Inflammation of the Prostate Gland

The prostate is a gland the size of a walnut, about 20 grams, located directly behind the bladder in men. It surrounds the beginning of the urinary urethra. The prostate secretes the fluid that nourishes the semen, which also facilitates the process of transporting the fluid to the urethra.

Prostatitis is the enlargement and inflammation of the prostate gland. Prostatitis causes difficulty and pain when urinating, ejaculating, or both. In addition to other symptoms, such as pain between the thighs, in the pelvic area, in the genitals, and in the band connecting the testicle and the anus.

Prostatitis affects men at all ages, but it is more common among those aged 50 years or younger. Sometimes a bacterial infection occurs and sometimes the cause cannot be known. If a bacterial infection causes prostatitis, it can be treated with antibiotics. Prostatitis may occur suddenly or in several stages, depending on the type of cause. The inflammation can improve quickly. Some types of prostatitis last for several months or keep coming back after treatment (chronic prostatitis).

Prostatitis and its symptoms:

 

• • Feeling pain or burning during urination or ejaculation (dysuria)

• • Difficulty urinating, such as dribbling or interrupting urination

• • Frequent urination, especially at night (nocturia)

• • Feeling an urgent need to urinate

• • Dark urine

• • Blood appears in the urine

• • Feeling pain in the abdomen or lower back.

• • Feeling pain in the area between the scrotum or in the band between the testicle and the anus (perineum).

• • Feeling pain or discomfort in the penis or testicles

• • Feeling pain when ejaculating

Risk factors for prostatitis include:

 

• • Being young or middle-aged

• • You had previously had prostatitis

• • You have an infection in the bladder, or in the tube that carries semen and urine to the penis (urethra)

• • You have an injury to the pelvic area, such as a physical injury from cycling or horseback riding

• • You used a tube inserted in the urethra; To drain urine from the bladder (urinary catheter)

• • You have human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS)

• • You have previously undergone a prostate biopsy

Complications of prostatitis can include:

 

• • Bacterial infection in the blood.

• • Inflammation of the convoluted tube of the testicle (epididymitis)

• • A pus-filled cavity in the prostate (prostate abscess)

• • Semen abnormalities and infertility, which can occur with chronic prostatitis

There is no direct evidence that prostatitis leads to prostate cancer. Diagnosing prostatitis involves ruling out other conditions as the cause of your symptoms and determining the type of prostatitis you have. The doctor will ask you about your medical history and symptoms. He will also perform a physical examination, which will likely include a digital rectal examination

 

Initial diagnostic tests may include:

 

• • Urine tests. A urine sample for analysis; is used to look for signs of infection in the urine (urinalysis). Blood tests. Your doctor may test samples of your blood to look for signs of prostatitis or other prostate problems.

• • Imaging tests. The doctor requests a rectal ultrasound examination of the prostate, and a CT scan of the urinary system and prostate may be required in some cases. A CT scan provides more information.

Test results indicate that you have one of the following types of prostatitis:

 

• • Acute bacterial prostatitis. This type of prostatitis is often caused by common strains of bacteria, generally begins suddenly, and causes signs such as fever, chills, nausea, and vomiting.

• • Chronic bacterial prostatitis. It occurs when antibiotics cannot eliminate the bacteria causing prostatitis, and the infection will reoccur or become difficult to treat. But you may not feel any symptoms, or perhaps only minor symptoms, in the periods between episodes of chronic bacterial prostatitis.

• • Chronic prostatitis/chronic pelvic pain syndrome. This type of prostate infection—the most common—is not caused by bacteria. The exact cause is often unknown. For some men, symptoms stay the same over time. But it gets intense and calms down at times.

• • Asymptomatic prostatitis. This type of prostatitis does not cause symptoms and is usually discovered incidentally when tests are performed for other medical conditions. It does not require treatment.

Treatment:

Prostate treatment depends on the underlying cause. It may include the following:

 

• • Antibiotics. Antibiotics are commonly used to treat prostatitis. Your doctor will determine the medication based on the type of bacteria that may be causing the infection.
    If you have severe symptoms, you may need intravenous antibiotics. You’ll likely need to take oral antibiotics for four to six weeks, but you may need longer treatment for chronic or recurrent prostatitis.

• • Alpha blockers. These medications help relax the bladder neck and the muscle fibers where the prostate connects to the bladder. This treatment may relieve symptoms, such as pain when urinating.

• • Anti-inflammatory agents. Nonsteroidal anti-inflammatory drugs (NSAIDs) may cause discomfort.
    
    

Sometimes some medicinal herbs are added that may help treat prostate infections.

 

Dr.Nabih Karim

Urology Consultant