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Prostatitis
Prostatitis is not cancer, nor is having prostatitis related to increased prostate cancer risk. Prostatitis is simply an infection or inflammation of the prostate gland. The suffix "itis" is used to indicate an infection or inflammation of other body parts as well-think of appendicitis or bronchitis.
Usually, prostatitis is divided into at least two categories: acute and chronic. Acute just means sudden or sharp, so acute prostatitis occurs quickly and causes sudden and sometimes intense pain. Chronic means that the problem lingers, usually for three or more months, causing prolonged pain that is often less intense.
These two categories are divided once again, usually into four types of prostatitis: acute bacterial prostatitis, chronic bacterial prostatitis, chronic prostatitis/chronic pelvic pain syndrome, and asymptomatic inflammatory prostatitis.
ACUTE BACTERIAL PROSTATITIS
This type of prostatitis is a bacterial infection of the prostate. That's why it's called "bacterial." Although uncommon, acute bacterial prostatitis can be frightening when it occurs because symptoms are often quite severe and happen suddenly. You might experience the following:
- Fever and chills;
- Nausea, muscle aches, and other flu-like symptoms;
- Pain in the pelvic area, lower back, or genitals;
- Frequent urination (during both the day and night);
- A burning sensation when urinating;
- An inability to empty the bladder; and
- Pain with ejaculation.
Also, a man's PSA level may increase quite rapidly if he contracts acute bacterial prostatitis. Sometimes, this form of prostatitis occurs because of surgery to the area, such as a prostate biopsy, or because of the insertion of a catheter.
CHRONIC BACTERIAL PROSTATITIS
Bacteria also cause this form of prostatitis. Although with chronic bacterial prostatitis the infection often hangs on for 3 months or more, symptoms are usually less severe than with acute bacterial prostatitis. Sometimes, men do not even know they have a problem until they develop another difficulty, such as an infection of the urinary tract.
CHRONIC PROSTATITIS / CHRONIC PELVIC PAIN SYNDROME
This third category of prostatitis is a kind of catchall for prostatitis that is not caused by the usual bacteria (non-bacterial prostatitis) and pain in the pelvic region (prostatodynia) that affects a man's perineum, prostate, and pelvis. Symptoms are similar to those of acute bacterial prostatitis and may be severe. They include
- Discomfort or pain in the perineum, bladder area, testicles, and penis;
- Painful and frequent urination; and
- Difficult or painful ejaculation.
ASYMPTOMATIC INFLAMMATORY PROSTATITIS
Asymptomatic prostatic inflammation is an inflammation that is not causing pain or other symptoms but is evident during a biopsy or other tests.
Notice that some of the symptoms of prostatitis are similar to those of benign prostatic hyperplasia (BPH), urethritis or cystitis (inflammation of the urethra or bladder), and prostate cancer. So men feeling these symptoms, even if discomfort is not acute, should consult a physician.
DIAGNOSIS
Usually, your doctor will first conduct a digital rectal examination to see whether the prostate is enlarged or tender and to feel for any lumps or hard areas that could suggest the possibility of prostate cancer. Your doctor or urologist might also test your urine flow or send various urine specimens or samples of prostatic fluid for analysis to see if infection can be detected and whether that infection might be in the urethra, bladder, or prostate.
A PSA test to check for the possibility of prostate cancer may also be recommended. It should be noted, however, that, occasionally, the inflammation caused by some forms of prostatitis can affect the prostate tissue enough to allow prostate-specific antigen (or PSA) to leak into the blood, raising PSA levels. You may also be asked to keep a diary of when you urinate and when you experience pain in the pelvic area and the site and intensity of this pain.
If necessary, a transrectal ultrasound (TRUS) may be used to get a picture of the prostate gland. In addition, a cystoscope, which is a small magnifying device, may be inserted into the bladder through the urethra. This device enables the close examination of the urethra, prostate, and bladder.
To determine effective treatment, the accurate diagnosis of prostatitis is important, but diagnosis is often difficult. Symptoms vary between individuals, and many symptoms can signal any of the four types of prostatitis or other problems of the prostate or urinary system.
TREATMENTS
Acute bacterial prostatitis is treated with antibiotics and pain medication for between 4 and 6 weeks. Occasionally, men need to be admitted to hospital so that intravenous antibiotics can be administered.
Chronic bacterial prostatitis is also treated with antibiotics and, if necessary, with pain medication. Usually, men need to take antibiotics for between 4 and 12 weeks. Sometimes, the infection recurs, and another course of antibiotics is prescribed. Some types of bacteria do not respond well to antibiotic treatment, and men must remain on antibiotics of various kinds over a long period to control symptoms.
Chronic prostatitis or chronic pelvic pain syndrome is often treated with antibiotics for a trail period because it is difficult to determine whether a man has a bacterial or a non-bacterial form of prostatitis. Besides, some evidence suggests that "non-bacterial" prostatitis might be caused by bacteria after all. If your symptoms respond to antibiotic therapy, it will be continued. If they do not, antibiotics will be discontinued and other methods will be tried to relieve your symptoms, including alpha-blockers (to relax the prostate) or anti-inflammatory drugs (to reduce inflammation and pain). Other therapies include massaging the prostate to drain fluid, taking hot tub bathes or using other heat therapies, and engaging in stress relief activities to encourage relaxation of muscles and pain control.
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