What is the prostate gland?
Only men have a prostate gland. It lies just beneath the bladder. It is normally about the size of a chestnut. The urethra (the tube that passes urine from the bladder) runs through the middle of the prostate. The prostate helps to make semen, but most semen is made by another gland nearby (the seminal vesicle).
What is the difference between acute and chronic bacterial prostatitis?
Acute Bacterial Prostatitis
This is when symptoms develop quickly. It usually occurs at the same time as a urine infection. Therefore, you may also have a bladder infection (cystitis). Bacteria (germs) are found in your urine if a urine sample is taken. Symptoms include:
- Pain from your prostate, which may be severe. You feel this mainly at the base of your penis, around your anus, and lower back. Pain may spread to your penis and testes. Passing stools (faeces) can be painful.
- Symptoms of a urine infection. For example: pain when you pass urine, passing urine frequently, an urgent desire to pass urine, and sometimes blood in your urine.
- Fever (high temperature). General aches and pains. You generally feel ill.
- A slight discharge (thick fluid) may come out of your penis from your urethra.
- Your prostate feels tender if a doctor examines it with a gloved finger in your rectum.
Chronic Bacterial Prostatitis
This is when the infection and symptoms develop more slowly. The infection is normally just in your prostate, and you do not have any other infection such as a bladder infection. Symptoms are not as dramatic as with an acute infection. The symptoms may 'drag on', or come and go. Symptoms may include:
- Pain similar to acute infection (described above) but usually not as severe. Ejaculation may be painful. The pain may vary in severity from day to day.
- Mild urinary irritation. You may have: mild pain when you pass urine, an urgent desire to pass urine at times, some hesitancy when trying to pass urine, a poor urinary stream.
- You may have general tiredness, and 'aches and pains'.
- Your prostate may feel tender, but not always, if a doctor examines it with a gloved finger in your rectum.
What causes bacterial prostatitis?
- Common bacteria that live in your bowel are the common cause. Some bacteria from your bowel may travel up your urethra and cause infection anywhere in the urinary tract - that is, the kidneys, bladder, prostate, or urethra. Urine infection with cystitis (bladder infection) is the common 'urinary tract infection'. However, a prostate infection may occur with or without other parts of the urinary tract being infected. Some conditions that cause pooling or blockage of urine increase the risk of a 'urinary tract infection' (eg enlarged prostate, kidney stones, etc.). This is because bacteria often thrive and multiply quickly in pooled urine.
- Less common causes:
- Damage to the prostate makes it more prone to infection, eg after prostate surgery.
- A catheter passed into the bladder may sometimes let bacteria travel to the prostate.
- Sometimes the prostate is infected by bacteria from blood that has travelled from other infections in the body.
- Sexually transmitted infection is a rare cause of prostatitis.
Do I need any tests?
- A urine test will usually detect bacteria in acute prostatitis.
- In chronic bacterial prostatitis, urine does not usually contain bacteria. To confirm chronic bacterial prostatitis, a sample of fluid ('secretions') from the prostate may be collected. To do this, a doctor can gently massage your prostate with a gloved finger in your rectum. By doing this, fluid from the prostate is pushed out into the urethra and comes out from the penis to be collected and tested for bacteria. If bacteria are found, it confirms that symptoms are due to an infection, and not to non-infective prostatitis.
- Tests such as x-rays or scans may be advised following acute prostatitis. This is to rule out any problem with your urinary tract that may have contributed to causing a urine infection.
What is the treatment for bacterial prostatitis?
- Antibiotics. A four week course is needed. The first antibiotic may be changed after the result of the urine test is back. The urine test finds which bacterium is causing the infection, and the best antibiotic to treat it.
- Paracetamol or ibuprofen ease pain and fever (high temperature). They are best taken regularly rather than 'now and then'. Stronger painkillers are sometimes needed.
- Laxatives can keep your stools (faeces) soft, if needed. They may help ease pain if you have hard stools in your rectum (back passage) pressing on your infected prostate.
What is the outlook?
- Acute infection usually clears with antibiotics. However, it is important to take the full course to completely clear the infection. There is a risk that an acute infection may become a chronic (persistent) infection if you do not take the full course of antibiotics.
- Chronic infection may clear with antibiotics. However, infection recurs in some cases, and symptoms may recur or become persistent despite treatment.
Further help and information
Prostate Research Campaign - 10 Northfields Prospect, Putney Bridge Rd, London, SW18 1PE
Tel: 020 8877 5840 Web:
www.prostate-research.org.uk
©EMIS and PIP 2005
