Prostatitis is inflammation of the prostate gland that can occur suddenly (acute) or develop gradually over a long period of time (chronic). Prostatitis is usually characterized by pain and difficulty urinating.
The prostate gland is an organ in the male reproductive system that plays a role in the production of sperm. If the prostate gland is swollen and inflamed, there will be pain in the pelvis and pain when urinating or ejaculating.
Prostatitis can affect men at any age, but is more common in men under 50 years of age. This is different from prostate cancer or prostate enlargement which tends to attack older men.
Causes of Prostatitis
Here are some causes of prostatitis grouped by type:
Acute bacterial prostatitis
Acute bacterial prostatitis is caused by a bacterial infection of the prostate gland. The types of bacteria that trigger prostatitis are the same as those that cause urinary tract infections and sexually transmitted infections, namely:
- Esherichia coli
- Pseudomonas
- Neisseria gonorrhoeae
- Chlamydia trachomatis
Chronic bacterial prostatitis
The type of bacteria that causes chronic bacterial prostatitis is the same as acute bacterial prostatitis. The difference is, acute bacterial prostatitis appears and gets worse in a short time, while chronic bacterial prostatitis develops slowly over several months.
Chronic bacterial prostatitis can also be triggered by other diseases, such as kidney disease, tuberculosis (tuberculosis), HIV, and sarcoidosis.
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)
It is not known what causes CP/CPPS. However, it is suspected that this disease is related to:
- Stress
- Injury to the nerves near the prostate
- Physical trauma to the prostate or the surrounding area, for example from impact
- History of urinary tract infection
- Chronic fatigue syndrome
- Irritable bowel syndrome
CP/CPPS is the most common type of prostatitis. In contrast to other types of prostatitis, there is no bacterial infection in CP.
Asymptomatic inflammatory prostatitis
Same as CP/CPPS, cause asymptomatic inflammatory prostatitis also not known for certain.
Prostatitis Risk Factors
There are several factors that can increase a person's risk of getting prostatitis, namely:
- Suffering from urinary tract infection
- Have a previous history of prostatitis
- Have an injury to the groin area
- Using a catheter
- Suffering from HIV/AIDS
- Have had a prostate biopsy (tissue sampling)
Symptoms of Prostatitis
Symptoms of prostatitis can be mild to severe, depending on the type of prostatitis. Symptoms that can appear are:
- Fever
- Shivering
- Weak urine flow
- Foamy urine and bad smell
- There is blood in the urine or sperm
- Constantly feeling like urinating or having difficulty urinating
- Frequent urination at night (nocturia)
- Pain when urinating, defecating, or ejaculating
- Pain in the abdomen, groin, penis, testicles, perineum (the area between the base of the testicles and the anus), or lower back
In patients asymptomatic inflammatory prostatitis, symptoms usually do not appear and are only known when the doctor performs an examination of the prostate gland.
When to go to the doctor
Immediately see a doctor if you experience symptoms of prostatitis. Please note, some of the symptoms of prostatitis can be similar to the symptoms of a urinary tract infection, benign prostate enlargement, or prostate cancer.
Immediately consult a doctor if the symptoms of prostatitis appear suddenly (acute). If not treated immediately, the infection can get worse and cause complications.
Prostatitis does not increase the risk of sufferers developing prostate cancer or other diseases of the prostate and kidneys. However, patients with prostatitis who have recovered are advised to do regular prostate cancer screening.
Prostatitis Diagnosis
The doctor will ask about the patient's symptoms and medical history. After that, the doctor will perform a physical examination, one of which is a digital rectal examination. Digital rectal examination aims to detect an enlarged prostate.
To confirm the diagnosis, the doctor will also perform supporting examinations, such as:
- Blood tests, to detect infection in the blood, include a complete blood count and check levels prostate-specific antigen (PSA)
- Urine test, to determine the type of bacteria present in the urine
- Prostatic massage or prostate massage performed during a digital rectal examination, to obtain a sample of secretions from the prostate which will then be analyzed
- Scan with ultrasound or CT scan, to see the condition of the prostate more clearly
Prostatitis Treatment
Treatment of prostatitis depends on its type and severity. Treatment methods include:
Administration of drugs
Medicines that doctors prescribe to treat prostatitis include:
- Antibiotics, to treat prostatitis caused by a bacterial infection. Antibiotics can be given in the form of oral drugs or injections
- Alpha blockers, to relieve pain and blockage that occurs when urinating
- Non-steroidal anti-inflammatory drugs (NSAIDs), to reduce inflammation
Catheter insertion
In prostatitis patients who experience swelling of the prostate gland and difficulty urinating, the doctor will insert a catheter from the lower abdomen (suprapubic).
Operation
If there are stones in the patient's prostate, the doctor will cut and remove the prostate through a procedure transurethral resection of the prostate (TURP) or total prostatectomy.
Support therapy
To help relieve symptoms, patients can take the following simple steps:
- Soaking the anal and genital area in warm water (sitz bath)
- Drink lots of water to help get rid of bacteria through urine
- Reduce consumption of spicy or acidic foods and caffeinated or alcoholic beverages
- Avoid activities that can cause pressure and irritation to the prostate, such as sitting for long periods of time or cycling
Prostatitis Complications
If not treated immediately, prostatitis can cause complications such as:
- Epididymitis, which is inflammation of the tube that carries sperm from the testicles
- Difficulty passing urine (urinary retention)
- Spread of infection throughout the body through the bloodstream (sepsis)
- Formation of a collection of pus (abscess) in the prostate
- Having sexual dysfunction
- Infertility and decreased semen quality
Prostatitis Prevention
In most cases, the cause of prostatitis is unknown, making it difficult to prevent. However, there are several ways that can be done to reduce the risk of getting prostatitis, namely:
- Regularly maintain the cleanliness of the genital area
- Avoid sitting for too long and make periodic changes in position from sitting to standing
- Regular exercise at least 3 times a week
- Drink a lot of water
- Eat lots of fruits and vegetables to keep your immune system strong
- Do not consume spicy food, caffeinated drinks, and alcoholic beverages
- Maintain ideal body weight
- Manage stress well, for example with meditation or relaxation
- Have safe sex, namely by using condoms and not changing partners