Prostatitis: What it is, Causes, Symptoms & Treatments

• There is no single cause of prostatitis, but it is usually caused by a bacterial infection of the prostate gland.
• To diagnose acute prostatitis, tests such as physical examination, blood tests, urine and semen cultures and, in cases of chronic prostatitis, even a biopsy are carried out.
• Antibiotic treatment is likely to last several weeks to ensure that the infection is completely eradicated.

Prostatitis is an inflammatory and/or infectious process that affects the prostate gland. It is a benign condition and its development is not directly related to the possibility of suffering from Benign Prostatic Hyperplasia or Prostate Cancer.

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Infectious inflammation of the prostate or prostatitis is the most common type of prostate inflammation in men under the age of fifty.

This condition causes the prostate to become inflamed due to urination, sexual and perineal disorders, depending on the cause, whether it is a bacterial infection of the prostate gland or not. In any case, it is a problem that is generally solved with pharmacological treatment without the need to resort to a surgical procedure.

Below we explain in detail what prostatitis consists of, its symptoms and, of course, the possible treatments that exist to solve it.

Prostate inflammation, in many cases, is caused by a bacterial infection of the prostate gland. So any bacteria that can cause a urinary tract infection can lead to acute bacterial prostatitis.

Another, less common, reason for prostate inflammation is sexually transmitted diseases (STDs).

To make it clearer, in the following comparison grid you can find the most common causes of prostate inflammation, taking into account its typology:

As with the causes of prostatitis, the symptoms of prostate inflammation will depend on the type and characteristics of each patient.

As you have read above, infectious prostatitis can be differentiated by the duration of the inflammation, i.e. acute prostatitis and chronic prostatitis. 

The symptoms of these conditions are generally as follows:

Symptoms of Acute Bacterial Prostatitis

Acute prostatitis is considered acute when the onset of symptoms is less than 2 weeks. The most common signs are:

• Pain or a feeling of heaviness in the perineal region or lower abdomen.
• Discomfort when urinating.
• Decreased urination stream and a feeling of not having completely evacuated the bladder.
• Occasionally may cause a small amount of bleeding with urine or in semen.
• May cause fever and chills.
• Very high prostate-specific antigen (PSA) values during infection.

Symptoms of chronic bacterial prostatitis

Chronic prostatitis develops when symptoms occur for more than one month despite antibiotic treatment.

In this type of prostatitis, the symptoms are milder and spaced out over time. Also, the presence of a high fever is difficult to detect. However, you may have irritative symptoms of urinary tract infection or even no symptoms at all.

Prostatitis can develop gradually, which may delay detection and a visit to a specialist.

As for the PSA level during prostate inflammation (chronic type), it is usually normal or moderately elevated. This makes it more difficult to detect the problem and to treat it.

Symptoms of abacterial (non-bacterial) prostatitis

Prostatodynia or non-bacterial prostatitis presents with a variety of genitourinary signs which usually include:

• Perineal and/or lower abdominal pain
• Penile discomfort and testicular pain
• Dysuria (difficulty or pain in passing urine)

First of all, if you start to notice discomfort when you urinate or any of the other symptoms we have explained above, you should see your GP or, preferably, a specialist in urology. 

This will help diagnose your clinical condition and determine the type of treatment you should follow to return to normal.

Diagnosis of prostate inflammation

To diagnose prostate inflammation, depending on the symptoms you present, the doctor will conduct a medical interview on the basis of which he or she will suspect the type of pathology you may be suffering from.

Once the pathology has been detected, the urology specialist must confirm the diagnosis with a series of tests.

If the specialist believes it to be acute or chronic prostatitis or an inflamed prostate due to another infectious cause, it may be necessary to perform:

• Urinalysis
• Sperm culture
• Blood test
• Prostate ultrasound

Treatments for Prostatitis

If, after the tests, it is indeed prostatitis and not another pathology that may cause the prostate to enlarge, such as benign prostatic hyperplasia or prostate cancer, then treatment will be followed, which, again, will depend on the type of prostatitis you suffer from.

• In the case of acute prostatitis, bactericidal antibiotics are prescribed. These drugs are suitable for gram-negative bacteria and are administered parenterally, i.e. the medication is given through a vein (intravenous), a muscle (intramuscular) or through the skin (subcutaneous).
• To combat chronic prostatitis, treatment is also with antibiotics. In this case the drugs are characterised by the fact that they penetrate well into the prostate tissue (liposoluble). Some of the drugs that diffuse best into the prostatic fluid are:

Antibiotic treatment to eliminate prostatitis lasts between 6 and 12 weeks.

Other recommended treatments for prostatitis may be:

• Phytotherapy.
• Alpha-blockers.
• Muscle relaxants.
• 5-alpha-reductase inhibitors.
• Anti-inflammatory drugs.
• Changes in lifestyle habits.

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• ANDROILE, G. L. (2018, marzo). Prostatitis. Recuperado de https://www.msdmanuals.com/es-es/professional/trastornos-urogenitales/enfermedad-prost%C3%A1tica-benigna/prostatitis
• LÓPEZ LARRAYOZ, I., GARCÍA CORES, F., PEREIRA SANZ, S., MANRIQUE OLMEDO, B., ESCRIBANO ROMO, G., & PANADERO CARLAVILLA, F. J. (2003). PROSTATITIS. Recuperado de https://botplusweb.portalfarma.com/Documentos/2003/4/22/15417.pdf
• GARCÍA-ARENZANA ANGUERA, J. M. (2005). Tratamiento de las prostatitis. Recuperado de https://www.mscbs.gob.es/biblioPublic/publicaciones/docs/vol29_6Prostatitis.pdf
• SEGADO SORIANO, A., REGALADO DE LOS COBOS, J., & GONZÁLEZ RAMALLO, V. J. (s.f.). CAPÍTULO XIV: Infecciones urológicas [Libro]. Recuperado de https://www.fesemi.org/sites/default/files/documentos/publicaciones/capitulo-14.pdf