Diseases & Conditions

Prostatitis

Authors: John Krieger , MD
Last updated: November 21, 2005

Overview |
Symptoms |
Causes|
Diagnosis |
Treatment
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Overview

The prostate is part of the male reproductive system. The normal prostate is a small gland (walnut sized) located below the urinary bladder. The prostate surrounds the upper urethra (the tube that conducts urine from the bladder through the penis).

The major function of the prostate is to produce fluid and enzymes for the semen. During sexual climax the the prostatic fluid is mixed with the sperm from the testicles and other fluids, to produce the semen that is ejaculated from the penis.

Prostatitis includes infections and inflammations of the prostate gland as well as symptoms of chronic pelvic pain. These conditions represent a very common cause of morbidity. Epidemiological studies suggest that 2-10% of adult males suffer from prostatitis at any time. Patients with chronic symptoms can have a very poor quality of life, comparable to that of patients suffering from a heart attack or chronic inflammatory bowel disease.

Symptoms

Patients may suffer from urinary tract symptoms or they may have no symptoms whatsoever.

Urinary tract infection symptoms
Some patients present with symptoms of urinary tract infection, such as increased urinary frequency, painful urination, difficulty emptying the bladder, and getting up at night to urinate. Occasionally, with systemic symptoms such as fever, chills and feeling generally poorly.
Chronic pelvic pain symptoms
Some patients present with pelvic pain symptoms that can be evaluated using the National Institutes of Health Chronic Prostatitis Symptom Index.
Diagnosis of asymptomatic prostatitis
A third group of patients has inflammation noted in their prostate tissue or semen that have been obtained for other reasons.

Causes

Some cases of prostatitis are clearly related to infection of the prostate. However, the cause(s) of most patients’ symptoms are unclear. There are numerous theories about possible causes, but none has been proven convincingly.

Diagnosis

The basic evaluations include a thorough history and physical examination, including a digital rectal examination. Basic laboratory evaluations include urinalysis and urine culture. Further evaluations for patients with findings suggesting prostatitis unclude segmental cultures of samples from different sections of the urinary stream to determine whether the prostate is the source of infection or inflammation. Other evaluations include the Chronic Prostatitis Symptom Index, a urine flow rate and determination of urine remaining in the bladder following urination. Selected patients should have evaluation for urethral infection, a PSA, urine cytology test (for cancerous cells in the urine), or other evaluations.

Treatment

Patients with evidence of bacterial infection benefit from treatment with antibiotics. Other patients benefit from various other traatments, such as alpha-blockers, anti-inflammatory and other medications.