Everything to know about prostatitis 

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Infection of the prostate, as diagnosed by urologist in Karachi, is a painful condition that men of any age may undergo. It presents like any other infection with tenderness, fever and inflammation, that needs expert management. Read on to know more about prostatitis and how to deal with it:

What is prostatitis?

Prostate is a small gland, located just underneath the bladder in men, which makes up part of the semen. Prostatitis is a painful condition due to the inflammation of the prostate due to any infectious or non-infectious cause.  Prostatitis is different from an enlarged prostate, which is seen in benign prostatic hyperplasia or cancer of the prostate.

As the surrounding nerve plexus is impinged, prostatitis causes severe pain and tenderness. Depending on the cause of prostatitis, the symptoms can be sudden in onset (acute prostatitis) or keep recurring after every few months (chronic prostatitis).

What are the symptoms of prostatitis?

The symptoms of prostatitis vary with the cause behind it.

Acute bacterial prostatitis: comes on suddenly as the ascending infection from the urogenital tract. The symptoms include: high grade fever with chills, cloudy urine, trouble in urination, urgency in urination and pain around the genitalia—including base of penis and scrotum.

Chronic prostatitis: is the prostatitis of more common variety. The symptoms of chronic form of prostatitis are similar to the acute form, but no organism is isolated in investigations. The symptoms last more than three months and include: pain in the penis tip, or lower abdomen, pain on urination, painful sex and inability to hold the urine with increased frequency and urgency.

Asymptomatic prostatitis: is an incidental finding as it produces no symptoms. This type of prostatitis involves inflammation, but like chronic prostatitis, no organism is isolated on investigation. This form of prostatitis needs no treatment, but has the risk of eventually leading to infertility. 

How is prostatitis diagnosed?

The diagnosis is based on clinical findings and investigations. The clinical findings include a detailed history of the patient, and a physical exam like digital rectal exam (DRE). DRE involves the doctor checking the size and firmness of the prostate by putting a finger in the rectum. Other investigations include: trans-rectal ultrasound of the prostate, urine culture, prostatic fluid tests, cystoscopy and urine flow studies.

What are the causes of prostatitis?

For infectious acute prostatitis, the causative agent can involve acquiring the infection from sexual contact, urinary catheter, ascending infection, prostatic abscess or bladder infection. Other causes of prostatitis include: prostate stones, prostate cancer, benign prostatic hyperplasia and urethral stricture.

What are the risk factors of prostatitis?

The risk factors of prostatitis include:

  • History of recurrent urinary tract infections, especially ascending infections that may involve the prostate
  • History of HIV/AIDS
  • Men with enlarged prostate
  • History of recent bladder infection
  • Men with history of pelvic injury
  • Men who are frequently catheterized
  • Men who have had prostatic infection before
  • Men who have undergone prostatic biopsy procedure

What are the treatment options for prostatitis?

The treatment of prostatitis is dependent on the cause. Common treatment options include:

  • Antibiotics: for acute infection, antibiotics are given for a period of 10 to 14 days. In resistant cases, intravenous antibiotics are used by the healthcare provider after admission. For chronic infections, low-dose antibiotics may be used for up to 12 weeks. This longer duration allows the antibiotics to clear up the infection.
  • Anti-inflammatory agents: manage the inflammation of the prostate to minimize pain.
  • Alpha blockers: these drugs make urination easier by relaxing bladder muscles.
  • Prostatic massage: drains fluid from prostatic ducts and eases pain.
  • Home remedies: include a hot bath or hot shower. 
  • Surgery: may be recommended by Best urologist in Smart Medical and Diagnostics Center if medical therapy fails.