Introduction:

Prostatitis is inflammation of the prostate gland, a walnut-sized gland found just under the bladder in men. Up to 16% of men are diagnosed with prostatitis during their liftetime. It can be caused by bacteria and come on suddenly (acute), or develop slowly over time (chronic). The most common kind of prostatitis is nonbacterial, but there is also a sudden form of prostatitis that is less common (about 5% of cases) but more severe. Left untreated, infection can spread to the testicles and epididymis (tubules in back of the testis) and, in severe cases, destroy the prostate gland.

Signs and Symptoms:

Acute bacterial prostatitis:

• Fever, chills
• Prostate pain
• Painful ejaculation
• Difficult or painful urination

Chronic bacterial prostatitis:

• Frequent and urgent urination
• Pain when urinating
• Blood in semen or urine
• Frequent bladder infections
• Pain in the lower back, pelvis, or perineum (lining of the pelvic area)
• Slight fever

Chronic nonbacterial prostatitis:

• Similar to chronic bacterial prostatitis, but without fever

What Causes It?:

Risk factors for prostatitis include the following:

• Recent bladder infection or urinary tract infection
• Recent catheterization
• Diabetes

What to Expect at Your Provider's Office:

Your health care provider will do a physical examination of the prostate and use laboratory tests, such as urinalysis, semen sample, or blood cultures.

Treatment Options:

Drug Therapies

Several antibiotics and other drugs can treat prostatitis. You may take these medications by mouth, except in cases of sudden and severe prostatitis, which may require intravenous administration. The treatments may last 4 - 12 weeks, depending on the severity of the infection. Stool softeners, anti-inflammatory agents (such as ibuprofen), and hot sitz baths may also relieve symptoms. Alpha blockers (which help relax the bladder) may help if you have trouble urinating.

Surgical Procedures

In severe cases of bacterial prostatitis, you may need surgery.

Complementary and Alternative Therapies

Nutrition and Supplements

• Cernilton, a flower pollen extract (500 - 1,000 mg two to three times a day), has been used extensively in Europe to treat nonbacterial prostatitis. It also has a contractile effect on the bladder and relaxes the urethra.
• Quercetin (500 mg two times per day), an antioxidant flavanoid that fights inflammation, may help reduce pain and symptoms of nonbacterial prostatitis. In one study, quercetin was combined with bromelain and papain, showing even greater effects. Both supplements enhance the absorption of quercetin and are anti-inflammatories.
• Beta sitosterol (20 mg per day), a naturally derived chemical found in various plants, is frequently used to treat prostatitis and is often a component in prostate health formulas.
• Vitamin C (250 - 500 mg two times a day)
• Zinc (60 mg a day) has been shown to reduce an enlarged prostate, but it is not known whether zinc helps prostatitis.
• Omega-3 fatty acids (1,000 - 1,500 mg one to two times a day), over time, may help reduce inflammation.
• Pumpkin seeds have been used historically for a healthy prostate.
• Avoid simple sugars, alcohol (especially beer), and coffee. Drink plenty of water (48 oz. a day).

Herbs

Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, you should work with your health care provider to diagnose your problem before starting any treatment. You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, make teas with 1 tsp. of herb per cup of hot water. Steep covered 5 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink two to four cups per day. You may use tinctures alone or in combination as noted.

• Saw palmetto (Serenoa repens, 160 mg in capsule form two times per day) has been studied for its effects on benign prostatic hyperplasia (BPH), and used traditionally to treat nonbacterial prostatitis, although studies for prostatitis are lacking. An extract standardized for 85 - 95% of fatty acids and sterols is recommended.
• African pygeum (Prunus africana, 75 - 200 mg per day) has also been used to treat BPH. Some preliminary evidence suggests it may help symptoms of both chronic bacterial and nonbacterial prostatitis.
• Stinging nettle (Urtica dioca, 80 mg per day) has shown some promise in helping maintain prostate health, but studies show mixed results.

Herbs traditionally used for prostatitis (but lack evidence) include:

• Pau d'arco (Tabebuia impetiginosa). This herb can be toxic in large doses. Do not use pau d'arco unless your doctor tells you to and establishes a safe dose.
• Horsetail (Equisetum arvense). Do not take horsetail if you have high blood pressure or heart disease, and take it only under the supervision of a doctor.

Homeopathy

Some of the most common remedies used for prostatitis are listed below. The usual dose is three to five pellets of a 12X to 30C remedy every 1 - 4 hours until your symptoms improve.

• Chimaphila umbellata for retention of urine with an enlarged prostate
• Pulsatilla for pain after urination, especially involuntary urination
• Pareira for painful urination, especially with painful urging
• Lycopodium for painful urination with reddish sediment in the urine, especially with impotence
• Thuja, specifically if there is a forked stream of urine

Physical Medicine

Kegel exercises increase pelvic circulation and improve muscle tone.

Aerobic exercise reduces pain and improves quality of life.

Contrast sitz baths: You will need two basins that you can sit in comfortably. Fill one basin with hot water, one with cold water. Sit in hot water for 3 minutes, then in cold water for 1 minute. Repeat this three times to complete one set. Do one to two sets a day, 3 - 4 days a week.

Acupuncture

Acupuncture may improve urinary flow and decrease swelling and inflammation.

Massage

Massage may help reduce symptoms. The focus may be on the lower abdominal area, lower back, and around the sacrum.

Following Up:

Be sure you follow your health care provider's instructions for treatment, and keep using the treatment as directed even if you start to feel better.

Special Considerations:

Men should have a yearly prostate examination after age 40, even if they have no symptoms of prostate problems. In recurring cases, you may need ongoing treatment with periodic checkups.

Alternative Names:

Prostate infection