Prostatitis Frequently Asked Questions Part 2 – Dr. David Samadi Explains The Condition
How Is Prostatitis Diagnosed?
As part of the initial evaluation for prostatitis, a urine sample is evaluated to determine whether the disease stems from a bacterial infection. If chronic prostatitis is suspected, a urine sample may be taken from a man’s normal urine flow and then from urine voided after a prostate massage (in which the doctor strokes the prostate until fluid is pushed into the urethra). However, the value of these pre- and post-massage urine cultures has been questioned. When the diagnosis is not clear-cut—which is often the case—other diagnostic tests such as a digital rectal exam (DRE) will need to be performed.
What Are The Different Types Of Prostatitis?
Acute bacterial prostatitis, caused by an infection, is least common but easiest to diagnose and treat. Symptoms come on strong and suddenly. This type of prostatitis can be quite serious if the infection spreads to the blood or other parts of the body.
Chronic bacterial prostatitis develops more gradually, and symptoms are usually less severe than in the acute form. The condition may be long-lasting or may recur after treatment.
Chronic abacterial prostatitis, or chronic pelvic pain syndrome, is prostatitis without a clear cause and, actually, the most common type. Symptoms may be constant or occur as occasional flare-ups. Sometimes tests will detect infection-fighting cells in the urine or semen, but no bacteria can be found.
Asymptomatic inflammatory prostatitis is diagnosed when infection-fighting cells are present in prostate tissue, urine or semen but no symptoms are present. This type is sometimes discovered by accident when patients are treated for another problem.
How Is Prostatitis Treated?
Treatment is based on the underlying cause. An antibiotic is used to treat prostatitis that is caused by an infection. Some antibiotics that might be used are trimethoprim-sulfamethoxazole, doxycycline, ciprofloxacin, norfloxacin and ofloxin. You might have to take antibiotics for several weeks or even a few months. If prostatitis is severe, you may have to go to a hospital for treatment with fluids and antibiotics.
What If My Prostatitis Is Not Caused By Infection?
Because medical science doesn’t fully understand what causes prostatitis without infection, it can be difficult to treat. Your doctor might try an antibiotic to treat a hidden infection or other forms of treatment aimed towards making you feel better. Nonsteroidal anti-inflammatory medicines, such as ibuprofen or naproxen, and hot soaking baths may help. Some men get better by taking medicines that help the way the bladder or prostate gland work. These medicines include oxybutynin, doxazosin, prazosin, tamsulosin and terazosin.
Can Prostatitis Return Even After Treatment?
Men who have had prostatitis once are more likely to get it again. Small amounts of bacteria not killed by the antibiotic may “hide” undetected in the prostate. Once you stop taking the antibiotic, the infection can return. If this happens, you might have to take antibiotics for a longer period of time to prevent the onset of another infection.
Can I Do Anything To Prevent It?
It is possible to prevent prostatitis if you practice good hygiene (keep your penis clean), drink plenty of fluids to stay hydrated and seek immediate medical attention if you suspect symptoms of prostatitis or a urinary tract infection (UTI).
When Should I See A Doctor?
Contact your doctor immediately if you develop sudden fever, chills, and experience urinary symptoms, such as pain or burning with urination or blood or pus in the urine. These symptoms may point to acute prostatitis.