What is Prostatitis?

Prostatitis is a condition where the prostate gland becomes swollen and inflamed. The prostate gland is only found in men and is located between the penis and the rectum. It is the size of a walnut and is responsible for producing seminal fluid, which transports and provides nutrients for semen. According to research from La Trobe University, around 2% of Australian men experience prostatitis symptoms [1]. Men over 50 and those with irritable bowel syndrome (IBS) are more likely to experience prostatitis. There are several different types of prostatitis, including [2]:

• Acute bacterial prostatitis: A sudden bacterial infection of the prostate gland.
• Chronic bacterial prostatitis: Inflammation of the prostate gland due to a bacterial infection for over three months.
• Chronic prostatitis (also known as chronic pelvic pain syndrome): Inflammation of the prostate gland due to non-bacterial reasons, including pelvic floor muscle tightness, injuries and stress.
• Asymptomatic inflammatory prostatitis: An inflamed prostate gland that is not caused by infection without symptoms.

 

Prostatitis Symptoms

Symptoms of prostatitis will vary depending on the condition's severity, type and duration. However, some people experience no symptoms even though there may be signs of an inflamed or enlarged prostate gland. Examples of symptoms that you may experience include [2]:

• Chills
• Fever
• Lower back, pelvic and groin pain
• Painful ejaculations
• Passing urine more frequently, even at night time
• More urgency when passing urine
• Discolouration of sperm
• Pain or burning sensation with urination (i.e. dysuria)
• Cloudy urine

 

Prostatitis Causes

Causes of prostatitis will vary depending on the type, which includes:

• Acute bacterial prostatitis: A bacterial infection of the prostate gland that has spread from other parts of the body (e.g. urinary tract, reproductive system, etc.). Infections can occur through trauma, catheters and sexual activities.
• Chronic bacterial prostatitis: Usually caused by the same acute bacterial infection that either keeps recurring or hasn't been treated sufficiently.
• Chronic prostatitis or pelvic pain syndrome: Prostatitis caused by non-bacterial reasons. Several reasons can cause symptoms, including previous infections, stress, changes in the nervous system, hormone imbalances and overly tight pelvic floor muscles.
• Asymptomatic inflammatory prostatitis: Prostatitis that is usually found during an examination with no causes and without symptoms. No treatment is often required in these circumstances.

 

Prostatitis Diagnosis and Testing

Early detection of prostatitis is essential for treating symptoms and preventing further complications. Before testing and a diagnosis, your doctor will ask you a list of important questions, such as your medical history and symptoms. If necessary, your doctor may recommend further testing.

Physical Examination

Your doctor may perform a physical examination to look for signs of prostatitis, including observing any changes around the pelvic region, palpating the groin/abdomen region and/or a digital rectal examination.

Urine Testing

Urine testing is performed to look for any signs of bacterial infection in the urinary tract that could be linked to prostatitis.

Blood Test

A sample of your blood may also be performed to look for any prostate problems or signs of potential infections.

Imaging

Imaging investigations (e.g. ultrasounds, MRIs, etc.) create images of the structures inside the body. These tests may help detect changes or conditions relevant to your symptoms. Areas of interest may include the kidney, bladder and prostate gland.

Referral to a Urologist

For ongoing symptoms of prostatitis, your doctor may refer you to a urologist. This is a doctor specialising in male reproductive and prostate gland care. Further testing with your urologist may be required before treatment for your symptoms.
 

Prostatitis Treatment

Treatment for prostatitis will depend on the type and severity of the condition. Treatment may be essential for the recovery from prostatitis to help resolve symptoms and to prevent further complications.

Medications

Antibiotics are generally prescribed to treat prostatitis that is caused by bacterial infections. Your doctor may also recommend pain medications, relaxants and supplements to help manage symptoms. Always take your medications as directed by your doctor.

Lifestyle Strategies

Specific changes in your lifestyle habits may also help manage symptoms of prostatitis, including:

• Limiting activities that may aggravate symptoms, such as weightlifting and bodybuilding
• Reducing alcohol, caffeine and spicy foods
• Spend less time sitting
• Warm showers to help relax the pelvic floor muscles
• Drinking enough water

Pelvic Floor Physiotherapy

Non-bacterial prostatitis can sometimes be caused by pelvic floor dysfunction due to various factors, such as stress or trauma. A pelvic floor physiotherapist may help you find strategies, exercises and other treatments to relieve your symptoms.

Treatment from a Urologist

Your doctor may refer you to a urologist for further testing and treatment for persistent symptoms. Your urologist may be able to provide further treatment, such as additional medications and surgery.
 

Recovery

Although rare, acute bacterial prostatitis can be successfully treated with the correct antibiotics [3]. Those with chronic prostatitis (bacterial or non-bacterial) can have lingering symptoms which persist longer than three months. There may be several causes of chronic prostatitis, including pelvic floor problems and persistent bacterial infections. Recovery will depend on treating these causes with appropriate guidance from your doctor.
 

Complications

Complications of prostatitis will vary depending on the type and severity. Acute bacterial prostatitis can be life-threatening if not detected or treated early. Additionally, symptoms of chronic prostatitis, such as pelvic pain, erectile dysfunction and urinary problems, can severely impact a men's overall health and well-being. If left untreated, prostatitis can lead to long-term complications, including:

• Infertility
• Chronic pain around the pelvis (e.g. testicles, groin, etc.)
• Spreading infection
• Prostate cancer [4].

 
 

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