What is prostatitis?

The prostate is a small organ located at the base of the bladder and wrapped around the urethra, the tube that empties the bladder through the penis. It sits in front of the rectum, and the back portion of the organ can be felt during rectal examination by a health care practitioner.

The prostate's purpose is to help with the male reproductive system. It makes up to 70% of the fluid that is ejaculated during intercourse, mixing its secretions with the sperm that are made in the testicles. The prostate also contracts at the time of ejaculation to prevent retrograde (or backward) flow of semen into the bladder.

Because of its location, the symptoms of any prostate problem tend to be associated with the bladder and can include urgency to urinate, frequency of urination, burning with urination (dysuria), poor urine flow, or inability to begin a urine stream.

Prostatitis is the general term used to describe prostate inflammation (-itis). Because the term is so general, it does not adequately describe the range of abnormalities that can be associated with prostate inflammation. Therefore, four types of prostatitis are recognized.

What are the types and symptoms of prostatitis?

There are four types of prostatitis: acute bacterial prostatitis;

chronic bacterial prostatitis

Acute bacterial prostatitis is an infection of the prostate that is often caused by some of the same bacteria that cause bladder infections. These include E. coli, Klebsiella, and Proteus. While it may be acquired as a sexually transmitted disease, the infection can also spread to the prostate through the blood stream, directly from an adjacent organ, or as a complication of prostate biopsy.Patients with acute bacterial prostatitis present with signs of an infection and may have: fever, chills, and shakes.Commonly there is urgency and frequency of urination and dysuria (painful or difficult urination).

Chronic prostatitis without infection, also known as chronic pelvic pain syndrome, is a condition where there is recurrent pelvic, testicle, or rectal pain without evidence of bladder infection. There may be difficulties with painful urination or ejaculation, and erectile dysfunction. The cause of chronic prostatitis without infection is not clearly understood.

How is prostatitis diagnosed?

After taking a history, the health care practitioner will likely have a directed physical examination concentrating on the scrotum, looking for inflammation of the testicle(s) or epididymis, and the flank and mid-back, where the kidney is located. If a rectal examination is performed, the prostate may be swollen and boggy, consistent with acute inflammation.

The most important laboratory test is a urinalysis to help differentiate the types of prostatitis.

A blood test called PSA (prostate surface antigen) may be elevated in chronic prostatitis. While PSA is used as a prostate cancer screening tool, it can also be elevated whenever the prostate is inflamed.

What is the treatment for prostatitis?

Treatment depends on the type of prostatitis. For example treatment for acute bacterial prostatitis is a prescription for antibiotics by mouth, usually ciprofloxacin (Cipro) or tetracycline (Achromycin). Home care includes drinking plenty of fluids, medications for pain control, and rest.