Prostatitis – Copy
Prostatitis: The nagging pain in the groin
What Is Prostatitis?
Prostate inflammation, also known as prostatitis, is a common condition that can cause discomfort and affect the quality of life for many men. Although the number of patients diagnosed with prostatitis during their lifetime is varied, the Prostate Cancer Foundation estimates that half of men will develop symptoms of prostatitis during their lifetime. Fortunately, prostatitis has different severities, from dull, aching pain in the groin to debilitating symptoms that cause urinary retention and require some men to get a catheter to drain their bladder until the symptoms subside
What causes prostate inflammation?
Prostate inflammation, or prostatitis, can be caused by various factors. The most common causes include bacterial infection, non-bacterial inflammation, and certain lifestyle factors. Although it can often be associated with a bacterial infection, this is not always true. Therefore a urine culture can be particularly helpful in treating men, especially men with acute prostatitis with fevers and chills and those men with chronic prostatitis that has gone on for months or years.
Bacterial infection is one of the leading causes of prostate inflammation. Bacteria from the urinary tract or other parts of the body can enter the prostate gland, leading to infection. Common bacteria responsible for prostatitis include Escherichia coli (E. coli) and Klebsiella. However, these bacteria can be hard to culture, so a urinalysis in the clinic is essential, and if any bacteria are found, a more detailed urine culture should be obtained. Regular urine cultures have a false negative rate (an infection is present, but the test returns negative) of up to 30%. This statistic is likely higher in men with prostate infections as much of the bacteria can hide in the prostate. Dr. Bevan-Thomas routinely recommends a DNA-specific culture using RT-PCR testing to test for the bacteria if this is found in the urine.
Non-bacterial inflammation, or non-infectious prostatitis, can occur without bacteria as the culprit. This type of inflammation is often associated with generalized prostate irritation by sitting down on hard surfaces for long periods or activities similar to riding a bike. The pressure of sitting on a bleacher stand for hours can cause discomfort under the scrotum and results in a generalized aching. This may also arise from autoimmune conditions, dehydration, and even anatomic problems within the urinary tract. This does not respond as well to antibiotics, but antiinflammatory medication and hydration can help tremendously. (See Dr. Bevan-Thomas’ prostatitis regimen below.)
Causes of Prostate Inflammation
Common types of bacteria causing prostate inflammation include Escherichia coli, Klebsiella
pneumoniae, and Proteus mirabilis. These bacteria can enter the prostate through the urinary tract
through the penis and lead to infection and subsequent inflammation. Symptoms of bacterial
prostatitis may include pain in the lower abdomen or back, frequent urination, and burning with
urination. This can occasionally cause men to go into urinary retention, requiring a catheter in
the bladder to relieve the pressure from the bladder and drain the urine. Treatment options for
bacterial infections typically involve antibiotics tailored to the specific type of bacteria present.
Prostatitis is one of the most common urinary problems that men have. It’s more common in men under 50, but any man can develop it.
There are several types of prostatitis, and the causes vary. It’s possible that Dr. Rich Bevan-Thomas won’t be able to tell what caused yours; however there is usually a solution.
Prostatitis can be acute or chronic. Acute cases come on suddenly and are usually caused by a bacterial infection. This type of prostatitis usually responds to antibiotics.
In chronic cases, the symptoms can come and go, or they can be constant. It’s often hard to find a cause for chronic prostatitis. It could be caused by an immune reaction to a urinary tract infection or inflammation from irritation of the pelvis and the muscles around the area of the prostate.
Because there are several types of prostatitis, there are many different symptoms. No one will have all the symptoms on this list, but your symptoms might include:
- Pain in the lower back, lower abdomen, penis, or scrotum.
- Pain in the perineum (the area between the scrotum and rectum).
- Pain or burning with urination.
- Needing to urinate more often or more urgently than usual.
- Needing to urinate at night more than usual.
- Changes in your urine stream – a weak stream, starting and stopping, etc.
- Blood in the urine.
- Painful ejaculation.
- Nausea and vomiting.
- Flu-like symptoms – fevers, chills, and body aches.
- Inability to empty the bladder completely.
Yes. They can include:
- Abscess—a collection of pus in the prostate.
- Sexual dysfunction.
- Abnormalities in your semen or infertility (with chronic prostatitis).
- Bacteremia/sepsis—a bacterial infection of the blood or the immune system’s reaction to it (with bacterial prostatitis).
These prostatitis complications can be severe. If you have urinary symptoms that are more than a little bothersome, make an appointment right away.
Dr. Rich Bevan-Thomas will first use RT-PCR testing to look for DNA fragments in your urine, which will tell him if your prostatitis is caused by one or more bacteria or a virus. For this procedure, he uses the Guidance UTI test located in his clinic in Arlington.
This is important because regular urine cultures can miss not only viruses but also many bacteria. Knowing the cause is the first step in solving the problem.
However, many men will only have the inflammatory prostatitis with no offending virus or bacteria. For these men, Dr. B-T will focus primarily on the inflammatory process itself and not prescribe antibiotics.
Stop the inflammation! Whether it is secondary to a bacteria or a virus, the inflammation must be treated to improve the symptoms ASAP. Dr. Rich Bevan-Thomas recommends the following for many of his patients to improve symptoms quickly.
- Epsom salt baths. Epsom salts contain magnesium sulfate, which, along with hot water helps relax the surrounding pelvic muscles in the pelvis for quick relief.
- Cranberry extract. Cranberries contain a compound called proanthocyanidin, which prevents E. coli from attaching to the lining of the urinary tract. It’s like rock-climbing on a rainy day. The juice won’t help, though, so stick to the pills.
- Fluids. Drink 2-3 liters of water a day, and no, coffee and alcohol don’t count.
- Nonsteroidal anti-inflammatory drugs (NSAIDs). Naproxen and ibuprofen work great but should be taken regularly for at least five days. Ask Dr. B-T for further details.
- Medrol Dosepak (in select patients). Stops inflammation in its tracks.
- Other home remedies may have some benefit, but realize that not everyone with prostatitis needs antibiotics to get better.
- More complex cases require further treatment.
Prostatitis can be easy to misdiagnose. Because the cause of prostate symptoms isn’t always clear, doctors will often diagnose prostatitis because it’s the most likely option. For this reason, it’s best to see a urologist to see if you’re having prostate or urinary symptoms. Many doctors give patients antibiotics hoping for a good response, but often this complicates the issue even further.
Dr. Rich Bevan-Thomas has the expertise and determination to get to the bottom of your symptoms and ensure that you get the correct diagnosis. He will then discuss your treatment options with you in clear, easy-to-understand terms.
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