Important
It is possible that the main title of the report Prostatitis is not the name you expected. Please check the synonyms listing to find the alternate name(s) and disorder subdivision(s) covered by this report.

Synonyms

• prostrate infection (inflammatory)

Disorder Subdivisions

• prostatitis, acute bacterial
• prostatitis, chronic bacterial
• prostatitis, nonbacterial
• prostatodynia

Related Disorders List

Information on the following diseases can be found in the Related Disorders section of this report:

• epididymitis
• acute cystitis
• .

General Discussion

Prostatitis is a common infection of the prostate gland, the gland near the penis that is situated at the base of the male urethra. The prostate secretes an alkaline fluid that is the major ingredient of ejaculatory fluid. Prostatitis is classified into four subcategories: acute bacterial, chronic bacterial, nonbacterial and prostatodynia.
.

Symptoms

Acute bacterial prostatitis is characterized by low back pain, pain in the joints or muscles, high fever, and chills. Affected individuals usually have problems with urination including frequency, urgency, difficulty and pain in urinating along with excessive urination at night. There may be a discharge from the urethra. The prostate gland is usually tender and swollen when examined by a physician's gloved finger in the rectum. Affected individuals often exhibit inflammation of the bladder (acute cystitis). If left untreated, acute bacterial prostatitis may result in kidney inflammation, the appearance of abscesses that may rupture into the urethra or rectum, and infection of the tightly coiled tube (epididymis) which carries sperm from the testicle to the spermatic duct. Infection of the testicle (orchitis) and shock may also occur.

In chronic bacterial prostatitis, some affected individuals may show no symptoms except a urinary tract infection that recurs after antibiotic therapy has been completed. As with acute bacterial prostatitis, however, the majority of patients complain of frequency and urgency in urination, excessive urination at night and painful or burning urination. Most also experience low back pain. Secretions from the urethra, particularly at night, are common, and the prostate gland is usually tender. Chronic bacterial prostatitis infections may involve the scrotum, resulting in severe discomfort and swelling. There may be pain in the area of the prostate or rectum and decreased sexual desire with premature ejaculation.

In nonbacterial prostatitis, symptoms are usually very similar to those associated with chronic bacterial prostatitis. However, in most cases, affected individuals have no history of urinary tract infections.

Prostatodynia refers to a condition characterized by painful and burning urination with no evidence of infection. Symptoms of prostatodynia are also similar to, but more severe than, those of chronic bacterial prostatitis. In rare cases, the pain may be incapacitating.
.

Causes

Bacterial prostatitis is most commonly caused by the bacterias, Escherichia coli (E. coli) and Streptococcus faecalis. Infection may be introduced through the urethra, usually by the flowing back of infected urine into the ducts of the prostate. It can also be caused by the invasion of rectal bacteria or by infection spread through the bloodstream from another area of the body. Whether or not bacterial prostatitis may be sexually transmitted is uncertain.

The causes of nonbacterial prostatitis and prostatodynia are unknown.
.

Affected Populations

Prostatitis is a common disorder occurring in men most frequently over 50 years of age.
.

Related Disorders

Symptoms of the following disorders can be similar to those of prostatitis. Comparisons may be useful for a differential diagnosis:

Epididymitis is an infection of the long tightly coiled tube behind each testicle (epididymis) that carries sperm from the testicle to the spermatic tract. Symptoms may include fever, chills and pain in the scrotum. Affected men may need to urinate frequently, and urination may be painful. (For more information on this disorder, choose "epididymitis" as your search term in the Rare Disease Database.)

Acute cystitis is an infection of the bladder. The most common cause of bladder infection in men is chronic bacterial prostatitis. Symptoms may include low back pain, urgency nd frequency of urination, excessive urination at night, and burning or painful urination.
.

Standard Therapies

Treatment of bacterial prostatitis is determined by a thorough clinical evaluation and the results of bacterial cultures. Treatment of serious acute bacterial prostatitis may require hospitalization with bed rest and the administration of analgesics, fluids, and antibiotic drug therapy (such as with ampicillin or amoxicillin). As prevention against the future development of chronic bacterial prostatitis, trimethoprim-sulfamethoxazole may be administered for 30 days. Less serious cases of acute bacterial prostatitis may respond to three or four weeks of treatment with oral antibiotics.

Chronic bacterial prostatitis is more resistant to treatment. Treatment often consists of antibiotic therapy with indanyl carbenicillin sodium or trimethoprim-sulfamethoxazole for four weeks. Bacterial cultures are then repeated. If the cultures are still positive, a longer period of therapy may be required. If the infection is still present after 12 weeks of therapy, different antibiotic medication may be tried. Some individuals do not respond completely to antibiotic treatment. In these cases, symptomatic infection may be treated as it occurs or preventive measures taken to avoid recurrent episodes of cystitis, the primary source of symptoms.

Antibiotics are of no value in treating nonbacterial prostatitis or prostatodynia. Anticholinergic drugs and hot sitz baths may provide relief from symptoms. Some patients may find relief with periodic massage of the prostate.

Investigational Therapies

Information on current clinical trials is posted on the Internet at www.clinicaltrials.gov. All studies receiving U.S. government funding, and some supported by private industry, are posted on this government web site.

For information about clinical trials being conducted at the NIH Clinical Center in Bethesda, MD, contact the NIH Patient Recruitment Office:

Tollfree: (800) 411-1222
TTY: (866) 411-1010
Email: prpl@cc.nih.gov

For information about clinical trials sponsored by private sources, contact:
www.centerwatch.com

References

INTERNAL MEDICINE, 2nd Ed.: Jay H. Stein, ed.-in-chief; Little, Brown and Co., 1987. Pp. 1547-1548.

THE MERCK MANUAL, Volume 1, 14th Ed.: Robert Berkow, M.D. ed.-in-chief; Merck Sharp & Dohme Laboratories, 1982. Pp. 1615-1616.

PROSTATITIS. C. Stewart; EMERG MED CLIN NORTH AM (August, 1988: issue 6(3)). Pp. 391-402.

CHRONIC BACTERIAL PROSTATITIS: 10 YEARS OF EXPERIENCE WITH LOCAL ANTIBIOTICS. L. Baert et al.; J UROL (October, 1988: issue 140(4)). Pp. 755- 757.

MEASUREMENT OF URINARY ANTIBODIES TO CRUDE BACTERIAL ANTIGEN IN PATIENTS WITH CHRONIC BACTERIAL PROSTATITIS. L.M. Shortliffe et al.; J UROL (March, 1989: issue 141 (3)). Pp. 632-636.

Parsons CL. The role of the urinary epithelium in the pathogenesis of interstitial cystitis/prostatitis/urethritis. Urology. 2007 Apr;69(4 Suppl):9-16.

Bergman J, Zeitlin SI. Prostatitis and chronic prostatitis/chronic pelvic pain syndrome.
Expert Rev Neurother. 2007 Mar;7(3):301-7.

Sadeghi-Nejad H, Seftel A. Sexual dysfunction and prostatitis. Curr Urol Rep. 2006 Nov;7(6):479-84.

Langer JE, Cornud F. Inflammatory disorders of the prostate and the distal genital tract.
Radiol Clin North Am. 2006 Sep;44(5):665-77.

Kutikov A, Guzzo TJ, Malkowicz SB. Clinical approach to the prostate: an update.
Radiol Clin North Am. 2006 Sep;44(5):649-63.

FROM THE INTERNET
Mayo Clinic Staff. Prostatitis. Mayo Clinic.com. Updated Dec 29, 2006.
http://www.mayoclinic.com/health/prostatitis/DS00341
Accessed: 6/15/2007

Prostatitis: Disorders of the Prostrate. National Kidney and Urologic Diseases Information Clearinghouse. December 2003.
http://kidney.niddk.nih.gov/kudiseases/pubs/prostatitis/index.htm
Accessed: 6/15/2007

Prostatitis, Acute. Medical Encyclopedia. MedlinePlus. Update date: 6/13/2006.
http://www.nlm.nih.gov/medlineplus/ency/article/000519.htm
Accessed: 6/15/2007

Resources

American Urological Association Foundation
1000 Corporate Blvd.
Linthicum, MD 21090
USA
Tel: (410)689-3700
Fax: (410)689-3800
Tel: (866)746-4282
Email: auafoundation@auafoundation.org
Internet: http://www.auafoundation.org

NIH/National Kidney and Urologic Diseases Information Clearinghouse
3 Information Way
Bethesda, MD 20892-3580
Tel: (800)891-5390
Email: nkudic@info.niddk.nih.gov
Internet: http://kidney.niddk.nih.gov/

Genetic and Rare Diseases (GARD) Information Center
PO Box 8126
Gaithersburg, MD 20898-8126
Tel: (301)251-4925
Fax: (301)251-4911
Tel: (888)205-2311
TDD: (888)205-3223
Email: ordr@od.nih.gov
Internet: http://rarediseases.info.nih.gov/Default.aspx

The information provided in this report is not intended for diagnostic purposes. It is provided for informational purposes only. NORD recommends that affected individuals seek the advice or counsel of their own personal physicians.

It is possible that the title of this topic is not the name you selected. Please check the Synonyms listing to find the alternate name(s) and Disorder Subdivision(s) covered by this report

This disease entry is based upon medical information available through the date at the end of the topic. Since NORD's resources are limited, it is not possible to keep every entry in the Rare Disease Database completely current and accurate. Please check with the agencies listed in the Resources section for the most current information about this disorder.

For additional information and assistance about rare disorders, please contact the National Organization for Rare Disorders at P.O. Box 1968, Danbury, CT 06813-1968; phone (203) 744-0100; web site www.rarediseases.org or email orphan@rarediseases.org

Last Updated:  12/15/2009
Copyright  1990, 1995, 2007 National Organization for Rare Disorders, Inc.