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Prostatitis

Prostatitis is the inflammation of the prostate gland that can affect men at any age. There are different types of prostatitis. When this inflammation is caused by a bacterial infection, it is called bacterial prostatitis, which in turn can be classified as acute bacterial prostatitis or chronic bacterial prostatitis. When prostatitis is not caused by bacteria, it is called chronic bacterial prostatitis.

Some patients, will need psychological support to transit this pathology, since in some men the urinary symptoms are painful and of prolonged duration.

 

 

Symptoms:

Usually prostate infections are almost asymptomatic or have mild symptoms that are diagnosed as a urinary tract infection or even a flu-like condition. But not all patients present the same symptoms in episodes of prostatitis and some may become very symptomatic and their quality of life may be compromised by this pathology.

Some of the most common symptoms are

  • Chills.
  • General malaise, muscle aches, back pain.
  • Fever.
  • Reddening of the skin.
  • Blood in the urine.
  • Burning or pain when urinating
  • Difficulty initiating urination.
  • Difficulty emptying the bladder
  • Urgent need to urinate
  • Incontinence of urine
  • Foul-smelling urine.
  • Weak urinary stream
  • Pain or discomfort in the abdomen above the pubic bone, in the lumbar region, in the area between the genitals and the anus, or in the testicles.
  • Pain with ejaculation or blood in the semen.
  • Pain with bowel movements.

Causes:

The causes by which germs reach the prostate gland and cause prostatitis are varied. Inflammation of the prostate (prostatitis) can be produced by various origins, for example, any bacteria that can cause a urinary infection, could produce a prostatitis, even some sexually transmitted diseases can also cause bacterial prostatitis; prostatitis can also be caused by problems in the urethra, for example: Bladder outlet obstruction or by inability to retract the foreskin (phimosis), by an injury in the area between the scrotum and the anus (perineum) or also after having a bladder catheter, some endoscopy or prostate biopsy.

Men with an enlarged prostate (benign prostatic hyperplasia) have an increased risk of prostatitis. This is because the prostate gland can become obstructed, which facilitates the proliferation of bacteria. It is interesting to note that the symptoms of chronic prostatitis can be very similar to those of enlargement of the prostate gland (BPH) and it is the urologist who with his medical examination and the results of the corresponding studies should evaluate your pathology.

This is a small list of the most common causes that can lead patients to transit a prostatitis:

  • Patients who undergo a prostate biopsy.
  • Patients who have undergone minimally invasive medical studies.
  • Prostate diseases: BPH, prostate cancer.
  • Sexually transmitted diseases.
  • Urethral problems.
  • Most often present without apparent cause.

Diagnosis:

The evaluating Urologist will ask you for all or some of the following medical tests to verify the diagnosis of prostatitis and to know which type of prostatitis to treat:

Urinalysis, prostatic massage to obtain prostatic secretion for culture, transrectal ultrasound of the prostate, blood tests, (It is important to know that prostatitis can affect the results of the prostate specific antigen test (PSA) giving a value well above normal, in this blood test used to detect prostate cancer), among other studies that the Doctor considers necessary, according to the patient’s medical history.

Evaluating the symptoms and the results of the clinical analysis, the Urologist Doctor can conclude what type of prostatitis the patient suffers from.

CLASSIFICATION OF PROSTATITIS:

There are several types of prostatitis:

  • Acute Bacterial Prostatitis: this type of prostatitis usually begins suddenly, it is usually accompanied by flu-like symptoms such as fever, chills, nausea and vomiting. It is usually caused by common bacteria.
  • Chronic Bacterial Prostatitis: This type of prostatitis usually lasts 3 months or more. It is caused when the antibiotics prescribed do not eliminate the bacteria that cause prostatitis. This causes the patient to have recurrent and/or difficult to treat infections. We can say that when urinary and painful symptoms are recurrent, we have to think of chronic prostatitis.
  • Chronic prostatitis or chronic pelvic pain syndrome: This type of prostatitis is not caused by bacteria, as the previous ones are. The exact cause is usually not identified. The symptoms vary in each man, in some the symptoms go through moments of greater symptomatology and then pass to a period of less or no symptomatology. This type of prostatitis is also called chronic pelvic pain syndrome, which is divided into: Chronic inflammatory pelvic pain syndrome or Chronic non-inflammatory pelvic pain syndrome.

 

Pelvic pain syndrome (chronic prostatitis):

Usually, the treatment of pelvic pain syndrome is very difficult and disappointing. Since the persistent symptomatology in the patient generates a great discomfort in the quality of life, because the pain, the urinary discomfort and the (usual) failure of different medical treatments cause the patient and his environment a continuous search for an answer.

There are alternative physical therapies that are used to treat the symptomatology of pelvic pain syndrome. Some of them are: the application of low intensity shock waves, acupuncture, neuromodulation, prostate laser, botulinum toxin injection, among others.

The application of shock waves in the treatment of chronic pelvic pain

Currently the application of low energy shock waves are used for various medical treatments, for example in traumatology, chronic pain such as plantar fasciitis, tendinitis, etc., are treated with very good results.

In the treatment of chronic pelvic pain the application of low energy Shock waves are directed at perineal level and usually produce a significant decrease in pelvic pain, also showing an improvement in the discomfort of urination, which generates a good quality of life in the patient.

Treatment:

The Urologist will evaluate the most appropriate treatment to treat prostatitis, depending on how the symptoms manifest in the patient and what type of prostatitis should be treated.

Usually in the treatment of chronic prostatitis the use of medication such as alpha blockers, bladder relaxants and / or anti-inflammatory, is usually the most convenient, since the most predominant symptomatology is irritative urinary discomfort.

To summarize:

  • Antibiotics: this is the treatment frequently used for prostatitis. The urologist should evaluate which is the most appropriate antibiotic, depending on the type of bacteria that is causing the prostatitis. If the symptoms are severe, it may be necessary for the antibiotic to be given intravenously at first and then continued orally. Patients with chronic or recurrent prostatitis often take antibiotics for prolonged periods of time. . Usually, antibiotic treatments for short periods fail and the patient often relapses into prostatitis.
  • Alpha blockers: This type of medication is used to relax the muscle fibers and the bladder neck, which is where the prostate joins the bladder. This type of treatment can help decrease the patient’s painful symptoms.
  • Anti-inflammatory agents. Nonsteroidal anti-inflammatory drugs can also help the patient get through the symptoms of prostatitis without pain.
  • Lifestyle changes: The following are some tips that can help the patient to alleviate the symptoms, for example: take a warm bath (sitz bath) or use a hot compress, limit or avoid alcohol, caffeine and spicy and/or acidic foods, avoid activities that can irritate the prostate, such as spending a lot of time sitting or riding a bicycle.  It is important to drink non-caffeinated beverages, as this will increase the urge to urinate and help flush bacteria from the bladder.