Prostatitis – Classification and Symptoms

When the prostate gland becomes swollen, painful and inflamed, one is said to have prostatitis or prostate infection. Prostatitis is not the same as prostate enlargement or benign prostatic hyperplasia (BPH), neither does it lead to BPH or prostate cancer. Prostatitis however, has been shown to contribute to male infertility.

The prostate gland is an important organ in the male reproductive system when it comes to fertility. It is a walnut-sized organ found just under the urinary bladder and in front of the rectum. Females do not a prostate gland. The main function of the prostate gland is to produce seminal fluid which ensures the safe travel of sperm as it goes to fertilize an egg in the female. This seminal fluid provides nourishment and protection for the sperm against the harsh environment of the female genital tract.

Usually, as men age, the size of the prostate gland starts to enlarge, which can block the urethra and make urination very difficult for the patient. In prostatitis, it is an infection that causes the enlargement of the prostate and other urinary symptoms.




Statistics show that prostatitis can affect men of all ages, but is more common among middle-aged men between 36 to 50 years old. The incidence of prostatitis in Nigeria is about 100 thousand cases per year whiles it is as high as 2 million cases per year in other countries like the US. Prostatitis can be treated in the hospital as out patient cases and would rarely require hospital admission or surgeries.


What Causes of Prostatitis?  

As stated above, prostatitis is primarily caused by an infection, mostly bacteria infection. Sometimes, harmful bacteria like E. Coli found in the urinary tract can ascend upward and infect the prostate gland causing it to get inflamed, swollen and painful. The infection can also be from the spread of harmful bacteria from the rectum through the lymphatic system or a sexually transmitted infection like N. Gonorrhea, Chlamydia or HIV.

There are several risk factors that can increase the chances of getting prostatitis, which include

  • Age below 50 years.
  • A prior history of prostatitis.
  • Having a recent urinary tract infection.
  • Recent use of a urinary catheter or a recent urologic procedure.
  • Enlarged prostate gland.
  • Engaging in anal sex.
  • Having a structural or functional urinary tract abnormality.
  • Dehydration (not enough fluids).
  • Local pelvic trauma or injury such as from bicycle riding or horseback riding.


Classifications of Prostatitis 

Based on the differences in symptoms and causes, prostatitis have been classified into 4 types namely

  1. Acute bacterial prostatitis.
  2. Chronic bacterial prostatitis.
  3. Chronic prostatitis/Chronic pelvic pain syndrome (CP/CPPS).
  4. Asymptomatic prostatitis.

Acute bacteria prostatitis  is the least common type of all the four. It is due to bacteria infection of the prostate gland which causes inflammation and swelling of the prostate gland. Symptoms of acute bacteria prostatitis are sudden in onset and may be accompanied by other flu-like symptoms.

A chronic bacterial prostatitis is one where by there is a recurrent bacteria infection of the prostate gland. Symptoms usual come and go and this makes treatment very difficult. The symptoms may be mild or even absent during recurrent attacks.

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is the most common of all the types of prostatitis. It is however the least understood in terms of its exact cause. The patient has symptoms of prostatitis but there may be absent indication of any infection when tested in the lab.

Asymptomatic prostatitis do not show any symptoms in the patient although there is an infection of the prostate gland. This type of prostatitis is diagnosed accidentally during medical examination for BPH or prostate cancer.


Symptoms of Prostatitis

The symptoms of Prostatitis may vary in its onset and severity depending on the type of the prostatitis. Generally, symptoms of Prostatitis will include

  • Painful, difficult and/or frequent urinating
  • Blood in the urine
  • Groin pain
  • Rectal pain
  • Abdominal pain
  • Low back pain
  • Fever and chills
  • Malaise and body aches
  • Urethral discharge
  • Painful ejaculation or sexual dysfunction

The doctor can use these symptoms to suspect prostatitis and then further investigates to confirm the diagnosis. See your doctor if you are experiencing these symptoms. The doctor will do some medical examination including a digital rectal exam, laboratory tests and imaging studies like ultrasound scan to assess the prostate gland for any inflammation and swelling.


Treatment of Prostatitis 

The treatment of prostatitis is dependent on the cause and geared towards relieving the symptoms of the patient. The treatment is mainly medications and lifestyle changes. Surgeries are very rare.

Antibiotics will be prescribed to fight the bacterial infection. The doctor will decide which type of antibiotics will suit the infection best, so avoid trying self medication.

Anti inflammatory drugs will help treat the inflammation in the prostate gland and reduce the pains. Again, the doctor will decide which anti inflammatory drugs to prescribe that will give the best result. Do not try to treat yourself by going to the drug store to buy over the counter drugs without prescription.

Alpha-blockers are drugs that can cause the muscle fibers around the prostate gland and bladder to relax so that urinating can become easier and less stressful for the patient.

Lifestyle changes like warm sitz baths (sitting in warm salted water) can also be very helpful to the patient. The patient will need to avoid alcohol, caffeine and spicy foods. If the patient is involved in cycling or horse riding, he may need to suspend it for a while until treatment is complete.

If prostatitis is not properly treated, it can develop into a chronic case and complications like infertility, abscess in the prostate gland, sepsis and even death can occur.



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