Prostatitis

Prostatitis is a diagnosis used to describe inflammation of the prostate gland. It is thought that prostatitis results from bacterial infection; however, infection is not always found. In fact, most cases of recurrent prostatitis do not demonstrate active infection.

Prostatitis can affect men of any age. Half of all men will experience an episode of prostatitis at some point in their lives. Prostatitis is the most common urological disorder in men over the age of 50 and the third most common disorder in men under 50. Prostatitis alone makes up nearly a quarter of all office visits involving the urinary system by young and middle-aged men. The prostate is located at the base of the bladder where it grows around the urethra, the tube that drains urine from the bladder. The prostate mainly functions to produce ejaculatory fluid, though it is also thought to protect the testicles and bladder from infection. Half of all men experience prostate inflammation at some point in their lives. If you have prostatitis, we can help.

Symptoms of Prostatitis

• Dull pain deep down in the pelvis
• Specific pain directly behind the scrotum, in the rectum or at the tip of the penis
• Pain may moving up into the groin or across the lower back
• Burning or pain when urinating or ejaculation
• A pain that goes down the leg
• Sudden and severe pain in the testicle
• Pain or tenderness in the back of the testicle

The prostate gland sits in a very nerve- rich area of the body. For this very reason, inflammation of the prostate can result in the irritation of many different nerves and organs. These pains can be very specific or vague, depending on the nerves affected.

The most common complaints include pain deep down in the pelvis that is dull. More specific pain directly behind the scrotum, in the rectum or at the tip of the penis can also be from prostatitis. Sometimes the pain may move up into the groin or across the low back. Burning with urination or pain with ejaculation can also occur with prostatitis. Rarely, patients may even complain of pain that goes down the leg.

Sudden and severe pain in the testicle always warrants a prompt evaluation. It is not uncommon, however, to have gradually worsening testicular aching with or without prostatitis. This can occur either from swelling in the prostate causing blockage of the tubes that drain the testicles into the prostate (vas deferens) or from an infection of the testicles with or without an infected prostate. Your doctor may examine your testicles and scrotum if you have symptoms of prostatitis. Pain or tenderness in the back of the testicle (epididymis) can be a sign of inflammation or infection of the testicle (epididymo-orchitis). Your urine may be cultured to look for infection and a scrotal ultrasound to examine the testicles may be done. The treatment for this condition uses the same medications that treat prostatitis: antibiotics and anti-inflammatory drugs. Patients sometimes require several weeks to months to clear these symptoms, and long term treatment is vital to achieve this.

Sometimes a lump in the testicle will develop after episodes of infection. It is just fluid in a cyst called an Epididymal cyst or spermatocele. It is usually smaller than a jellybean, but can enlarge over time. They usually are tender during the infection phase, but stop hurting after treatment. In some cases, the lump will go away, other times it will stay forever. If it is a nuisance it can be surgically removed; however, in most cases it is just left alone.

Types of Prostatitis

Treatment of Prostatitis

Prostatitis can be a lifelong problem that comes and goes. Management of symptoms before they become severe is the key. A treatment regimen commonly consists of antibiotics and anti-inflammatory drugs.

Antibiotics are commonly prescribed for both infectious and non-infectious problems of the prostate. Why? While antibiotics kill bacteria, it takes special antibiotics to even get into the prostate. Treatments take a longer time than other areas of the body because of the difficulty in getting medicine into the prostate. The prostate protects the male bladder and testicles from infection and contains high levels of certain minerals that may also inactivate antibiotics.

Three classes of antibiotics are commonly used to treat prostatitis: Fluoroquinolones (Cipro and Levaquin), Sulfa drugs (Septra and Bactrim), and Doxycycline. These classes are able to enter the prostate and kill the typical bacteria that are present. They are also able to soothe some of the inflammation that results from infection. In patients who have no identified infection, antibiotics are sometimes used solely because of their anti-inflammatory properties, although this concept is somewhat speculative. Thus antibiotics are used in bacterial and non-bacterial forms of prostatitis for their anti-infective and anti-inflammatory properties.

Anti-inflammatory drugs, like ibuprofen, directly counteract the cause for the aches and pains of prostatitis, and are commonly used to alleviate them. Your doctor will recommend which medication is right for you based on your medical history.

If you have prostatitis, our doctors will work with you to develop a treatment program that fits your specific needs.