which is obtained by massaging the prostate gland during the rectal exam.
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Imaging tests: To provide detailed images of the prostate gland and the urinary tract, such as ultrasound, CT scan, or MRI.
Treatment of Prostatitis
Treatment options for prostatitis depend on the type, cause, and severity of the condition. Its main goals are to eliminate the infection, reduce inflammation, relieve pain, and prevent complications. These options include:
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Antibiotics: To kill the bacteria that cause acute or chronic bacterial prostatitis. The duration and type of antibiotics may vary depending on the patient’s response and the sensitivity of the bacteria.
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Anti-inflammatory drugs: To reduce the inflammation and pain in the prostate gland and the urinary tract. These may include nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, or corticosteroids, such as prednisone or dexamethasone.
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Alpha-blockers: To relax the muscles of the bladder and the prostate gland, and improve the urine flow. These may include drugs such as tamsulosin, alfuzosin, or doxazosin.
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Pain relievers: To ease the pain and discomfort caused by prostatitis. These may include over-the-counter or prescription drugs, such as acetaminophen, aspirin, or tramadol.
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Other medications: To address specific symptoms or complications of prostatitis, such as antidepressants, antihistamines, antispasmodics, or herbal remedies.
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Physical therapy: To improve the blood circulation and muscle tone in the pelvic area, and reduce the tension and spasms that may contribute to prostatitis. This may include exercises, massage, heat therapy, or electrical stimulation.
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Alternative therapies: To complement the conventional treatments and enhance the overall well-being of the patient. These may include acupuncture, biofeedback, meditation, yoga, or dietary supplements.
Prevention of Prostatitis
There is no sure way to prevent prostatitis, but some measures may help reduce the risk or recurrence of the condition. These include:
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Drinking plenty of fluids: To flush out the bacteria and toxins from the urinary tract and prevent dehydration.
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Urinating regularly: To empty the bladder and avoid the accumulation of urine that may harbor bacteria.
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Practicing good hygiene: To keep the genital area clean and dry, and avoid the transmission of sexually transmitted infections (STIs) that may cause prostatitis.
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Avoiding irritants: To limit the exposure to substances that may irritate the prostate gland or the urinary tract, such as caffeine, alcohol, spicy foods, or artificial sweeteners.
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Managing stress: To cope with the emotional and psychological factors that may trigger or worsen prostatitis, such as anxiety, depression, or anger.
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Seeking medical attention: To get prompt and proper treatment for any symptoms or signs of prostatitis, and follow the doctor’s instructions and recommendations.
