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Prostatitis is a swelling of the prostate gland which lies between the penis and the bladder. It affects men of all ages. Most men will get better reasonably quickly with the right treatment, although one in ten go on to develop chronic prostatitis in the future after an acute bout. If it becomes a chronic, long term condition it can be harder to treat.
It’s a swollen prostate - often described as infection - which isn’t entirely accurate because swelling of the prostate can happen without any infection. It’s thought that only around five to 10 per cent of cases are caused by a bacterial infection, although sometimes it can be related to a urinary tract infection.
Chronic prostatitis is more common than acute - two to 10 per cent of adult men experience the symptoms of chronic prostatitis at some point, and 15 per cent of men will have some form of prostatitis at some point in their lives. It’s not true that developing prostatitis puts you at a higher risk of prostate cancer.
Symptoms usually start gradually but in acute prostatitis they will come on suddenly. They include:
In some cases you might feel tired, with aching joints and muscles, chills, or a high temperature. If these symptoms come on quickly, seek medical advice straight away.
In chronic prostatitis where your symptoms come and go it’s not unusual for doctors to find no infection, and the cause isn’t clear.
Where the symptoms develop suddenly they need immediate treatment. Acute prostatitis is often caused by bacteria in the urinary tract (kidneys, bladder, and connecting tubes). It’s possible that bacteria could get into the prostate through infected urine flowing backwards or stool bacteria enters from the rectum.
Only a small number of cases are sexually transmitted, although you are more at risk of developing the condition if you take part in anal intercourse.
Other things that can lead to a higher risk of getting prostatitis include:
Your doctor will ask you questions about:
Your doctor will need to carry out a physical examination of your abdomen and usually what’s called a digital rectal examination where you lie on your side while a gloved, lubricated finger is slid into your rectum to feel your prostate. It’s nothing to worry about, it might be a little uncomfortable but it doesn’t take long.
Your urine will usually be tested for signs of infection, and if your doctor suspects other conditions you may be referred to a urologist for further tests such as a prostate fluid analysis, a transrectal ultrasound, a biopsy or voiding studies (monitoring the flow of urine to see if there are any obstructions).
There’s another test called a PSA test - a blood test that detects the signs of an enlarged prostate. The test measures the level of prostate-specific antigen (PSA) in your blood. There are issues with the test’s accuracy when detecting prostate cancer, but a raised level of PSA can also indicate prostatitis.
For chronic prostatitis, doctors often recommend anti-inflammatory medicines and sitting in two to three inches of warm water to relieve uncomfortable symptoms. If it’s caused by a bacterial infection, you’ll be given antibiotics. For chronic bacterial prostatitis, a four week course of antibiotics clears up about 75 per cent of cases. If that doesn’t work, a low dose of antibiotics long term might be an option.
Symptoms can often be eased with painkillers or muscle relaxant drugs, and sometimes you might be advised to try prostate massage or stool softeners. Sometimes hormone medication can help shrink the prostate.
For chronic prostatitis that doesn’t respond to treatment, doctors may suggest surgical removal of the infected parts of the prostate. This is only used in severe cases, or if your swollen prostate is interfering with the flow of urine.
It depends on the type of prostatitis and what’s causing it. Antibiotic treatment for chronic prostatitis can take anything from 2-3 weeks to several months. If the antibiotics don’t help, you may have to have more tests. There’s no definitive treatment so it might be a case of trying different things until something works for you.
In acute prostatitis, treatment usually lasts for 4 to 6 weeks.
Not usually, but in certain types of prostatitis, called asymptomatic inflammatory prostatitis, where there’s swelling but no obvious infection, there can be a raised PSA level and higher amounts of white blood cells in semen leading to fertility problems. This type of prostatitis isn’t usually discovered until infertility is being looked into, and if you’re not trying to conceive, it probably won’t need treating.
No, although some people find that avoiding spicy foods and caffeinated or acidic drinks can help with their symptoms.
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