Medical Info and News

Chronic prostatitis is usually not caused by a bacterial infection. When it is caused by bacteria, chronic prostatitis may occur with or follow:

 

Acute prostatitis
Epididymitis
Urinary tract infection
Urethritis

 

Risks include:

 

Age over 30
Certain sexual practices (such as anal sex without a condom)
Excessive alcohol intake
Injury to the perineum (the area between the scrotum and anus)
These factors may cause congestion of the prostate gland, which produces a breeding ground for bacteria.

 

Other possible causes are related to stress and tightness of the pelvic muscles.

 

Symptoms

 

Blood in the urine
Decreased urine stream
Frequent urination
Incontinence
Low-grade fever
Pain with urination
Urinary hesitancy (delayed start of urination)
Low-grade or subtle symptoms may include:

 

Low back pain
Pain and burning with urination
Pain in the perineum or pelvic floor
Pain with bowel movement
Pain with ejaculation
Testicular pain
Note: There may be no symptoms.

 

Exams and Tests

 

A physical examination may show:

 

Discharge from the urethra
Enlarged, mildly tender prostate
Enlarged or tender lymph nodes in the groin area
Swelling and tenderness of the scrotum
Triple-void urine specimens may be collected for urinalysis and urine culture. Urine may be collected:

 

Initial stream
Mid-stream
After a prostate massage by examiner
Other tests may include:

 

Culture of prostate secretions
Semen analysis

 

Treatment
Treatment options for chronic prostatitis include a combination of medication, surgery, and lifestyle changes.

 

MEDICATIONS

 

Chronic prostatitis is treated with a long course (6 - 12 weeks or longer) of antibiotics. Trimethoprim-sulfamethoxazole (Bactrim) and ciprofloxacin (Cipro) are commonly used. Other antibiotics that may be used include:

 

Carbenicillin
Erythromycin
Nitrofurantoin
Tetracycline
Most antibiotics do not get into the prostate tissue well. Often, the infection continues even after long periods of treatment. After antibiotic treatment has ended, it is common for symptoms to return.

 

Stool softeners may be recommended to reduce discomfort with bowel movements.

 

Nonsteroidal anti-inflammatory medications (NSAIDs such as Aleve and Motrin) and alpha blockers (such as Hytrin, Flomax, and Cardura) may also be used.

 

SURGERY

 

Transurethral resection of the prostate may be necessary if antibiotic therapy is unsuccessful or the condition keeps returning. This surgery is usually not performed on younger men because it carries a risk of retrograde ejaculation, which can lead to sterility, impotence, and incontinence.

 

Prostate massage and myofascial release are other treatments that may help this condition.

 

OTHER THERAPY:

 

Frequent and complete urination is recommended to decrease the symptoms of urinary urgency. If the swollen prostate restricts the urethra, the bladder may not empty. Inserting a suprapubic catheter, which allows the bladder to drain through the abdomen, may be necessary.

 

 

MONITORING:

 

See your health care provider for an exam after you finish taking antibiotics to make sure that the infection is gone.