Prostatitis is inflammation of the prostate gland. The prostate is a walnut-sized gland that lies between the penis and the bladder and produces a fluid that nourishes sperm to create semen. Prostatitis usually occurs in 30 and 50 year olds. It can be very painful but, rest assured, it does get better with time, and treatment if needed.
Symptoms depend on whether symptoms have come on suddenly and severely, known as acute illness, or have niggled for months, known as chronic prostatits. Acute prostatitis requires immediate treatment, and brings with it pain in your penis, testicles, anus and lower pelvic region. You may get pain passing urine, doing a poo or ejaculating. You may get other urinary symptoms like going toilet more often needing to rush to the toilet, blood in your urine or finding it difficult to urinate, which is an emergency if it continues for several hours called acute urinary retention. You may feel generally unwell with a high temperature and lower back pain. In rare circumstances it can be life threatening. In chronic prostatitis, symptoms wax and wane over several months. It’s more common than acute prostatitis, but with similar symptoms. There may be less dramatic symptoms of feeling unwell, but you may notice symptoms during sex, such as pain ejaculating, pelvic pain afterwards or difficulty getting and maintaining an erection. You may also have nagging urinary symptoms, like getting up to pee in the night and a weak or dribbling stream. It can take its toll on your quality of life.
In chronic prostatitis, the cause is less clear but acute prostatitis is usually caused by bacteria entering the prostate from any organ in the urinary system. You're more at risk of acute prostatitis if you have had a recent urinary tract infection (UTI) or sexually transmitted infection STI). It's also more likely if you have anal sex, a urinary catheter, HIV or AIDS, and if you’ve had a biopsy of your prostate or an injury to your pelvis. It’s more likely in older men, if you’ve had it before, have been sexually abused or suffer from other painful abdominal issues like irritable bowel syndrome.
Your doctor will ask about your symptoms and any treatments you’ve already tried, and they will examine your abdomen, your groin area and your rectal passage. A digital rectal examination is an intimate examination where a gloved finger is placed into your back passage, from where they can feel the prostate gland and determine its size and surface, to aid diagnosis. If you have prostatitis, this may cause you pain, but it helps the doctor to determine if the prostate feels enlarged or unusual. A sample of urine will be taken to check for any urine infection or STI, particularly chlamydia or gonorrhoea. Chronic prostatitis is sometimes referred to a specialist called a urologist. Acute prostatitis is usually referred straight away to hospital.
Acute prostatitis requires a two to four week course of antibiotics and regular painkillers. If you are very unwell or have acute urinary retention, you may be admitted to hospital and have a catheter inserted. Painkillers are the mainstay of managing symptoms of chronic prostatitis, symptoms improve given some time. Your doctor may consider prescribing you antibiotics, as any infection won’t always show up on tests. Alpha blocker tablets are considered if you’re having difficulty passing urine, to help relax the muscles around the prostate gland. Laxatives may have a place, if you are straining and that is adding to your pain.