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Prostatitis – Overview

January 23, 2021


“Prostatitis is felt to be the most common reason men seek attention through urology clinics, but there are two distinct subgroups of prostatitis. One is acute and the other is chronic. The acute prostatitis is typically a very aggressive bacterial infection. Men can present with fevers and chills and significant discomfort, both in just resting and especially when trying to urinate. Sometimes blood will also be present in the urine. This is truly an emergency and should be seen and dealt with through an emergency room. Acute bacterial prostatitis is treated aggressively with antibiotics and can be most often cured with an extended course of appropriate antibiotics. This is also a situation where it’s possible to obtain a culture, to figure out which bacteria is present in the urine, coming from the prostate. And that should be distinguished from chronic prostatitis where we almost never know which bacteria is present.

So chronic prostatitis is a much more indolent condition than acute bacterial prostatitis. And chronic prostatitis may or may not even be bacterial. It tends to present with some degree of discomfort, maybe discomfort with plus or minus a little blood, particularly blood in the semen. Often the degree of inflammation will affect one’s PSA value. The prostate blood test may be elevated because of prostatitis, especially acute, but in some cases also chronic and chronic prostatitis tends to be treated with simple measures. Typically a course of antibiotics is offered, even though we don’t have a very clear idea of which bacteria is present. Sometimes warm baths, like sitz baths, anti-inflammatory agents like ibuprofen are prescribed and sometimes prostate specific pills like Flomax or derivatives of the alpha blocker therapy that we use in BPH, because it seems to alleviate some tension within the prostate. It’s called chronic prostatitis because it can come and go. And often is a signal for some degree of BPH resulting in the retention of urine. So a urologist will address this problem, not just by treating a single episode, but by usually also doing some further investigation to get to the root of the cause.”

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