Prostatitis: Types. Symptoms, Treatment and Side Effects

A walnut sized gland is found in men below the bladder, in front of the rectum. The prostate gland function is to produce a fluid that contains the sperm and fluids from other glands which makes up semen. When the sperms are travelling towards female eggs, they are protected by this fluid.

The situation of swelling or inflammation in this gland is known as prostatitis. It is a painful condition which causes difficulty in urination. All age groups of men can suffer from prostatitis, but it is more common in men of age group 50 or young.

There are 4 types of prostatitis:

• Chronic Prostatitis: Chronic prostatitis which is the most common type of prostatitis. There are two main types of chronic prostatitis.
  • Chronic Bacterial Prostatitis: It is caused by persistent infection with a germ which is generally bacterial infection.
  • Chronic Pelvic Pain Syndrome: The other one is chronic prostatitis or chronic pelvic pain syndrome.
• Acute Prostatitis: Acute prostatitis which is caused by bacterial infection of the prostrate gland.
• Asymptomatic Inflammatory Prostatitis: Asymptomatic inflammatory prostatitis is a condition where the prostate is inflamed but the patient have no symptoms at all. It can be diagnosed only at the time of lab tests.

There are various symptoms of prostatitis. In different people symptoms occur according to the underlying causes. The symptoms may appear very quickly or come up very slowly, they improve rapidly or last for several months or keep recurring. The severity and rapidity of its occurrence is usually marked with bacterial prostatitis.

The signs and symptoms of prostatitis may include:

• Painful urination
• Fever and chills
• Urethral Discharge
• Malaise and body aches
• Abdominal pain. Rectal pain, Groin pain or back pain
• Blood flow in urine

The cause of prostatitis depends on the type of prostatitis.

• Acute and chronic bacterial prostatitis:

  The reason behind the cause of bacterial prostatitis is bacterial infection in the prostate. The chronic type evolves steadily and lasts a long time while on the contrary acute bacterial prostatitis evolves fast and suddenly and vanishes in short periods of time. The infection may happen when bacteria goes into the prostate from the urethra.

• Chronic Prostatitis :

  It is believed by some researchers that the cause behind the conditions might be microorganism and not bacteria. This type of prostatitis may be because of chemicals in urine, nerve damage in pelvic area or body reaction to previously occurred UTI.

• Asymptomatic Inflammatory Prostatitis:

  The actual reason behind this is still unknown. Due to no symotoms its hard to find even.

The doctor who checks for prostatitis checks for:

• Personal and family history:

  Taking a family history and personal history will help the doctor find out if there are any defects in the genes which are the possible reason for prostatitis.

• Medical test:

  The doctor would recommend the person to consult a urologist, a person who specialises in Urinary Tract Infections and Male reproductive systems. The urologist takes a medical test and checks UTI problems related to prostatitis. Medical Tests may include:

  • Urinalysis
  • Blood Test
  • Biopsy
  • Cystoscopy
  • Urodynamic Test
  • Semen Analysis
  • Transrectal Ultrasound
• Physical examination:

  Physical examination is another way of diagnosing prostatitis. For physical examination, the healthcare provider generally:

  • Does an examination of the patient body and tests whether there are tender lymph nodes in the groin, swollen or tender scrotum or any kind of discharge from urethra.
  • Carry out a rectal examination digitally

Treatment of prostatitis depends on the causes and type of it. In case of bacterial infections, antibiotics are advised. All kinds of prostatitis needs to be treated with relief for complications or side-effects, treatment, pain control if needed, and it needs to be closely monitored and checked by the doctor. In some cases, the prostatitis patient needs to be hospitalised.

Some more treatments are:

• Antibiotics: The antibiotics which are to be given and the duration of treatment is decided by the doctors.
• Alpha Blockers: Alpha blockers decrease the urinary symptoms and help you to empty your bladder. It relaxes muscle fibres surrounding the bladder and prostate gland.
• Anti-inflammatory medicines: These are given to the patients to manage the pain.

Doctors may also recommend over-the-counter pain relievers such as acetaminophen and ibuprofen. Acute bacterial prostatitis is a medical emergency. Some antibiotics have very poor penetration of prostatic capsule but some penetrate very well which are as follows- ciprofloxacin, co-trimoxazole and tetracyclines such as doxycyclines (in case of CBP).

Severely ill patients may be hospitalized while others can be treated at home with bed rest, analgesics, stool softeners and hydration. Acute bacterial prostatitis require prompt recognition and treatments it may lead to sepsis.

Non-steroidal anti-inflammatory drugs may offer both analgesia and more rapid healing by liquefaction of prostatic secretions. If patients fail to improve through antibiotics a prostatic abscess is suspected. When the disease is mild or moderate- Trimethoprim, Cephalexin, Amoxicililin and Clavulanic acid are used. If it appears septic parenteral therapy is used.

In the case of which it is treated with medications like alpha blockers, paracetamol and ibuprofen. There are other medications too which can be beneficial for treating non-bacterial chronic prostatitis but evidence of effectiveness of treating with those medicines are very limited.

The medications of such type include finasteride which is used in treating prostate enlargement, fluoxetine is an antidepressant medicine which treats depression of the patient, gabapentin is a medicine which is used in the treatment of chronic pain, amitriptyline in its low doses treats pain and bladder problems and aids sleep as well. As acute prostatitis is treated with antibiotic tablets.

Pain is relieved through paracetamol and/or ibuprofen. In case of severe pain a strong painkiller like codeine is prescribed.

In case of severe pain please consult your doctor

The risk factors prostatitis include are:

• Previous history of having prostatitis
• If the person has gone through prostate
• Had a pelvic trauma i.e. injured because of cycle or horse ride
• Suffering from HIV/AIDS
• Having infection in bladder or urethra (a tube that transports urine and semen to the tube)
• Using a urinary catheter ( A tube that is inserted into urethra to drain the bladder)

A vegetable, fruit and healthy fats rich diet is advised to prostatitis patients. The food include:

• Salmon: Rich in healthy fats containing Omega3 fatty acids; help prevent and reduce inflammation in the body.
• Tomatoes: Filled with Lycopene which is an antioxidant which benefits prostate gland cells.
• Broccoli: Broccoli along with other cruciferous vegetables such cauliflower, brussel sprouts, cabbage etc contain sulforaphane. They target the cancer cells and make the prostate healthy.
• Nuts: Rich in zinc. Zinc is found in high concentration in the prostate and balances DHT and testosterone.
• Citrus: Citrus helps the prostate gland. Food containing Vitamin C like orange, lemon, grapefruits and limes are recommended.
• Berries: Raspberries, Strawberries, blackberries and blueberries are excellent sources of antioxidants. They help to remove free radicals from the body.

Ciprofloxacin is a fluoroquinolone antibiotic treatment that is taken for acute bacterial or chronic bacterial prostatitis. CIPRO and other Fluoroquinolones including CIPRO are associated with an increased risk of tendinitis which is the inflammation of the tissue that connects muscle to bone and tendon rupture which is a separation of the tissue connecting muscle to bone in all ages.

But this risk is increased further in older patients of over sixty years of age. This risk is increased in patients with kidney, heart or lung transplants. Fluoroquinolones may also cause exacerbate muscle weakness in patients suffering from myasthenia gravis. Doxycycline and other tetracycline may cause permanent staining of teeth if used during teeth development.

It may also be associated with diarrhoea which can be mild or fatal. It may interact with Coumadin leading to extreme thinning of blood. If Coumadin is taken before doxycycline, reduction of its dose is required.

Though having prostatitis does not neccessarily increase the risk of developing of prostate cancer or any other diseases like other prostate or kidney diseases but it is recommended to continue to undergo regular examinations to detect prostate cancer even after prostatitis is cured.

After the primary management and stabilization of the patient suffer from acute prostatitis , care should be appropriately transferred to an urologist.

Aggressive treatments can also lessen the risk of developing chronic prostatitis. After the initial improvement through the parental antibiotic medicines, the acute bacterial prostatitis may be managed with outpatient care with a course of two to four weeks of oral antibiotic medicines and a urologic follow-up.

Prostatitis is a treatable condition where even if the problem does not get cured, relief from the symptoms can be achieved by following the treatment recommended by the doctors. If the cause of prostatitis is bacterial infection then a four to six weeks of antibiotics are generally prescribed.

For chronic infectious prostatitis medicine is taken for a longer period of time usually six to twelve weeks. With this treatment chronic infectious disease get cleared up but if the case does not get solved then antibiotics are prescribed for a long time at a low dose which help to get a relief from the symptoms of the disease. Now for acute infectious prostatitis patients usually need to take antibiotic medicine for seven to fourteen days.

Cost of prostate treatment in India will vary depending on the type of prostate the patient is suffering from and the procedure chosen to relieve the patient from his ailment. There are various states offering treatment. Hospitals like Fortis and Apollo have charge the patients differently depending upon the case.

It is healthy to continue regular examinations even after the prostatitis is cured. The treatment results are generally permanent. If the infection comes back the patients may be prescribed to take medicine for up to twelve weeks. There are cases where patients have recovered from prostatitis for five years or more. There are even some patients who have not recovered.

Non-infectious prostatitis does not have a definitive cure and the treatment is generally aimed at controlling the symptoms causing it. Chronic prostatitis symptoms may seem to go away but then can also return without warning. Medications can help but the condition is unlikely to go away entirely. Thus, it can be concluded that permanency of the treatment is very much dependent on the type of prostatitis and the patient’s condition.

The symptoms of Prostatitis may last for a long time. However they may vary in severity and come and go. Men who are diagnosed with chronic prostatitis tend to experience improvement in their condition in 6 months. It entirely depends on the person that how long will prostatitis stay. Some people have experienced it for a year, some for two years and some for just 3 months.

Prostatitis is a serious condition that could affect the overall body of the person. One must be aware of the family history of diseases and illness to prevent this kind of problem. If the symptoms are seen, the person consult the doctor immediately instead of ignoring them. While you are on treatment, you must complete the whole course of medicines even if you see the symptoms going away.

Often, antibiotics can be used to treat prostatitis which is caused by bacterial illness. If the condition is chronic and recurs, it requires long-term medical attention.

Acute bacterial prostatitis have a good prognosis and thus can have a successful treatment. In case of unsuccessful events, Chronic Prostatitis, especially non-bacterial prostatitis can lead to sheer discomfort and long-term symptoms.

The treatments/remedies that could be performed at home can help to cure or prevent prostatitis and reduce the chances and needs of going to the hospital. The remedies are:

• Prostate Massage: According to some studies, prostate massage helps to decrease the symptoms in some patients with chronic nonbacterial prostatitis.
• Acupuncture has been proven to show decrease in symptoms for some people who are victims of prostatitis.
• You must avoid spicy food and alcohol.
• Take a warm bath everyday.

Some alternative treatments for prostatitis are as follows- drinking of copious amount of water is needed to keep the system flushed. Cranberry juice has the properties which can dislodge bacteria from the bladder wall so that the loose invading bacteria are washed away.

Patient should try to relax and free themselves from stress. Using herbs like Valerian, Scullcap help to relax muscles. Patients should eat lightly. They should have whole grains , steamed vegetables, fresh fruits and herb teas.

Herbs like Buchu, Chamomile, roots and leaves Comfrey which helps relieve inflammation, Couch grass which is very helpful in treating enlarged and infected prostates, Camp bark, Garlic are also beneficial.

Summary: Prostatitis can be described as swelling of the small walnut-sized gland known as the prostate which is responsible for producing seminal fluid.