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Prostatitis

Also listed as: Prostate infection


Prostatitis is inflammation of the prostate gland, a walnut-sized gland found just under the bladder in men. It can be caused by bacteria and come on suddenly (acute), or develop slowly over time (chronic). The sudden kind is less common but more severe. There is also a non-bacterial form of prostatitis, the most common kind. 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

Chronic bacterial prostatitis

Chronic nonbacterial prostatitis


What Causes It?

Risk factors for prostatitis include the following:


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 or blood cultures.


Treatment Options

Drug Therapies

Several antibiotics and other drugs can treat prostatitis. They are usually given orally, except in cases of sudden and severe prostatitis, which may require intravenous administration. The treatments may last 4 - 12 weeks, depending on how severe the infection is. 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

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 get your problem diagnosed before starting any treatment. You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, you should make teas with 1 tsp. herb per cup of hot water. Steep covered 5 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink 2 - 4 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.

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.

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 which lack evidence include:

Homeopathy

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

Physical Medicine

Kegel exercises increase pelvic circulation and improve muscle tone.

Contrast sitz baths: You will need two basins that you can comfortably sit in. 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

May improve urinary flow and decrease swelling and inflammation.

Massage

May help reduce symptoms. 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.


Supporting Research

Bartram T. Encyclopedia of Herbal Medicine. Dorset, England: Grace Publishers; 1995:52, 128, 203.

Berkow R, ed. The Merck Manual of Diagnosis and Therapy. 16th ed. Rahway, NJ: The Merck Publishing Group; 1992.

Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Boston, Mass: Integrative Medicine Communications; 1998:75, 201.

Buck AC, Rees RWM, Ebeling L. Treatment of chronic prostatitis and prostadynia with pollen extract. Br J Urol. 1989;64:496-499.

Carr AC, Frei B. Toward a new recommended dietary allowance for vitamin C based on antioxidant and health effects in humans. Am J Clin Nutr. 1999;69(6):1086-1107.

Conn RB, Borere WZ, Snyder JW, eds. Current Diagnosis 9. Philadelphia, Pa: WB Saunders Co; 1996.

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.

Gruenwald J, Brendler T, Jaenicke C, et al., eds. PDR for Herbal Medicines. Montvale, NJ: Medical Economics Co; 1998:817, 1229.

Johnston CS. Recommendations for vitamin C intake. JAMA. 1999;282(22):2118-2119.

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.

Klippel KF, Hiltl DM, Schipp B. A multicentric, placebo-controlled, double-blind clinical trial of beta-sitosterol (phytosterol) for the treatment of benign prostatic hyperplasia. Br J Urol. 1997 Sep;80(3):427-32.

Levine M, Rumsey SC, Daruwala R, Park JB, Wang Y. Criteria and recommendations for vitamin C intake. JAMA. 1999;281(15):1415-1453.

Menchini-Fabris GF, Giorgi P, Andreini F, et al. New perspectives on treatment of prostato-vesicular pathologies with Pygeum africanum. Arch It Urol . 1988;LX:313-22.

Murray MT, Pizzorno JE. Encyclopedia of Natural Medicine. 2nd ed. Rocklin, Calif: Prima Publishing; 1998:480-486.

Shoskes DA, Zeitlin SI, Shahed A, et al. Quercetin in men with category III chronic prostatitis: a preliminary prospective, double-blind, placebo-controlled trial. Urology . 1999;54:960-63.

Tierney LM Jr, McPhee SJ, Papadakis MA, eds. Current Medical Diagnosis & Treatment 1999. 38th ed. Stamford, Conn: Appleton & Lange; 1999.

Werbach, M. Nutritional Influences on Illness. New Canaan, Conn: Keats Publishing; 1988:82-84.


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