Prostatitis (Prostate Infection)

What are the symptoms of Prostatitis?

Typically, you will have one or more of the following:

• Blood in the urine
• Burning when you urinate
• Fevers/chills
• Pain in the lower back, the lower midsection, or in the area between the scrotum and anus
• Painful ejaculation
• Tender or swollen prostate
• Urinary frequency/urgency
• Weak urinary stream

What causes Prostatitis?

Prostatitis can be categorized broadly as bacterial/infectious or non-bacterial/chronic.

Acute bacterial prostatitis occurs if you have a prostate infection or urinary tract infection.

Chronic non-bacterial prostatitis may occur due to inflammation of the bladder or pelvic floor muscles. The exact cause is unknown but is thought to be related to interstitial cystitis and/or chronic bladder pain syndrome (an inflammatory condition of the bladder).

How is Prostatitis diagnosed?

What to know before your visit to Michigan Institute of Urology in Southeast Michigan:

• During your visit, your doctor will ask about your medical history, surgical history, and medications. Your doctor will examine your groin and genitalia. A digital rectal exam may be needed. 

Tests that may be performed during or after your visit:

• Digital rectal exam: The physician inserts a finger into your rectum to check for the size of your prostate and to check for any abnormalities.
• Urine studies: This test looks for blood in the urine or signs of infection.
• Post-void residual: You may be asked to urinate. Then you’ll be checked with a non-invasive ultrasound to determine if you are emptying your bladder completely.
• Urine flow: You may be asked to urinate in a funnel to assess the speed of your urinary stream.
• Prostatic fluid analysis: The prostate gland may be massaged to produce a fluid sample for microscopic evaluation.
• Cystoscopy: This test involves a small flexible scope which is inserted into the penis to check the urethra for any scar tissue and evaluates the prostate for obstruction or inflammation
• Imaging: An ultrasound of the prostate, kidneys/bladder, or a CT scan of the abdomen and pelvis may be needed.

How is Prostatitis treated?

NON-SURGICAL TREATMENTS

• Acute bacterial prostatitis:
  • Anti-inflammatories: Ibuprofen is used to reduce inflammation. For mild cases, this may be the only treatment.
  • Antibiotics: If there is concern for acute or chronic infection, antibiotics may be prescribed sometimes for as long as 12 weeks.
  • If you have fevers, or your condition gets worse despite antibiotics, you may need hospitalization.
• Prostatitis associated with chronic pain (non-bacterial):
  • Behavioral changes: Dietary changes can help (i.e., avoiding or decreasing spicy foods, caffeine, diet sodas, artificial sweeteners, acidic foods that contain vitamin D, alcohol, and tea). Doing what you can to avoid constipation is also helpful.
  • Lifestyle changes: Non-bacterial prostatitis may be helped with heat (soaking in a warm bath), regular exercise, and stress reduction.
  • Pelvic floor physical therapy: Techniques that relax/stretch the pelvic muscles (similar to physical therapy in other parts of the body) may improve symptoms if the pain is due to excessive contraction of the pelvic muscles and not a prostatic specific problem.
  • Acupuncture
  • Alpha blockers: Oral medications which relax the prostate and bladder neck, making urination less difficult.
  • Quercetin: An anti-inflammatory medication
  • Tadalafil (Cialis)
  • A pain specialist may be necessary for significant or atypical pain or if there is no improvement with other therapies.

SURGICAL TREATMENTS

• Transurethral resection of prostate (TURP): This is a surgical procedure done under general anesthesia. A scope is inserted in the urethra to remove excess prostatic tissue. This is often necessary if you have recurring prostatitis or severe infections.