Prostatitis

What is Prostatitis?

Prostatitis refers to infection within the gland. Infection within the prostate gland causes a temporary increase in the size of prostate because of its swelling which also produces same symptoms as enlargement of the prostate may produce. However these symptoms can be relieved very fast once the inflammation in the prostate may subside.

What is the prostate?

The Prostate is a very small gland which lies below the bladder. The passage of urine passes through prostate and because of this enlargement or prostate compresses on the pipe of the urinary tract and causes various symptoms. The prostate is about 18-20 gm in size and its main function is to produce semen.

Prostate Gland

What are the signs and symptoms of Prostatitis?

Prostatitis can be of various types such as acute prostatitis, chronic prostatitis and chronic pelvic pain syndrome.

Acute Infection: Whenever there is an Acute infection or recent infection, there is immediate symptom of burning in urine, feeling of discomfort in lower part of the abdomen and in the genital region, pain during ejaculation and sometimes there may be some severe infection that it may lead to fever and difficulty in passing urine.

However in many patients there is a small amount of inflammation or infection that stays in the prostate or develops in the prostate leading to a condition called Chronic Prostatitis.

In Chronic Prostatitis the infection is usually long standing of about 3-6 months. Patient with chronic prostatitis usually come with the symptoms like white material in the urine, discomfort in the lower abdomen and the genital region, burning in urine, lower urinary tract symptoms such as increase in the passage of urine and urgency to go and pass urine, getting up many time in night to pass urine and sometimes there may be difficulty in completely emptying the bladder or reduction in the stream of the urinary passage. Apart from this many patient may also develop sexual symptoms such as erectile dysfunction, painful ejaculation and sometimes pain in the testes and the perineal region. Occasionally this pain may also involve the motion passage. Numerous times there may be no symptoms of this problem at all except for just weakness, malaise and lethargy.

Why does Prostatitis develops?

Usually Prostatitis develops from the 3 main regions. The main common is the infection in urinary tracts settles inside the prostate where it stays because of the complexity of the anatomy of prostate as explained. The prostate gland is made up of about 500 caves which produce semen. Within these caves bacteria can strive, and it becomes very difficult for medicines to penetrate inside the prostate and within these caves to kill the bacteria. It is because of this reason that medicine has to taken for very long period so that the bacteria eventually killed once they migrate from the cave to the urinary tract. So whenever there is a infection in the urine and urine goes inside the prostate gland, these bacteria can find the new home within these caves and stay there.

Prostatitis can also happen because of transmission from the sexual partner. If the spouse or female partner also has problem like vaginal discharge, irritation in the vagina and urinary infection, the can be transmitted to the male partner and from there they can find the route inside the prostate. Many patients have been found to have blockage in the urine leading to prostatitis. Blockage in urine can result from either small bladder neck which is a congenital problem or because of dysfunction in the sphincters of the urinary passage which means the gate of the urinary passage do not open well in time because of stress and sometimes there may be other problem like sphincters which are narrowing in the passage which increase the pressure within the urine tract and leading to the urine to go into prostate.

What is the course of prostatitis?

Usually prostatitis in its acute form resolve well with 2-6 weeks course of antibiotics along with that your doctor will give you anti-inflammatory medicine to reduce the swelling and medicine to increase the passage of urine.

Acute Prostatitis which is a sudden symptom due to the inflammation of the prostate is treated by a course of antibiotics, sitz bath in which the patient has to sit in a tub, anti-inflammatory agents and alpha blockers medicines which increase the size of the passage of urine.

Patients with Chronic Prostatitis may also need similar medicines but along with that they may require some urorelaxants, pelvic rehabilitation, painkillers and lifestyle modification. Usually with 6 weeks of medicines the patient may improve a significant improvement in the symptoms. But sometimes medicine course has to continued for upto 3 months. Usually prostatitis has a torrential journey in the form of multiple episodes happening now and then but with medication and right guidance the number of episodes, there frequency and the intensity of episodes will reduce with time.

How is the Diagnosis of Prostatitis made ?

  • Usually to confirm the diagnose of prostatitis your doctor will perform a rectal examination wherein he will insert the finger in the motion area to feel the prostate and its inflammation.
  • He may perform a semen culture which may guide regarding the bacteria causing the infection and which medicine the bacteria would be susceptible to.
  • In many causes a test called uroflowmetry , wherein you have to pass urine in a machine to assess a flow of urine is required.
  • In some rare cases an ultrasound and cystoscopy also we needed. In situations where the diagnose of the prostatitis is not being with certainty or situation where the medicine  is not helping top the extent that assured.
  • Some additional examinations like MRI scan of the abdominal pelvis may also be perform. If there is poor response to oral therapy, we may require giving intravenous injections for painkillers and antibiotics also.

What is the etiology behind prostatitis ?

Prostatitis is a infection that may be caused by bacteria but it may also cause by other organism such as viruses and sometimes just exposure of prostate gland to urine which is called Chemical Prostatitis.

What are the lifestyle changes suggested in patients with prostatitis ?

  • In situations such as chemical prostatitis there is usually no infection to sexual partner, however patients with bacterial prostatitis can transmit infection to their partner. It is therefore advisable to perform sexual activity with protection.
  • Patients with prostatitis should manage their lifestyle well by increasing raw fruits and vegetables in their diet which have antioxidant properties along with adequate exercise for at least 30 minutes morning and evening in form of walk. Along with that they should do meditation exercises and stress reduction should be part of their life.
  • Many patients may notice an increase in symptom on taking spicy food and fatty food both of which should be avoided as far as possible.
  • It is controversial when the sexual activity should be increased in patient with prostatitis however many doctors believe that increase in frequency of masturbation or sexual activity leads to more release of sperm which can help to drain out the infection.