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Prostatitis is a painful prostate gland disorder that commonly affects young and middle aged men. It may be difficult for doctors to diagnose prostatitis because many of the symptoms, such as burning feeling while urinating and incomplete emptying of the bladder could be signs of another urinary problem.

The prostate, a walnut-sized gland, is located in front of the rectum just below the bladder. It produces a fluid, which becomes a component of the semen. The prostate gland surrounds a part of the urethra—called the prostatic urethra—which is a common passageway for urine and semen.
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Types of Prostatitis

Prostatitis is the medical term for the inflammation of the prostate. However, doctors also use the term to describe four different disorders.

The different types of prostatitis are:

Acute bacterial prostatitis. Although considered as the least common type, acute bacterial prostatitis is a potentially life-threatening condition if left untreated. This type is the easiest to diagnose and treat effectively. It is caused by bacteria and occurs suddenly. Men with acute bacterial prostatitis often experience signs and symptoms, such as

 Fever and chills
 pain in the lower back and genital area
 frequent urination and urge to urinate (usually at night)
 burning or painful urination

Chronic bacterial prostatitis. This type of prostatitis occurs when bacteria find a place on the prostate where they can survive. Men with chronic bacterial prostatitis have urinary tract infections that seem to go away but then come back with the same bacteria.

Chronic (nonbacterial) prostatitis. Also called chronic pelvic syndrome, chronic prostatitis is the most common type. Although common, the reason why it occurs is not fully clear. This form can occur in men of any age. Its symptoms go away and then return without warning, and may be inflammatory or noninflammatory. In the inflammatory form, urine, semen, and other fluids from the prostate show no evidence of a known infecting organism, but do contain infection-fighting cells. The noninflammatory form, however, shows no evidence of inflammation and infection-fighting cells are also not present.

Asymptomatic inflammatory prostatitis. In this form, the patient does not complain of pain or discomfort. However, infection-fighting cells are found in his prostate fluid and semen. Asymptomatic inflammatory prostatitis is usually found when doctors are looking for causes of infertility or testing for prostate cancer.

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Diagnosis

Diagnosis of prostatitis is based on the patients medical history, signs and symptoms, and results of physical exam and laboratory tests. The doctor may also ask a series of questions from a standard questionnaire.

Physical exam may include digital rectal exam of the patient’s prostate. The doctor performs digital rectal exam (DRE) by gently inserting a gloved and lubricated finger into the patient’s rectum, just behind the prostate. The doctor can feel the back surface of the prostate to see if it is enlarged or tender to touch.

Urine tests may also be done to aid in the diagnosis of bacterial prostatitis. The doctor will examine samples of the patient’s urine for bacteria and white blood cells.

To rule out other conditions, the doctor may recommend other tests, such as imaging test, biopsy, blood tests, and test for bladder function.
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Treatment

Prostatitis caused by bacteria is treated with antimicrobials—medicines that kill microbes. The doctor will determine which medications are best for the patient and for how long he will take them.

Antimicrobials, however, are not effective against nonbacterial prostatitis. The patient should work with his doctor in finding an effective treatment.
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References:
National Kidney and Urologic Diseases Information Clearinghouse (January 2008). Prostatitis: Disorders of the Prostate (NIH Publication No. 08—4553). National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH), Bethesda, MD. Web URL: http://kidney.niddk.nih.gov/kudiseases/pubs/prostatitis/index.htm. Accessed: October 11, 2008

Rados, C. (2006). FDA Consumer Magazine – Prostate Problems: What Every Man Needs to Know. Retrieved October 12, 2008, from the U.S. Food and Drug Administration. Web Site: http://www.fda.gov/fdac/features/2006/306_prostate.html

Image Credit: NIDDK Image Library

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This Page Last Revised: February 27, 2011