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. However, it 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 have 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.
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.
- 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.
- Acute bacterial prostatitis.
- Chronic bacterial prostatitis.
- Chronic prostatitis/Chronic pelvic pain syndrome (CP/CPPS).
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.
The symptoms of Prostatitis may vary in its onset and severity depending on the type of the prostatitis. Generally, symptoms of Prostatitis may 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
These symptoms are definitive to suspect prostatitis and further investigates to confirm the diagnosis. See your doctor if you are experiencing any of the listed. Your doctor will make some medical examination, a digital rectal exam, laboratory tests and imaging ultrasound scan to assess the prostate gland for any inflammation and swelling.
Treatment is dependent on the cause and geared towards relieving the symptoms. This is mainly medications and lifestyle changes. Surgeries are very rare. Antibiotics will be prescribed to fight the bacterial infection. Anti inflammatory drugs also to help treat the inflammation in the prostate gland and reduce the pains. An Alpha-blocker can cause the muscle fibers around the prostate gland and bladder to relax so that urinating can become easier and less stressful
Lifestyle changes like warm sitz baths (sitting in warm salted water) can also be very helpful, there is a need to avoid alcohol, caffeine and spicy foods, cycling or horse riding, 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.