PROSTATITIS

It refers to Inflammation of the prostate. Prostatitis is not primarily about growth or malignancy.
Instead, it is a complex condition that can appear suddenly or persist for months, causing pain,
urinary difficulties, and in some cases, psychological stress.

RISK FACTORS
You’re more likely to have prostatitis if:
 You have a history of frequent UTIs or bladder infections
 You’ve had prostatitis before
 You’ve had a pelvic injury
 You use a urinary catheter
 You’re older than 50 and have an enlarged prostate
Prostatitis refers to inflammation of the prostate gland, which can be due to infection, injury, or
other unknown causes. But prostatitis is not just one disease.

EPIDEMIOLOGY
Overall, since the published epidemiological data have relied upon varying definitions and
measures, no simple summation is possible. Instead, here are some pertinent research findings as
aggregated from a number of sources:
Prostatitis explained 1,798 annual outpatient visits per 100,000 populations in the United
States
Prostatitis annually accounts for an estimated 2 million outpatient visits in the United
States
Prostatitis is responsible for an estimated 8% of outpatient urology practice visits
The prevalence of acute and chronic prostatitis in China is an estimated 8%
Chronic prostatitis accounts for an estimated 90% of all cases of prostatitis
The prevalence of chronic prostatitis in Finland is an estimated 10-14%
The prevalence of chronic prostatitis in Australia is an estimated 8%
Chronic prostatitis explained 14% of visits to Italian urological clinics

The National Institutes of Health (NIH) has classified prostatitis into four categories:

A. Acute bacterial prostatitis: A sudden and severe infection of the prostate, often
accompanied by fever, chills, and painful urination. It requires urgent medical care.
B. Chronic bacterial prostatitis: A recurrent bacterial infection that lingers for months or
keeps coming back, often leading to persistent discomfort and urinary problems.
 C. Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS): The most common form,
responsible for about 90% of cases. It involves pelvic pain lasting more than three
months, often without evidence of bacterial infection. Its exact cause remains unclear.
D. Asymptomatic inflammatory prostatitis: A silent form detected only during medical
testing, often when evaluating fertility or another prostate condition.

CLINICAL MANIFESTATION
Each of the four types of prostatitis has its own set of symptoms — or in the case of
asymptomatic prostatitis, no symptoms.
Acute bacterial prostatitis symptoms

 Trouble peeing
 Urgent need to pee but only a little comes out, or you have to get to the toilet quickly to
prevent an accident
 Urinary blockage (difficulty peeing or a weak urine stream)
 Peeing often in the night
 Cloudy urine
 Burning or pain while peeing
 High fever
 Chills
 Body aches
 Nausea and vomiting
 Pain around the base of your penis or behind your scrotum

Chronic bacterial prostatitis symptoms

 An urgent need to pee, often in the middle of the night

 Painful urination
 Pain when you ejaculate (release semen at orgasm)
 Pain in the genitals, groin, or lower belly
 A “heavy” feeling behind your scrotum
 Urinary blockage (difficulty peeing or a weak urine stream)

Chronic pelvic pain syndrome (CPPS) symptoms

The main symptom of CPPS is pain that lasts more than

3 months in at least one of these body parts:
 Penis (often at the tip)
 Scrotum
 Between your scrotum and rectum (the
perineum)
Lower abdomen
 Other symptoms include:
 Pain when you pee or ejaculate
 Frequent or urgent peeing
 A weak pee stream

DIAGNOSIS
 During the physical exam, your doctor may look for:
Any discharge
Enlarged or tender lymph nodes in the groin
Swelling or tenderness in the scrotum
 Digital Rectal Examination (DRE): inserts a gloved finger into the rectum to feel the
prostate. Tenderness may suggest prostatitis, while size and texture changes may indicate
other conditions.
 Urinalysis, to test your urine sample for an infection
 Blood tests, to check for infection or other prostate problems including prostate cancer
 Urodynamic tests, to check how well your bladder and urethra keep and release urine
 Cystoscopy, to look at the insides of your urethra and bladder.
 Transrectal ultrasound, to look at the prostates for any unusual signs that may mean
problems such as prostate cancer.
 Biopsy, to test a prostate tissue sample for prostate cancer
 Semen analysis, to examine the quality and quantity of your semen and sperm and to
check for any signs of an infection.

DIFFERENTIAL DIAGNOSIS
 Prostatic abscess
 Urolithiasis (bladder or distal ureteral stones)
 Prostate cancer
 Urinary tract infection (UTI)
 Acute epididymitis
 Benign prostatic hyperplasia (BPH)
 Anorectal conditions (proctitis, rectal abscess, internal
hemorrhoids)
TREATMENT
 Antibiotics: called fluoroquinolones are effective treatments for acute and chronic
bacterial prostatitis. A four-to six-week course of the drugs typically does the trick.
However, bacterial resistance to fluoroquinolones is a growing problem.
 Over-the-counter pain relief: acetaminophen or ibuprofen.
 Antidepressants or anti-seizure medications are just two types of medicine that can be
used to treat long-term prostate pain.
COMPLICATIONS
 Urinary Retention
 Prostatic Abscess
 Bacteremia & Sepsis
 Recurrent UTIs

REFERENCES
1. [Link]
20355766
2. [Link]
3. [Link]
202503253092
4. [Link]
[Link]
5. [Link]
disease/prostatitis
6. [Link]
disease/prostatitis