Acute bacterial prostatitis is a sudden-onset infection that lasts for several days. It often begins with chills and fever, lower abdominal discomfort, perineal pain (pain in the area between the genitals and the anus), and burning with urination.
Symptoms of more advanced prostatitis include a diminished urine stream and difficulty urinating. In the most severe cases, an episode of acute prostatitis can cause complete urine retention (the urethra is squeezed shut by the inflammed prostate), which requires hospitalization and the insertion of a catheter to release the urine flow again.
What Causes Acute Prostatitis?
- Bacterial infection of the prostate gland. The same bacteria that cause a urinary tract infection (UTI) are also capable of causing acute bacterial prostatitis.
- Sexually transmitted diseases (STDs), such as gonorrhea, chlamydia, urealyticum, and trichomonas, usually in younger men. Prostatitis from an STD typically closely follows sexual contact with an infected partner.
- In men older than 35, E. coli and other common bacteria are more often the cause of prostatitis. E. coli prostatitis may follow UTI, urethritis, or epididymitis.
- Procedures involving the urethra, such as catheterization or cystoscope, or bladder outlet obstruction.
Who Is At risk?
- Men between the ages of 20 and 35 who have multiple sexual partners and men who engage in anal intercourse, especially without using condoms.
- Men age 50 or older who have an enlarged prostate (benign prostatic hyperplasia) are at increased risk for prostatitis due to their risk of UTI.
Symptoms
- Fever and chills
- Low back pain
- Abdominal pain above the pubic bone
- Perineal pain (pelvic floor)
- Pain and burning with urination
- Urinary retention, or the inability to completely empty bladder
- Pain with ejaculation or with bowel movement
Other symptoms that may be associated with this acute prostatitis include:
- Blood in the urine
- Increased urinary frequency or urgency
- Difficulty urinating
- Testicle pain
- Blood in the semen
Treatment
Both acute and chronic prostatitis are treated with antibiotics, usually a 4- to 8-week course, although it can go longer. In severe cases, hospitalization and intravenous (IV) antibiotics may be required. For men with prostatitis caused by an STD, a shot of ceftriaxone is usually followed by a 10-day course of doxycycline or ofloxacin.
Beware of Chronic Prostatitis
If accurately diagnosed with acute prostatitis, the majority of men become symptom-free after treatment. However, patients who have had acute prostatitis are prone to recurrence and are likely to develop chronic prostatitis, which has no known cure.
In middle-aged and elderly men, prostatitis is increasingly being viewed by medical researchers as a potential preliminary stage for prostate cancer if it becomes a persistent inflammatory condition.
Contributing background information for this article: John Hopkins Medical white papers 2007 and 2008, the New York Times online, and the American Cancer Society website
Other articles by Steve Vogel on prostate disease and prostate cancer.
