My grandfather had been complaining of pain and burning sensation during urination for a week now. The frequency of urination increased during night time, he even developed pain in lower back. For some or the other reason, he kept on postponing his appointment with the physician. However, he developed high fever with chills and noticed blood in his urine which panicked him. Finally, he visited the doctor who conducted some diagnostic tests. It was found that the cause of his symptoms was inflammation of the prostate gland, called prostatitis.
About Prostatistis
The prostate is a small gland below the urinary bladder of a man. It surrounds the urethra and lies in front of the rectum. The main function of this prostate gland is to produce parts of semen (seminal fluid containing sperms in male). The inflammation of prostate gland is called prostatitis, which may cause swelling of the gland.
Prostatitis usually manifests as pain and burning sensation during urination. The frequency of urination may increase, especially at night. Urine and semen may be staimned with blood due to inflammation. Pain may also be experienced in the abdomen, groin, penis, testicles, lower back, and perineum( region between penis and rectum). During sexual intercourse, ejaculation may also cause pain. In case of acute prostatitis, the person suffers from high fever with chills; nausea and vomiting, and general feeling of illness. If the symptoms persist for more than 3 months, then it is termed as chronic prostatitis, which is characterized by frequent urinary tract infections.
Causes
Prostatitis may be caused due to strains of bacteria that remain hidden in the prostate gland. These bacteria reach the prostate gland through urine that leaks from the urethra. The bacterial strains that can cause prostatitis are Escherichia coli, Enterococci, Klebsiella pneumonia, Pseudomonas aeruginosa, Proteus mirabilis and Staphylococcus aureus. Sexually transmitted diseases can also cause prostatitis and they include Trichomoniasis (STD caused by parasite Trichomonas vaginalis), Gonorrhea (STD caused by bacteria Nesseiria gonorrhea), Chlamydia (caused by bacteria Chlamydia trachomatis) and Ureaplasma urealyticum (STD causing bacteria that lives in urogenital system of men and women).
The other causes include
- Psychological stress
- Disorder of nervous system
- Infection
- Traumatic injury
- Disorder of immune system
- Pressure exerted by diseased tissue on the prostate gland
- Biopsy of prostate
- Phimosis (tightness of foreskin of penis)
- Anal intercourse
- Catheterization (insertion of plastic tube into bladder)
- Bladder outlet obstruction (blockage at base of bladder)
- Transurethral surgeries (surgical procedure that removes pieces of prostate gland through urethra)
Diagnosis
To know the exact cause of prostatitis (acute or chronic) and to rule out other conditions that are causing it, the doctor gives a questionnaire that needs to be answered which is called as the National institutes of Health Chronic prostatitis symptom index. The patient has to score regarding pain, urination, discomfort, and other symptoms in the questionnaire from which the doctor will diagnose the type of prostatitis.
The doctor may take samples of semen and urine to check for the presence of any bacteria or white bloods cells that are a result of body’s immune response to infection. In a manual rectal exam, the doctor may insert a gloved finger into the rectum of the patient, and feels for the prostate to check if it is enlarged. To check for the function of the urinary bladder, urodynamic tests are conducted by the doctor.
To examine the urethra and urinary bladder, an instrument called cytoscope is used which consists of a small tube which has a magnifying lens or camera at its end. This tube is inserted into the bladder through the urethra .This procedure is known as cytoscopy, and it is used to rule out other conditions that may be causing prostatitis.
Treatment
Treatment involves oral antibiotic medications like trimethoprim-sulphamethoxazole (bactrim or septra); tetracyclines like doxycycline and fluroquinolones (floxin or cipro). If the condition is severe, then hospitalization is done in which antibiotic injections are given. Once there is improvement in the condition of the patient, then oral antibiotics are resumed. To help relax the urinary bladder and muscles associated with it, alpha blockers like doxazosin (cardura) and alfuzosin (uroxatral). To relieve pain, analgesics like ibuprofen, and aspirin are given. All medications should be taken only under doctor’s prescription. Prostatitis can be treated with medications and surgery is not needed generally.
Relapse of prostatitis
There is a chance of prostatitis recurring again in a person who had it before. The antibiotic therapy may not be able to destroy all the bacteria in the prostate gland which results in prostatitis coming back again. Prostatitis does not cause prostate cancer. Most cases of prostatitis that are caused due to bacterial infection are not sexually transmitted. It is important to consult your doctor without delay as soon as you find any symptoms. The sooner you get treatment, the faster you will recover.
