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Johns Hopkins Symptoms and Remedies

Johns Hopkins Medicine

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Prostatitis

What is it?

Prostatitis is an acute or chronic inflammation of the prostate, a walnut-size gland located just below the bladder in men, which produces about 30 percent of the fluid portion of semen. Inflammation may be caused by an infection. Acute prostatitis is characterized by the sudden onset of symptoms; chronic prostatitis causes persistent, long-term symptoms that are less severe. Chronic prostatitis may affect as many as 35 percent of men over age 50. An inflamed prostate may press upon the urethra and completely block the flow of urine. Additionally, if left untreated, acute prostatitis may lead to a prostate abscess, an infected, pus-filled cavity. Treatment for the acute and chronic forms of prostatitis may differ considerably.

What Causes It?

  • The cause is unknown in almost all cases.
  • Bacterial infection may cause about 5 percent of cases. Infection usually ascends through the urethra to the prostate. It may be transmitted sexually.
  • The use of a urinary catheter increases the risk of prostatitis.
  • Acute prostatitis may lead to chronic prostatitis in some cases.
  • Risk of acute prostatitis is higher among men between the ages of 20 and 40 who have multiple sex partners and who practice high-risk behaviors such as anal intercourse or failure to use condoms.

Prevention

  • Get prompt treatment for urinary tract infections.
  • Use condoms to prevent the spread of sexually transmitted disease.

Diagnosis

  • Patient history and physical examination, which includes a digital rectal examination (DRE). In DRE the doctor inserts a gloved finger into the rectum to press on the prostate gland.
  • Microscopic examination and culture of secretions expressed from the prostate during a DRE.
  • Culture and microscopic analysis of urine.
  • Ultrasound scans, which may be helpful in detecting an abscess.

How to Treat It

  • Hospitalization is often necessary to treat acute prostatitis. Intravenous antibiotics are given for bacterial infections, and a urinary catheter may be required to permit urination.
  • Oral antibiotics are prescribed to treat acute and chronic prostatitis and should be taken for the full term prescribed (from four to 12 weeks).
  • Caffeinated and alcoholic beverages should be avoided until symptoms subside, because the diuretic effect of these drinks increases urinary frequency.
  • Warm baths may provide some relief from symptoms of chronic prostatitis.
  • Over-the-counter analgesics may be taken as necessary to reduce pain and fever.
  • If the prostate has become abscessed, surgical drainage is needed.
  • Stress reduction techniques may be advised to help patients manage nonbacterial chronic prostatitis.

When to Call a Doctor

  • Call a doctor if you become unable to urinate or if you develop difficult or painful urination.