Four Types of Prostatitis | Causes, Symptoms, and Treatments
Prostatitis is the inflammation and swelling of the prostate, a sometimes painful condition that only affects men. Men of all ages can get prostatitis but men who are 50 and under are more commonly affected by it.
Contrary to popular myth, prostatitis does not lead to prostate cancer.
There are four categories of prostatitis—1) acute bacterial prostatitis, 2) chronic bacterial prostatitis, 3) chronic nonbacterial prostatitis, and 4) asymptomatic inflammatory prostatitis.
This article will walk you through all four categories, explaining their causes, symptoms, and treatments.
What is the male prostate?
The prostate is a walnut-shaped gland the size of a small plum that produces fluid to protect the sperm as it is ejaculated through the penis.
The prostate sits in front of the rectum and in between the bladder and the penis. The prostate surrounds a part of the urethra—when the urethra extends out of the bladder neck, it passes through the middle of the prostate to reach the penis, leading the urine out of the body.
What is prostatitis?
Prostatitis is the swelling and inflammation of the prostate, which presents with various symptoms and has various causes, not all of which is definitively diagnosable.
Prostatitis is characterized by perineal pain—pain in the perineum. The perineum is located behind the scrotum and before the rectum. Another common symptom is pain during urination or ejaculation. Other symptoms include urgency—the sudden urge to urinate, and urinary retention—the inability to empty bladder or empty completely.
The National Institutes of Health (NIH) has classified prostatitis into four categories:
- Acute bacterial prostatitis
- Chronic bacterial prostatitis
- Chronic nonbacterial prostatitis/chronic pelvic pain syndrome
- Asymptomatic inflammatory prostatitis
Acute bacterial prostatitis cause, symptoms, and treatment
Cause: this kind of prostatitis is caused by an acute bacterial infection of the prostate. It is diagnosed by the increased presence of bacteria and white blood cells in the urine, semen, and prostatic secretion.
- Joint and/or muscle aches
- Pain in the area of the perineum, pelvis, and genitals.
- Pain/burning with urination and ejaculation
- Symptoms of urinary tract obstruction: frequent urination (especially at night), urgency (sudden strong urge to urinate), hesitancy (unable to start stream), weak stream, and incomplete voiding
- Lower back and/or lower abdominal pain
- Spontaneous urethral discharge—a fluid that is not urine or sperm, but the product of an infected or irritated urethra.
- Erectile dysfunction
Please note that the above symptoms can also occur in patients who don’t experience prostatitis, but instead have active urethritis, urinary or genital cancer, urinary tract disease, urethral strictures, or neurogenic bladder. Therefore it is important to consult your doctor and get a professional diagnosis.
Treatment: acute bacterial prostatitis is often treated with and cured by antibiotics. Sometimes, pain medication is prescribed to manage pain.
In cases where the prostate has enlarged and obstructed the urethra, an intermittent catheter can be prescribed to help void the bladder. An intermittent catheter is a thin tube that is inserted into the obstructed urethra, creating a clear passage for urine to come out. The intermittent catheter is inserted every time one needs to urinate and is disposed of afterward.
Chronic bacterial prostatitis cause, symptoms, and treatment
Cause: chronic bacterial prostatitis is caused by the recurring bacterial infection of the prostate. It is diagnosed in the same way as acute bacterial prostatitis by the elevated presence of white blood cells and bacteria, but different from acute bacterial prostatitis, the infection does not respond immediately to antibiotics and needs further treatment.
Symptoms are the same as acute bacterial prostatitis but present recurrently and often less intensely.
Treatment often includes several courses of antibiotics instead of one, and in the case of blocked urethra, a catheter can be prescribed to manage symptoms of urinary retention.
Chronic nonbacterial prostatitis aka chronic pelvic pain syndrome
Chronic nonbacterial prostatitis is diagnosed when patients exhibit the same symptoms as chronic bacterial prostatitis but no bacteria presence is detected in urine, semen, or prostate secretion.
This condition is subdivided into two types: inflammatory and noninflammatory.
- Inflammatory: defined by the high level of white blood cells in semen and prostate secretions without a detectable presence of an infectious agent.
- Noninflammatory: no presence of either white blood cells or infectious agents.
Chronic nonbacterial prostatitis is the most common type of prostatitis but very little is understood about it. There is no known cause or treatment at this point in time.
Asymptomatic inflammatory prostatitis
Asymptomatic inflammatory prostatitis is when the prostate is inflamed but the patient feels no symptoms at all. Because of the lack of symptoms, this condition is often diagnosed during tests for infertility or elevated prostate-specific antigen (PSA) level when a large amount of white blood cells is found in ejaculation.
The presence of high-level white blood cells in the semen can cause male infertility. Unless fertility is desired, acute inflammatory prostatitis is generally not treated.
A common effect of prostatitis: urinary retention
One major effect of prostatitis is urinary retention, which is the inability of urine to leave the body completely or partially. As the prostate becomes inflamed and enlarged, it obstructs the urethra, which travels through the middle of the prostate to connect the bladder and the penis. The obstruction of the urethra causes urinary retention, in which case the urine cannot leave the body or have trouble being emptied completely.
Untreated urinary retention can increase risks for getting a bladder infection, bladder damage, UTI, kidney infection, and kidney failure.
Doctors may prescribe catheters to manage urinary retention. Here is a comprehensive guide for how the choose the right catheter for you, covering important topics like size, tip, infection risks, types of lubrication, discretion and portability.
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