Prostatitis: an overview

The prostate is a walnut-sized gland below the bladder and in front of the rectum. It produces the fluid (semen) that contains the sperm.

Prostatitis is a condition which is characterized by the presence of an swollen, tender, and inflamed prostate gland. It is different from having an enlarged prostate, or prostate cancer. Main risk factors include urinary tract infection, HIV/AIDS, injury of the inguinal region, previous prostatitis, prostate biopsy, and use of Foley (urinary) catheter.

There are four types of prostatitis.

ACUTE BACTERIAL PROSTATITIS

Acute bacterial prostatitis is a severe condition that may be caused by bacteria from the urinary tract.

Symptoms and signs include high fever and chills, muscle aches, joint pain, lower back pain, pain around the base of the penis (or behind the scrotum), disordered urination, and weak urine stream.

CHRONIC BACTERIAL PROSTATITIS

Chronic bacterial prostatitis is more common in older men, usually after an urinary tract infection or acute bacterial prostatitis.

It is a milder bacterial infection with recurrences over several months. Symptoms and signs include urgent and painful urination, pain after ejaculation, lower back pain, rectum pain, blood in the semen, and inability to urinate,

CHRONIC PROSTATITIS / CHRONIC PELVIC PAIN SYNDROME

Chronic prostatitis / chronic pelvic pain syndrome is the most common type of prostatitis sharing many of the same clinical features as bacterial prostatitis. However, no bacteria can be found based on the laboratory investigations.

The syndrome may be triggered by stress, adjacent nerve damage, or physical injury. It has been associated with immune disorders and irritable bowel syndrome. Moreover, chemicals in the urine or a previous urinary tract infection may play a role in the pathophysiology of the syndrome.

Symptoms and signs last more than 3 months, and include weak urine stream and pain in at least one of the following body parts: penis, scrotum, between scrotum and penis, lower abdomen, or lower back. The patient may suffer from urgent, frequent and painful urination. Ejaculation may be also painful.

ASYMPTOMATIC PROSTATITIS

Asymptomatic prostatitis is characterized by prostate inflammation without any clinical features.

Although no treatment is required, asymptomatic prostatitis may affect fertility.

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