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Saturday, September 5, 2015
Prostatitis is an inflammation of the prostate gland that may result from a bacterial infection. It affects at least half of all men at some time during their lives. Having this condition does not increase your risk of any other prostate disease.
Several tests, such as DRE and a urine test, can be done to see if you have prostatitis. Correct diagnosis of your exact type of prostatitis is key to getting the best treatment. Even if you have no symptoms you should follow your doctor's advice to complete treatment.
BPH stands for benign prostatic hyperplasia. Benign means "not cancer," and hyperplasia means abnormal cell growth. The result is that the prostate becomes enlarged. BPH is not linked to cancer and does not increase your risk of getting prostate cancer—yet the symptoms for BPH and prostate cancer can be similar.
At its worst, BPH can lead to: a weak bladder, backflow of urine causing bladder or kidney infections, complete block in the flow of urine and kidney failure.
The prostate gland is about the size of a walnut when a man is in his 20s. By the time he is 40, it may have grown slightly larger, to the size of an apricot. By age 60, it may be the size of a lemon. The enlarged prostate can press against the bladder and the urethra. This can slow down or block urine flow. Some men might find it hard to start a urine stream, even though they feel the need to go. Once the urine stream has started, it may be hard to stop. Other men may feel like they need to pass urine all the time, or they are awakened during sleep with the sudden need to pass urine. Early BPH symptoms take many years to turn into bothersome problems. These early symptoms are a cue to see your doctor.
Some men with BPH eventually find their symptoms to be bothersome enough to need treatment. BPH cannot be cured, but drugs or surgery can often relieve its symptoms. Talk with your doctor about the best choice for you. Your symptoms may change over time, so be sure to tell your doctor about any new changes.
Men with mild symptoms of BPH who do not find them bothersome often choose this approach. Watchful waiting means getting annual checkups. Treatment is started only if symptoms become too much of a problem.
If you choose watchful waiting, these simple steps may help lessen your symptoms:
Some medications can make BPH symptoms worse, so talk with your doctor or pharmacist about any medicines you are taking such as:
Many American men with mild to moderate BPH symptoms have chosen prescription drugs over surgery since the early 1990s. Two main types of drugs are used. One type relaxes muscles near the prostate, and the other type shrinks the prostate gland. Some evidence shows that taking both drugs together may work best to keep BPH symptoms from getting worse.
Taking these drugs can help increase urine flow and reduce your symptoms. You must continue to take these drugs to prevent symptoms from coming back. 5-alpha reductase inhibitors can cause the following side effects in a small percentage of men including: decreased interest in sex, trouble getting or keeping an erection, and smaller amount of semen with ejaculation.
It's important to note that taking these drugs may lower your PSA test number. There is also evidence that these drugs lower the risk of getting prostate cancer, but whether they can help lower the risk of dying from prostate cancer is still unclear.
The number of prostate surgeries has gone down over the years. But operations for BPH are still among the most common surgeries for American men. Surgery is used when symptoms are severe or drug therapy has not worked well. Be sure to discuss options with your doctor and ask about the potential short- and long-term benefits and risks with each procedure.
Types of surgery for BPH include:
Acute bacterial prostatitis: This type is caused by a bacterial infection and comes on suddenly (acute). Symptoms include severe chills and fever. There is often blood in the urine. Your PSA level may be higher than normal. You must go to the doctor's office or emergency room for treatment. It's the least common of the four types, yet it's the easiest to diagnose and treat.
Most cases can be cured with a high dose of antibiotics, taken for 7 to 14 days, and then lower doses for several weeks. You may also need drugs to help with pain or discomfort. If your PSA level was high, it will likely return to normal once the infection is cleared up.
Chronic bacterial prostatitis: Also caused by bacteria, this type of prostatitis doesn't come on suddenly, but it can be bothersome. The only symptom you may have is bladder infections that keep coming back. The cause may be a defect in the prostate that lets bacteria collect in the urinary tract.
Antibiotic treatment over a longer period of time is best for this type. Treatment lasts from 4 to 12 weeks. This type of treatment clears up about 60 percent of cases. Long-term, low-dose antibiotics may help relieve symptoms in cases that won't clear up.
Chronic prostatitis or chronic pelvic pain syndrome: This disorder is the most common but least understood type of prostatitis. Found in men of any age from late teens to the elderly, its symptoms can come and go without warning. There can be pain or discomfort in the groin or bladder area. Infection-fighting cells are often present, even though no bacteria can be found.
There are several different treatments for this problem, based on your symptoms. These include anti-inflammatory medications and other pain control treatments, such as warm baths. Other medicines, such as alpha-blockers, may also be given. Alpha-blockers relax muscle tissue in the prostate to make passing urine easier. Some men are treated with antibiotics in case the symptoms are caused by an undetected infection.
Asymptomatic inflammatory prostatitis: You don't have symptoms with this condition. It is often found when you are undergoing tests for other conditions, such as to determine the cause of infertility or to look for prostate cancer. If you have this form of prostatitis, your PSA test may show a higher number than normal.
Men with this condition are usually not treated, but a repeat PSA test will usually be done if the PSA number is high.
Adapted from the National Cancer Institute's Prostate Cancer Topic: (http://www.cancer.gov/cancertopics/types/prostate/understanding-prostate-changes)
Last Reviewed: Mar 10, 2015