Prostatitis

Prostatitis is a benign condition. It is NOT prostate cancer. It is caused by inflammation of the prostate, which can feel sore and irritated. Prostatitis can occasionally be caused by an infection but in most case (>90%) no infection can be identified.

Urologists often classify this type of prostatitis as chronic prostatitis, as there is an acute prostatitis that is caused by a bacterial infection that is regarded as an emergency – a man will usually need to be admitted to hospital for intravenous antibiotics if he gets this form of prostatitis.

What are the symptoms?

Prostatitis can cause a wide range of symptoms, which vary from man to man. Some common symptoms include:

  • Discomfort, pain or aching in your testes, the perineum (the area between your scrotum and anus) or the tip of your penis.

  • Discomfort, pain or aching in the lower abdomen, groin or back.

  • Pain or stinging during or after urinating.

  • Painful ejaculation.

  • Needing to urinate frequently or urgently.

  • Feeling as if you’re sitting on a golf ball.

  • Fever / chills – is often an indication of infection.

  • Lack of energy.

How is prostatitis diagnosed?

Prostatitis is a “clinical diagnosis” – that is there is no specific test - after your doctor has taken a history and preformed a physical examination including a digital rectal examination (DRE).

Investigations usually include:

  • MSU – urine test to check for sign of infection.

  • General blood tests – full blood count, CRP, renal & liver function tests as well as blood sugar levels.

  • PSA test.

  • Cystoscopy – telescopic inspection of the urethra, prostate and bladder.

What is the treatment?

Treatment varies from man to man and is specific to each individual. Some types of prostatitis can be harder to treat, especially if symptoms have present for a long time.

Chronic prostatitis is not well understood which can make it difficult for doctors to know how to treat it- this can be frustrating for patients suffering from this condition. Most men need to try a number of different treatments before finding the one(s) that work best for them.

If your symptoms are not improving with the treatment offered by your GP, you can ask them to refer you to a urologist who specialises in managing prostatitis.

Medication

You’re likely to be given the following medicines:

  • A course of antibiotics, which you’ll need to take for at least four to six weeks. It may be necessary to remain on antibiotics even longer – a number of months in some instances.

  • NSAIDs – non-steroidal anti-inflammatory drugs e.g. Nurofen.

  • Analgesics – pain relieving drugs, if you need them.

  • Alpha blockers (such as Tamsulosin).

  • 5-alpha-reductase inhibitors (such as Dutasteride or Finasteride).

Other treatments

If you have prostatitis that goes on for a long time, you might be offered the following treatments. Although there is no strong scientific evidence for them, some men have found them helpful:

  • Prostate massage – the doctor massages your prostate through the wall of the back passage. This is most often done under anaesthetic as it can be quite uncomfortable.

  • Surgery – very occasionally, surgery is an option for men with prostatitis. It usually involves removing the prostate gland or part of it. It isn’t often done because there is a risk it can make symptoms worse and cause a number of side effects.

You might also be offered the following to help with the effects of prostatitis.

  • Anti-depressants – if your prostatitis affects your mood and you become very low, depressed or anxious, your doctor might suggest you try taking anti-depressants.

Lifestyle changes

There are a number of things you can try which other men have found helpful:

  • Drink sufficient water – 6-8 glasses a day.

  • Avoid carbonated drinks.

  • Coffee & tea can exacerbate symptoms.

  • Alcohol can be an irritant as well.

  • Food – especially spicy food can trigger symptoms.

  • Hard seats may be uncomfortable e.g. use a cushion.

  • Bike riding can also be a trigger.

  • Pelvic floor exercises have been shown to help many men suffering from prostatitis.

Complementary therapies

Many men find that complementary therapies can help them feel better and can help manage symptoms. They are used alongside conventional treatments, rather than instead of them. Some of these therapies include:

  • Acupuncture.

  • Massage.

  • Reflexology.

  • Aromatherapy – particularly useful.

  • Hypnotherapy.

  • Relaxation techniques e.g. yoga, meditation etc.

Herbal supplements

  • Quercetin.

  • Saw palmetto.

  • Cernilton.

  • L-Arginine.

Speak to your doctor or nurse if you’re thinking of using complementary therapies or supplements, as they may be able to advise you.