Guide to chronic prostatitis: symptoms, diagnosis and treatment

What is prostate gland ?

Prostate is a walnut sized reproductive gland present below the bladder in all men. Urethra (urinary passage) passes through it. Its function is to provide nutrition to the sperms.

What is prostatitis ?

Prostatitis means that you have inflammation of your prostate gland. Prostatitis can present in short time duration with fever/chills (acute prostatitis) or can have persistent course (chronic prostatitis) and can have either infective or non-infective etiology.

What is meant by chronic prostatitis ?

Chronic prostatitis is the persistence of inflammation in the prostate for more than three months. It can be either infectious or non – infectious. Majority of patients have non infectious cause of chronic prostatitis and only 1 in 10 diagnosed having bacterial cause of infection. Read more about urinary tract infection at Urinary tract infection (UTI)

What are the symptoms of chronic prostatitis ?

Symptoms of chronic prostatitis are variable and include – Burning micturition (painful urination), pain in the penis, scrotum or suprapubic region, difficulty in initiating urinary stream, frequent urge of passing urine, poor urinary stream, sensation of having residual urine in bladder after passing urine, dribbling at the end of passing urine, pain while ejaculation or during orgasm etc. These symptoms may be very subtle in few patients but can be very annoying and bothersome in others, interfering in daily activities, work and sexual life. (Know the symptoms of enlarged prostate at BPH (Enlarged prostate) Symptoms)

How to make a diagnose of chronic prostatitis ?

Diagnosis of chronic prostatitis is made after detailed history and work up of the patient. Workup includes physical examination with digital rectal examination (DRE) to palpate the prostate and rule out any acute infection and laboratory tests such as urine examination and imaging with ultrasound to look for source of infection. EPS (Expressed prostatic secretions) which are drops of urethral discharge obtained after DRE and initial urine sample after DRE helps in ruling out any bacterial infection within prostate. Occasionally doctor may advice cystoscopy to look at urethra, prostate and bladder for any pathology. Read how to diagnose BPH at Prostate enlargement diagnosis

What is the treatment of chronic prostatitis ?

Lifestyle changes

Use of heating pad or sitz bath (soaking lower body half in warm water), limiting caffeinated products such as cold drinks, tea, coffee, cutting down alcohol intake, avoid spicy and acidic food, avoiding large amount of fluid intake at a time, avoid prolonged sitting, daily brisk walk for atleast 15 minutes, pelvic relaxation exercises etc helps in improving symptoms.

Medical treatment

  1. Alpha blocker – This medicine relax the bladder neck and prostate muscle fibers and helps in easing pain or voiding symptoms associated with chronic prostatitis.
  2. Antibiotics – Role of antibiotics are controversial when urine examination tests are normal, but use of antibiotics for 2-3 weeks (Doxycycline, fluoroquinolones) are often prescribed for any subclinical infection harboring in the prostate.
  3. Analgesics and Anti-inflammatory drugs – Painkillers and anti-inflammatory drugs (NSAIDs) helps reducing inflammation and reduces pain. Other neuropathic painkillers such as pregabalin helps in few patients.
  4. Muscle relaxants – These drugs helps in relaxing spasm of pelvic floor muscles.
  5. Prostatic massage – Prostatic massage helps reducing inflammation and reduces the symptoms of chronic prostatitis.

What is the prognosis of chronic prostatitis ?

Chronic prostatitis is poorly understood entity and its association with infection is subtle. Hence, this disease is very difficult to cure with many men do not respond to the therapy . Nonetheless, several potentially effective treatments are available. Your urologist may be able to help out in alleviation of symptoms associated with this disease.

Does chronic prostatitis increase the risk of prostate cancer ?

There is no evidence that chronic prostatitis increases the risk of developing prostate cancer. Read more about prostate cancer and its diagnosis at Prostate cancer

Published by Dr Varinder Attri

MS MCh (PGI Chandigarh), Urologist and Andrologist

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: