CancerCare Manitoba
 
 
 
Prostatitis

 

Prostatitis is an extremely frustrating disease because the correct diagnosis of your problem is difficult and it cannot always be cured. However, prostatitis is a treatable disease and you can usually get some relief from you symptoms by following the recommended treatment.

The bacteria that cause acute and chronic bacterial prostatitis get into the prostate from the urethra by backward flow of infected urine into the prostate. Bacterial prostatitis is not contagious and is not considered to be a sexually transmitted disease. If you have a diagnosis of bacterial prostatitis, your sexual partner cannot catch this infection from you.

Certain conditions or medical procedures increase the risk of contracting bacterial prostatitis. You are at higher risk for getting prostatitis if you:
  • recently have had a urinary catheter or other instrument inserted into your urethra
  • have an abnormality of your urinary tract
  • have had a recent bladder infection

Non-bacterial prostatitis or prostatodynia (now called chronic pelvic pain syndrome) may not be due to the typical bacteria that cause urine infections. It maybe caused by one of the following reasons:
  • organisms called Chlamydia or mycoplasma or even organisms that cannot be cultured using standard techniques
  • urine itself flowing backwards into the prostate ducts,
  • immune (or allergic) problems
  • repetitive trauma to the perineal area (for example from a bicycle seat)
  • a problem with the nerves and muscles surrounding the prostate gland (longer term cases)

Prostatitis is categorized into four separate categories:

The symptoms of the various prostatitis syndromes are extremely variable and although they depend on the type of disease you have, there is considerable overlap.

 

Category I
Acute bacterial prostatitis is caused by bacteria and is treated with antibiotics. Acute bacterial prostatitis comes on suddenly and with a severity that may warrant you seeking medical help immediately. Symptoms are severe and include:
  • pain
  • chills
  • fever
  • sever burning when attempting to urinate
  • voiding problems (e.g. inability to empty your bladder)

Category II
Chronic bacterial prostatitis is also caused by bacteria and requires antibiotics. Unlike an acute infection, symptoms of chronic bacterial prostatitis may be less severe but are still extremely distressing, particularly during a flare-up and can include:
  • burning on urination
  • urinary frequency
  • frequent urination at night
  • perineal, testicular, bladder and/or low back pain
  • painful ejaculation
  • prostate is swollen and tender during examination by physician
Recurrences are common and you may have no symptoms between episodes

Category III
Chronic pelvic pain syndrome (non-bacterial prostatitis or prostatodynia) is not caused by the usual bacteria and its cause is unknown. Antibiotics may not be effective for this type of prostatitis but will be considered by your physician because of the difficulty in differentiating bacterial from non-bacterial prostatitis. The symptoms of non-bacterial prostatitis and prostatodynia (Category III chronic pelvic pain syndrome) can be indistinguishable from those of chronic bacterial prostatitis and may also include the following common symptoms:
  • discomfort or pain in the area of the perineum, bladder area, testicles, prostate and/or penis
  • voiding difficulties are common (e.g. urination)
  • frequent urination
  • painful urination
  • Difficult and/or painful ejaculation is also a very common complaint

Category IV
Asymptomatic prostatic inflammation is diagnosed on biopsy and does not usually require treatment.


What other disease cause similar symptoms?

  • Benign prostatic hyperplasia (BHP) is a non-cancerous enlargement of the prostate gland that is very common in men over age 50 and may produce urinary tract symptoms that are similar to those experienced with prostatitis.
  • Urethritis, an inflammation of the urethra (usually caused by a bacterial or sexually transmitted organism), may also give rise to many of the symptoms that one experiences with prostatitis. Similarly, cystitis or infection of the bladder produces similar symptoms.
  • Prostate cancer, which occurs in the same age group as BPH, can cause discomfort and voiding symptoms that can be mistaken for prostatitis.