Chronic prostatitis: Causes, symptoms, diagnosis, and treatment

In this article, we look at the causes and symptoms of chronic prostatitis. We also cover diagnosis, treatment, and home and alternative remedies.

What is chronic prostatitis?

The prostate is a small gland that forms part of the lower urinary tract in males. It sits under the bladder and surrounds the urethra, which is the tube that carries urine and semen out through the penis.

The prostate is part of the male reproductive system and produces one of the fluids that make up semen. The muscles of this gland also help push semen into the urethra during ejaculation.

Due to its location and function, problems with the prostate can affect urination as well as sexual function.

Prostatitis is an inflammation of the prostate that can often be painful. It can be chronic or acute:

• Chronic prostatitis develops gradually and can last for months or even years. Doctors consider prostatitis to be chronic if symptoms continue for 3 months or more. It may not respond well to the first treatments a doctor recommends.
• Acute prostatitis is a temporary condition that occurs suddenly. It may only last a few days or weeks and often responds well to treatment.

Prostatitis is the leading cause of urinary tract issues for men under 50 years of age, and the third most common urinary tract issue for men over 50 years of age.

Causes

An accurate diagnosis is key to effective treatment. However, diagnosing the cause of chronic prostatitis can sometimes prove challenging.

The causes of chronic prostatitis fall into two broad categories:

Chronic bacterial prostatitis

A bacterial infection of the prostate causes chronic bacterial prostatitis. In some people, this infection develops following a urinary tract infection or treatment for acute bacterial prostatitis.

The symptoms of chronic bacterial prostatitis are often less severe than those of acute bacterial prostatitis. A person who has previously had an acute infection might notice that their symptoms get better, but do not go away.

Some people with chronic bacterial prostatitis may find that the infection persists. This may be because the bacteria are resistant to antibiotic treatment or the antibiotic treatment course is too short. According to one study, some bacteria that infect the prostate can form biofilms in animals. Biofilms are similar to the plaque that develops on teeth and can make the infection harder to treat.

Chronic non-bacterial pancreatitis, or chronic pelvic pain syndrome

This is a non-bacterial form of prostatitis that can have many causes and is harder to treat. Someone who has had a previous bacterial infection of the prostate may be at risk of developing this type of prostatitis. Other people may develop chronic pain in the prostate after a bacterial infection clears up.

Possible causes of chronic prostatitis include:

• psychological stress
• damage to the urinary tract from surgery or a physical injury

The main symptom of chronic prostatitis is pelvic or genital pain. For some people, the pain feels like a gnawing ache. For others, it is intense and sharp. The pain may come and go or always be present.

Other symptoms of chronic prostatitis include:

• needing to urinate frequently, including getting up several times at night to use the bathroom
• pain during urination
• difficulty urinating
• a sense of urgency when needing to urinate
• pain in the perineum, the space between the scrotum and rectum
• pain in the lower back, rectum, penis, or testicles
• pain when ejaculating
• difficulty ejaculating
• signs of an infection, such as fever, chills, nausea, or vomiting

Kegel exercises, also known as pelvic floor exercises, can help improve urination difficulties in people with chronic prostatitis. The exercises work by strengthening the muscles around the bladder and penis.

To do these exercises, sit in a comfortable position then tighten and relax the pelvic muscles 10 to 15 times in a row. A person can locate their pelvic muscles by pretending to stop urination mid-flow.

Repeat these Kegel exercises several times a day. As a person becomes more comfortable with the exercises, they can increase the length of time they hold the muscle in, as well as the number of repetitions they do. It may take a few months before a person notices the results.

Other home and alternative remedies that may provide symptom relief for people with chronic prostatitis include:

• acupuncture
• biofeedback
• taking daily sitz or hip baths in warm or hot water
• relaxation exercises
• using a hot water bottle or heat pad to apply heat to the perineum or rectum

Outlook

Chronic prostatitis can be painful and can cause difficulties with urination. Anyone with symptoms of prostatitis should see a doctor.

Treatment depends on the cause and symptoms, but a doctor will often prescribe a course of antibiotics. Some people may also find symptom relief from trying Kegel exercises and certain home and alternative remedies.

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