Prostatitis is inflammation of the prostate gland. It is actually a group of conditions that affect the prostate, a walnut-sized gland found just under the bladder in men. The prostate produces part of seminal fluid, the fluid that helps carry sperm out of the body when men ejaculate. Prostatitis can cause pain and problems urinating. There are four major types of prostatitis:
Symptoms and treatment vary depending on what type of prostatitis you have.
In general, symptoms may include:
In addition, specific types of prostatitis can cause these symptoms:
Acute bacterial prostatitis:
Chronic bacterial prostatitis:
Chronic nonbacterial prostatitis:
Similar to chronic bacterial prostatitis, but without fever
Asymptomatic inflammatory prostatitis:
No symptoms; usually discovered when undergoing tests for other problems
As its name suggests, bacterial prostatitis is caused by bacteria. Researchers aren' t sure what causes chronic nonbacterial prostatitis or asymptomatic prostatitis. Trauma or injury to the prostate, or problems with the immune or nervous systems, may contribute to chronic nonbacterial prostatitis.
Your doctor will take a medical history and ask you about your symptoms. Your doctor will perform a digital rectal exam, examining your prostate by inserting a lubricated finger into your rectum. Lab tests, including urinalysis, semen sample, or blood cultures, may be ordered. Your doctor may suggest you see a urologist (a specialist who treats urinary tract disorders).
Bacterial prostatitis -- oral antibiotics, taken for several weeks. In some severe cases, you may need intravenous (IV) antibiotics. Other medications may include stool softeners and pain relievers such as ibuprofen (Advil).
Chronic nonbacterial prostatitis -- In addition to pain relievers such as ibuprofen (Advil), alpha blockers (which help relax the bladder) may help if you have trouble urinating. Alpha blockers include alfuzosin (Uroxatral) and doxazosin (Cardura). Side effects can include headaches and low blood pressure.
In severe cases of bacterial prostatitis, you may need surgery.
Be sure to let all of your doctors know about any herbs or supplements you take, or any alternative therapies you use. Some herbs, supplements, and alternative therapies may interfere with conventional medical therapies. Work with a doctor who is experienced in complementary and alternative therapies to find the right mix of treatments for you.
Drink plenty of water (48 oz. a day). Avoid alcohol, caffeine, and spicy foods. These supplements may help:
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.
Herbs traditionally used for prostatitis (but lacking scientific studies) include:
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.
Kegel exercises increase improve pelvic muscle tone. They may help some men reduce urinary symptoms. These exercises involve tightening and relaxing the pelvic floor muscles. To identify the muscles, it may help to think of the muscles you use to stop and start a stream or urine, or to keep from passing gas. Tighten muscles for a count of 10, then relax for a count of 10. Repeat 10 times, and do 5 - 10 sets daily.
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. Avoid sitz baths if you have acute bacterial prostatitis.
Acupuncture may improve urinary flow and decrease swelling and inflammation in some men with chronic nonbacterial prostatitis.
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.
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.
Bergman J, Zeitlan SI. Prostatitis and chronic prostatitis/chronic pelvic pain syndrome. Expert Rev Neurother. 2007;7(3):301-7.
Budia A, Palmero J, Broseta E, Tejadillos S, Benedicto A, Queipo JA, et al. Value of semen culture in the diagnosis of chronic bacterial prostatitis: A simplified method. Scand J Urol Nephrol. 2006;40(4):326-31.
Capodice JL, Bemis DL, Buttyan R, Kaplan SA, Katz AE. Complementary and alternative medicine for chronic prostatitis/chronic pelvic pain syndrome. Evid Based Complement Alternat Med. 2005 Dec;2(4):495-501.
Elist J. Effects of pollen extract preparation Prostat/Poltit on lower urinary tract symptoms in patients with chronic nonbacterial prostatitis/chronic pelvic pain syndrome: A randomized, double-blind, placebo-controlled study. Urology. 2006;67:60-3.
Giubilei G, Mondaini N, Minervini A, Saieva C, Lapini A, Serni S, et al. Physical activity of men with chronic prostatitis/chronic pelvic pain syndrome not satisfied with conventional treatments -- could it represent a valid option? The physical activity and male pelvic pain trial: A double-blind, randomized study. J Urol. 2007;177(1):159-65.
Hochreiter WW, Weidner W. Prostatitis -- a frequently unrecognized disease. Ther Umsch. 2006;63(2):117-21.
Kaplan SA, Volpe MA, Te AE. A prospective, 1-year trial using saw palmetto versus finasteride in the treatment of category III prostatitis/chronic pelvic pain syndrome. J Urol. 2004;171:284-88.
Larsen EH, Frimodt-Moller C. Prostatitis -- pelvic pain syndrome. Ugeskr Laeger. 2007;169(20):1921-3.
Murphy AB, Macejko A, Taylor A, Nadler RB. Chronic prostatitis: management strategies. Drugs. 2009;69(1):71-84.
Nickel JC. Treatment of chronic prostatitis/chronic pelvic pain syndrome. Int J Antimicrob Agents. 2008 Feb;31 Suppl 1:S112-6.
Wagenlehner FM, Schneider H, Ludwig M, Schnitker J, Brähler E, Weidner W. A pollen extract (Cernilton) in patients with inflammatory chronic prostatitis-chronic pelvic pain syndrome: a multicentre, randomised, prospective, double-blind, placebo-controlled phase 3 study. Eur Urol. 2009 Sep;56(3):544-51.
© 2011 University of Maryland Medical Center (UMMC). All rights reserved.
UMMC is a member of the University of Maryland Medical System,
22 S. Greene Street, Baltimore, MD 21201. TDD: 1-800-735-2258 or 1.866.408.6885