The prostate (prostate gland) is one of the internal sex organs in men. It’s about the size of a chestnut and lies just below the bladder. The urethra passes through the prostate.
In prostate inflammation, the prostate gland is inflamed, which is often very painful for those affected. The medical term for this is prostatitis. It is the most common urological disease in men under the age of 50 and the third most common in the over 50 age group.
There are four types of prostatitis:
All of these forms of prostatitis result in an inflamed prostate. Prostatitis can occur with or without signs of infection. Physicians distinguish between acute prostatitis and chronic prostatitis. Doctors speak of the chronic variant when the prostatitis lasts longer than three months.
The causes of prostatitis are different – depending on which form is present.
In the case of acute prostate inflammation, for example, a bacterial infection can be behind it. However, this only applies to five to ten percent of cases. The bacteria get into the prostate gland via the urinary tract or, in rarer cases, via the bloodstream, where they cause the inflammation. The most common causes are intestinal bacteria such as Escherichia coli (E. coli) and Enterococcus faecalis. In addition, there are other types of bacteria that come into question.
These can also be pathogens that cause sexually transmitted diseases such as chlamydia, trichomonads or Neisseria gonorrhoeae (trigger of gonorrhea). These pathogens cause inflammation of the urethra, genital tract and rectum. However, these infections often progress without or only with slight symptoms, which is why they often remain undetected. A doctor’s visit is advisable even with minor symptoms such as burning or pain when urinating, mucopurulent discharge, itching, diarrhea and pain in the testicles or lower abdomen.
Inflammation of the prostate is not contagious. However, if pathogens that are responsible for sexually transmitted diseases are to blame for prostatitis, the man can possibly transmit them during sex. As a precaution, avoid sex if you have acute bacterial prostatitis. It is best to discuss how long sexual intercourse is taboo with the doctor treating you.
If the acute prostatitis has not subsided after three months, doctors speak of a chronic course. The causes of this form of the disease are similar to those of the acute variant. Here, too, intestinal bacteria (E. coli) are usually involved and urinary tract infections are associated with them. Not taking antibiotics for long enough can also be a cause of prostatitis.
Chronic pelvic pain syndrome (also called CPPS) is the most common form of prostatitis. The disease occurs for more than three months at a time. Doctors cannot identify any bacterial pathogens here – or germs that can be detected in the laboratory. In the inflammatory form, doctors recognize an increase in immune cells (leukocytes or white blood cells) in the prostate secretion. These cells have the task of fighting off pathogens. If they are increased in the body, this indicates an infection or inflammatory disease. If there is no evidence of this, a non-inflammatory chronic pelvic pain syndrome is present.
How exactly chronic pelvic pain syndrome occurs has not been clearly clarified. Doctors assume that several factors work together here, for example:
In the case of prostate inflammation without symptoms, doctors can detect inflammation, but the patient has no symptoms. Doctors often discover prostatitis by accident, for example during a routine examination.
The symptoms of prostatitis are different depending on the form of the disease.
The most common symptoms of acute bacterial prostatitis include:
Symptoms of acute prostatitis always appear individually. The severity of the symptoms varies from man to man. If you suffer from one or more of the symptoms mentioned, you should always consult your family doctor or a urologist.
The symptoms of chronic prostatitis are milder than in the acute form.
Chronic prostatitis does not cause fever or chills. On the other hand, this variant of prostatitis is more likely to cause back pain, especially in the lumbar spine, feelings of pressure on the perineum, in the penis, in the testicles or in the lower abdomen. Problems with urination (mild or strong urge to urinate, difficulty emptying the bladder completely) or urinary tract infections are common. Painful ejaculation and the associated erectile dysfunction are also very typical.
Pelvic pain lasting longer than three months is common in inflammatory and non-inflammatory chronic pelvic pain syndrome. Furthermore, the same symptoms occur as with chronic prostatitis.
Patients with prostatitis without symptoms have no symptoms, although doctors can diagnose inflammation in the body.
What to do with prostate inflammation? The treatment of prostatitis depends on the form of the disease and its causes. The first most important question is: Is there chronic or acute inflammation? Based on this diagnosis, the doctor then selects a suitable prostatitis therapy.
Home remedies for prostatitis can primarily help to alleviate symptoms of chronic prostate inflammation. They represent a good supplement to drug treatment, but are not a substitute for therapy. In any case, talk to your doctor if you want to use home remedies.
A tea made from dried small-flowered willowherb can help with problems with urination in connection with prostatitis. You can buy ready-made teas in the pharmacy. You can drink the tea twice a day for three weeks.
In chronic pelvic pain syndrome, the musculature of the pelvic floor is often tense. Pain in this area is also common. Hot water bottles, sitz baths for 15 to 30 minutes or heating pads are recommended to relieve tension and pain. Those who prefer a bath can relax with bath additives made from hay flowers, bog mud and chamomile. It is also important to keep your feet and abdomen warm at all times.
Relaxation techniques such as progressive muscle relaxation, yoga and Qi Gong can have a positive effect on the perception of pain.
In general: a healthy, high-fiber diet, sufficient exercise, a normal weight and alcohol in moderation can prevent additional pressure on the bladder and prostate. Alcohol irritates the bladder and the lining of the bladder. This can affect bladder function. The result: bacteria can spread more easily and a bladder infection can occur. The pathogens can then in turn reach the prostate via the urinary tract and cause acute inflammation.
If the infection is bacterial (acute or chronic), treatment of prostate inflammation with antibiotics is the first choice. Once chronic pelvic pain syndrome has been diagnosed with or without inflammation, physicians try to base therapy on the main symptoms. The complaints range from physical symptoms to mental impairments.
A common symptom is trouble urinating. Doctors, on the other hand, prescribe alpha blockers, for example. These relax the bladder and its muscles.
If those affected suffer from an excessive urge to urinate, anticholinergic drugs are the standard. They reduce the symptoms of an irritable bladder.
Doctors also use pain-relieving and anti-inflammatory agents. Frequently used active ingredients are, for example, ibuprofen, acetylsalicylic acid (ASA) or diclofenac.
Almost 50 percent of people with pelvic pain syndrome have depressive moods. In order to be able to treat the latter effectively, a combination of psychotherapy and antidepressants can be recommended. Many patients also suffer from sexual problems such as erectile dysfunction, painful ejaculation and less desire for sex. Urologists can refer you to neurologists or psychotherapists if necessary.
Those affected with prostatitis without symptoms receive no therapy.
Which antibiotic drug doctors use depends on the bacteria that trigger the prostate inflammation. Antibiotics that work well for prostatitis are fluoroquinolones – in both the acute and chronic forms. If the bacterial infection is very severe, those affected receive an infusion. If the course is somewhat milder, tablets that you have to take for a few weeks are sufficient. It is important that you continue the therapy consistently to the end. Otherwise there is a risk of recurrence if bacteria remain in the prostate. Prostatitis can therefore be very persistent.
The sooner you get treatment for acute prostatitis, the better the chance of a lasting recovery.
If you feel typical symptoms of prostate inflammation, you should see your family doctor. After an initial conversation and an initial examination, he will decide whether he will refer you to a specialist. Suitable doctors for prostate problems are urologists. You can also make an appointment directly with a urologist to be examined.
Don’t be afraid to see a urologist. Discussions about supposedly taboo subjects and examinations of the intimate area are routine for the specialists. You will be relieved when you get professional help and overcome your fears.
The first thing to do is to ask about your previous medical history and your acute symptoms (anamnesis), for example whether you have problems urinating, what symptoms you have for how long, whether you have already been treated for prostate inflammation, etc. Doctors do this in advance to find out to be able to make a reliable prostatitis diagnosis. A standardized patient questionnaire can also help identify chronic prostatitis or chronic pelvic pain syndrome.
If your symptoms match prostate inflammation, the urologist will carry out various examinations – the order and number can vary. Here is an overview:
There are a few things you can do to avoid prostate inflammation:
This article was written by Stella Paschen, freelance journalist
The original of this post “Fever, fatigue, weakness: Symptoms of prostatitis and what you can do about it” comes from FOCUS doctor search.
