Prostatitis

Prostatitis is the inflammation and or infection of the prostate gland. It is a very common urological problem and mostly affects men aged 40-60 but can occur at any age.

Classification

Different types of prostatitis affect men and the symptoms and treatments depend on the type of prostatitis you are diagnosed with.

  1. Chronic Pelvic Pain Symptom (CPPS): This is the most common type of prostatitis and symptoms include perineal pain, pelvic pain and painful ejaculation. There is no evidence of inflammation or infection and usually pathology tests are normal.

  2. Asymptomatic Inflammatory Prostatitis: This condition doesn’t cause any symptoms, but inflammatory cells may be picked up in a patient’s seminal fluid whilst being investigated for other conditions.

  3. Acute Bacterial Prostatitis: This is the acute infection and inflammation of the prostate caused by bacteria and patients present with symptoms of fever, difficulty in emptying the bladder, burning sensation when passing urine and suprapubic or flank pain. Typically, these patients require an immediate course of antibiotics, typically administered intravenously in hospital.

  4. Chronic Bacterial Prostatitis: These patients present with recurrent UTI’s and have the same symptoms as patients with bladder infections like frequency, urgency and dysuria over a long period of time. This is typically caused by bacteria that inhabits the prostate and treatment usually hinges on a longer term course of antibiotics.

Diagnosis

Diagnosis is made on clinical history, physical examination (which includes rectal examination of the prostate itself) and may include laboratory tests like blood and urine tests. A cystoscopy may have to be done to inspect the water tube (urethra) as well as the bladder. Seminal and prostatic fluid may also need to be collected during a cystoscopy to make this diagnosis.

Treatment of Prostatitis

With Acute and Chronic Bacterial prostatitis the mainstay of treatment is antibiotics. Other medications which may be helpful in conjunction with antibiotics or on it’s own for non-bacterial prostatitis include:

Alpha Blockers

Muscle relaxant

Quercetin

Pelvic floor physiotherapy

Analgesics, including ibuprofen or paracetamol

The avoidance of certain foods ie; acidic foods, spicy foods or caffeine.