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Prostatitis
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Prostatitis

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MEN'S HEALTH

Prostate

Prostatitis is a general term for inflammation of the prostate gland — an organ about the size and shape of a walnut, located just below the bladder in males. The prostate gland's main function is to produce semen, the fluid that helps nourish and transport sperm. An inflamed prostate can cause a variety of symptoms, including a frequent and urgent need to urinate and pain or burning when urinating (dysuria) — often accompanied by pelvic, groin or low back pain.

Prostatitis can appear in several forms. The acute form is the least common, but is also the most severe. Symptoms are often sudden, and the condition may require hospitalization. Symptoms of chronic prostatitis tend to develop more slowly and aren't as severe as those of acute prostatitis.

It's not always possible to completely eliminate prostatitis, but in many cases your symptoms can be controlled. In addition to medication, treatments such as heat therapy, biofeedback and sometimes just drinking a lot of water or avoiding certain foods can provide relief.

When to seek medical advice

See your doctor if you develop any of the signs and symptoms of prostatitis, such as persistent urinary discomfort and pain, blood-tinged urine or semen, or pain while ejaculating — especially if these signs and symptoms come on suddenly. When not treated, prostatitis can lead to more serious problems. It's also important to see your doctor to rule out other conditions that eventually may cause bladder or kidney damage.

If you're being treated for acute bacterial prostatitis, it's a good idea to see your doctor when you've finished your course of antibiotics to make sure the infection has cleared. This is also a good time to discuss what you can do to prevent a recurrence.

In addition, most men have a prostate checkup in conjunction with a regular physical exam. If your doctor doesn't perform a digital rectal exam when you have a routine physical, ask whether you should have one.

Screening and diagnosis

Diagnosing prostatitis is a two-step process. The first involves ruling out any other conditions that may be causing your signs and symptoms, and the second focuses on determining what kind of prostatitis you have.

Your doctor will likely begin by taking a medical history and performing a physical exam. You may be asked to complete a questionnaire that quantifies the degree of symptoms you experience.

The physical exam may include checking your abdomen and pelvic area for tenderness and a digital rectal exam of your prostate. The idea of having a digital rectal exam may seem embarrassing, yet most men experience only minimal discomfort during the exam, and it can help detect prostate cancer as well as prostatitis and other prostate disorders.

During a digital rectal exam, your doctor manually examines your prostate gland by gently inserting a lubricated, gloved finger into your rectum. Because the prostate gland is next to the rectum, your doctor can feel the back surface of the gland this way. If it seems enlarged and tender to the touch, you may have prostatitis.

Your doctor may want to evaluate your urine and semen for bacteria and white blood cells — key cells in your immune system's response — to help establish a diagnosis of prostatitis. Seminal fluid may be obtained during the digital rectal exam by massaging the prostate and collecting the fluid that drains from the opening in your penis (urethral orifice).

Complications

There's no evidence that having acute or chronic prostatitis increases your risk of prostate cancer, but it may increase the level of prostate-specific antigen (PSA) in your bloodstream. PSA is a substance naturally produced in your prostate gland, and high levels in your blood may sometimes — but not always — be a sign of prostate cancer. For that reason, if you have an elevated PSA level and also have acute prostatitis, you should be rechecked after you've been treated with antibiotics.

Because prostatitis interferes with the development of semen and proper ejaculation, it can sometimes affect fertility. A few studies also show that men with prostatitis may have poor sperm quality. In addition, untreated acute prostatitis can lead to an inability to urinate and infection in your bloodstream (bacteremia).

 

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