Prostatitis is a common and painful disease of the prostate gland and its surrounding structures.

Acute bacterial prostatitis is the least common type of prostatitis and is always caused by bacterial infection. This condition can affect any age group, but it commonly occurs in young and middle-aged men. Chronic bacterial prostatitis is also caused by bacterial infection and may exist for several years without producing any symptoms. Like acute bacterial prostatitis, this condition can also affect any age group, but it is most common in young and middle-aged men. Nonbacterial prostatitis and prostatodynia, also called chronic prostatitis/chronic pelvic pain syndrome, are the most common types of prostatitis. The exact cause of these non-bacterial prostatitis conditions is not known, but it is believed they are caused by a non-infection type of inflammation or a neuromuscular problem rather than an infection.

What are the symptoms?

The symptoms of the various prostatitis conditions vary a great deal, but there is also much overlap. With acute bacterial prostatitis, symptoms include chills, fever, severe burning during urination and the inability to empty the bladder completely. The onset of symptoms is sudden and severe. With chronic bacterial prostatitis, the symptoms are similar, but they are much less severe. Symptoms of this condition include burning during urination, urinary frequency (especially at night), perineal, testicular, bladder and low back pain and painful ejaculation. The symptoms of chronic prostatitis/chronic pelvic pain syndrome include difficult and sometimes painful urination, discomfort or pain in the perineum, bladder, testicles and penis, as well as difficult and painful ejaculation.

How is prostatitis diagnosed and treated?

Making the correct diagnosis is very important because the treatment varies for the different types of prostatitis conditions. In addition, it is extremely important to make sure the symptoms are not caused by other conditions, such as prostate cancer. To examine your prostate gland and determine whether it is enlarged or tender and to assess your degree of pain or discomfort, your urologist will perform a digital rectal exam. If further evaluation is necessary, a transrectal ultrasound may be necessary. This procedure enables your urologist to visualize the prostate gland.

Treatment depends on the type of prostatitis. Antibiotics are prescribed for both acute bacterial prostatitis and chronic bacterial prostatitis. However, chronic bacterial prostatitis requires the use of antibiotics for a longer period of time. Antibiotics might not be needed for chronic non-bacterial prostatitis/chronic pelvic pain syndrome. They may be prescribed initially, and your response to the antibiotic therapy will help your urologist determine whether or not you should continue. Depending on your symptoms, you may receive another treatment, such as alpha-blockers, anti-inflammatory drugs, muscle relaxants, plant extracts (or vitamins) or repetitive prostatic massage (to drain the prostate ducts).