Chronic prostatitis is swelling and irritation (inflammation) of the prostate gland that develops slowly and continues for a long period of time.
Causes, incidence, and risk factors:
Chronic prostatitis is usually not caused by a bacterial infection. When it is caused by bacteria, chronic prostatitis may occur with or follow:
The most common bacteria species that cause chronic prostatitis include:
- E. coli
The disorder is diagnosed in 5 of every 1,000 outpatient visits. As many as 35% of men over age 50 may have chronic prostatitis.
- Age over 30
- Certain sexual practices (such as anal sex without a condom)
- Excessive alcohol intake
- Injury to the perineum (the area between the scrotum and anus)
These factors may cause congestion of the prostate gland, which produces a breeding ground for bacteria.
Other possible causes are related to stress and tightness of the pelvic muscles.
Treatment options for chronic prostatitis include a combination of medication, surgery, and lifestyle changes.
Chronic prostatitis is treated with a long course (6 - 12 weeks or longer) of antibiotics. Trimethoprim-sulfamethoxazole (Bactrim) and ciprofloxacin (Cipro) are commonly used. Other antibiotics that may be used include:
Most antibiotics do not get into the prostate tissue well. Often, the infection continues even after long periods of treatment. After antibiotic treatment has ended, it is common for symptoms to return.
Stool softeners may be recommended to reduce discomfort with bowel movements.
Nonsteroidal anti-inflammatory medications (NSAIDs such as Aleve and Motrin) and alpha blockers (such as Hytrin, Flomax, and Cardura) may also be used.
Transurethral resection of the prostate may be necessary if antibiotic therapy is unsuccessful or the condition keeps returning. This surgery is usually not performed on younger men because it carries a risk of retrograde ejaculation , which can lead to sterility, impotence , and incontinence .
Prostate massage and myofascial release are other treatments that may help this condition.
Frequent and complete urination is recommended to decrease the symptoms of urinary urgency. If the swollen prostate restricts the urethra, the bladder may not empty. Inserting a suprapubic catheter , which allows the bladder to drain through the abdomen, may be necessary.
Avoid substances that irritate the bladder, such as alcohol, caffeinated beverages, citrus juices, and hot or spicy foods.
Increasing the intake of fluids (64 - 128 ounces per day) encourages frequent urination. This will help flush bacteria from the bladder.
See your health care provider for an exam after you finish taking antibiotics to make sure that the infection is gone.
Barry MJ, McNaughton-Collins M. Benign prostate disease and prostatitis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 130.