Prostatitis is a condition referring to the inflammation of the prostate gland. Prostatitis is not actually one disease, but several. The differences between them are significant in terms of appropriate medical management.

What are the Types of Prostatitis and Their Symptoms?

Acute Bacterial Prostatitis

This type of prostatitis comes on suddenly, and can be severe. Symptoms include increased urinary urgency and frequency, as well as a flu-like feeling, fever, pain in the pelvic and/or lower back areas, and painful ejaculation. Acute bacterial prostatitis may sometimes require hospitalization.

Chronic Bacterial Prostatitis

This type of prostatitis is difficult to get rid of; an underlying defect in the prostate makes it susceptible to repeated bacterial infections. Symptoms include: increased urinary urgency and frequency, pain or burning on urination, getting up at night repeatedly to urinate, painful ejaculation, pain in the lower back or genital areas, and the occasional presence of blood in urine and/or semen.

Chronic Nonbacterial Prostatitis

This represents the most common type of prostatitis. However, a recent study suggests that some of these cases may actually be occult (hidden) chronic bacterial prostatitis, so it is important to determine the real etiology. Frequently, in this type of prostatitis, there are increased levels of leukocytes (white blood cells) in prostatic secretions; there may also be elevated levels of uric acid for unknown reasons. Patients usually have symptoms consistent with other types of prostatitis, such as painful ejaculation or pain in the penis, testicles or scrotum. They may complain of low back pain, rectal or perineal pain, or even pain along the inner aspects of the thighs. They often have irritative or obstructive urinary symptoms and decreased libido or impotence. As a rule, these patients do not have recurrent urinary tract infections.

Asymptomatic Prostatitis

As the name implies, there are no symptoms in this type, and it is usually found due to an increased blood PSA level.

Who Is Likely To Get Prostatitis?

Common risk factors are:

Bladder outlet obstruction

Urethral catheterization

Diabetes

Immunosuppression

Some sexually transmitted diseases

Nongonococcal urethritis

Gonorrhea

Unprotected vaginal or anal intercourse

What Does Treatment for Prostatitis Involve?

Acute Bacterial Prostatitis

First line antibiotic treatment choices include Bactrim (trimethoprim/sulfamethoxazole), doxycycline, or one of the fluoroquinolones such as ciprofloxacin. It is important to take your medication twice daily, and a 20 day course of therapy is recommended.

Chronic Bacterial Prostatitis

Trimethoprim-sulfamethoxazole and norfloxacin have shown good results in the treatment of CBP. However, sometimes a long course of therapy is needed. In certain patients, long-term antibiotic suppression is warranted to forestall recurrent urinary tract infections. The recommended protocol here is trimethoprim-sulfamethoxazole with nitrofurantoin (Furadantin, Macrodantin).

Chronic Nonbacterial Prostatitis

Because the etiology of this type of prostatitis is murky, treatment can present a challenge. Since there is sometimes occult bacterial infection, an antibiotic trial should be reasonable to see if there is any clinical response. Doxycycline or minocycline for a 14-day course is the usual route here. Due to the elevated uric acid levels commonly found in this disease, allopurinol treatment has been found to be somewhat effective.

Symptomatic treatment for all forms of prostatitis may involve the use of NSAIDs for pain and alpha-blockers such as terazosin (Hytrin).

Asymptomatic Prostatitis

Although strictly speaking, it may not appear that treatment is necessary, a 14-day course of antibiotics has been shown to restore PSA levels to normal values.

Surgery

For chronic prostatitis patients who have tried medication without success, surgery may be an option. Short of a prostatectomy (rarely recommended), the surgery used in most cases is transurethral resection of the prostate (TURP). An instrument called a resectoscope is inserted into the urethra, and contains a light, valves for controlling irrigating fluid, and an electrical loop to remove the obstructing tissue and seal blood vessels. The surgeon removes the obstructing tissue and the irrigating fluids carry the tissue to the bladder. This debris is removed by irrigation and any remaining debris is eliminated in the urine over time. You can expect to stay in the hospital for one to three days after surgery. During your recovery, you'll have a urinary catheter in place for a few days.

What Are The Advantages Of Surgical Treatment?

• The chronically infected and inflamed tissue is permanently removed.

How Long Does It Take?

This depends upon the individual procedure chosen.

How Many Treatments Are Required?

This depends upon the specific treatment chosen.

When Will I See Results?

With surgery, you should start seeing results after a reasonable healing period, but it is not often immediate.

What Are My Alternatives to Treat Prostatitis?

Medication

Prostatectomy

Will I Have Pain?

With most surgical procedures, there is some post-operative pain; this may be alleviated with prescription pain relievers.

When Can I Go Back To Work Or School?

With TURP, you should allow about two weeks before returning to work. Check with your physician for details.

Who Will Perform My Treatment?

One of our board-certified urologists will perform the procedure.

How Much Does It Cost?

Please call TopSurgeons at 800-506-8084 for more information.

Will My Insurance Cover Interstitial Cystitis Treatment?

Insurance should cover this condition and any approved treatments.