Chronic or acute prostatitis

Prostatitis is an inflammation of the prostate gland and can be chronic or acute.

The prostate gland is a gland the size of a walnut found in men.
It is located directly below the bladder and covers the urethra (urethra), through which urine and sperm are passed out of the body.
One task of the prostate is to liquefy the sperm.
This fluid protects the sperm on its way to the woman’s egg.

With inflammation of the prostate, this is manifested:

  • turgid
  • painful
  • inflamed.

This disorder is not cancer and not benign prostatic hyperplasia.
Due to its location, prostatitis can occur simultaneously with urethritis, inflammation of the urethra.

Prostatitis can occur in men of any age. Most commonly affected are men between 30 and 50 years of age.
However, the disease can also affect young men.


Causes of prostatitis depending on the type

There are four types of prostate infections:

  • Acute bacterial prostatitis
  • Chronic bacterial prostatitis
  • Chronic abacterial prostatitis (or chronic pelvic pain syndrome)
  • Asymptomatic inflammatory prostatitis

Acute bacterial prostatitis
Causes: There are many causes for this type of prostate infection, depending on the specific type.
As the name suggests, acute bacterial prostatitis originates:

  • from a bacterial infection,
  • is characterized by inflammation of the prostate.

The bacteria in the colon, bladder, and other parts of the urinary tract system can reach the prostate gland and cause prostatitis.
Sexually transmitted diseases (such as gonorrhea and chlamydiosis) can also cause prostatitis.
This type affects about 5-10% of all cases of prostatitis.
Untreated prostatitis can lead to serious consequences and does not pass on its own.
Acute prostatitis can also be viral or mycotic (caused by fungi) (source) – usually in people with immunodeficiency.

Chronic bacterial prostatitis
Causes: The causes of chronic bacterial prostatitis are not exactly known, but it is believed that this disease is caused by a previous bacterial infection of the prostate gland and by a frequently recurring infection of the urinary tract (cystitis).
Among the bacteria responsible are: Ureaplasma urealyticum, Chlamydia tracomatis, etc. (source)
There is a variant, granulomatous prostatitis, in which granulomas are formed by lymphocytes, histiocytes, plasma cells, etc.

Chronic abacterial prostatitis
Causes: The exact causes of chronic abacterial prostatitis are not exactly known.
There are two types of chronic nonbacterial prostatitis:

  • inflammatory – if white blood cells are present in semen or urine;
  • the non-inflammatory – without the presence of white blood cells in semen or urine.

Triggering factors include:

  1. Stress
  2. nerve damage,
  3. physical trauma (caused by activities such as horseback riding, cycling, and lifting heavy loads).

According to research, about 90% of cases of prostatitis are due to unknown factors.
This specific type of prostatitis is often confused with interstitial cystitis (chronic inflammation of the bladder).
Prostatitis can occur together with:

  • intestinal diseases, for example, due to irritable bowel syndrome;
  • chronic fatigue syndrome;
  • Fibromyalgia.

Asymptomatic inflammatory prostatitis
Asymptomatic inflammatory prostatitis is:

  • characterized by inflammation of the prostate gland,
  • does not cause any special symptoms.

This condition has no identified infectious cause and the affected patients do not have chronic pain, unlike the types of infections mentioned above.
Only when a biopsy of the prostate is performed because of other diseases (cancer, sterility or elevated prostate-specific antigens), white blood cells are found in the urine.

Symptoms of prostate infection

Prostatitis is divided into four types:

1. Acute bacterial prostatitis
This disease is provoked by a bacterial infection.
In acute bacterial prostatitis in advanced phase, urination symptoms are the main symptom.
The symptoms are caused by the swelling of the gland pressing on the urethra.

With this prostate infection, the most common symptoms are:

  • Fever
  • Pain in the genitals
  • Back pain
  • Frequent micturition (frequent urination)
  • Sensation of burning sensation during urination and/or painful micturition
  • Foul-smelling urine
  • Discomfort during defecation, as the enlarged prostate presses on the rectum
  • Enlarged lymph nodes in the groin area

Incontinence is not a symptom of prostatitis

The urine is examined for the presence of bacteria and white blood cells.

2. Chronic bacterial prostatitis Chronic bacterial prostatitis
is rare.
This type is characterized by recurrent inflammation or infection.
Recurrent inflammation indicates a disturbance in the functioning of the prostate.
Infection of chronic bacterial prostatitis can also spread to the bladder.
It is important to accurately diagnose the condition before any treatments are undertaken.
Usually, with this disease, the doctor prescribes antibiotics and nonsteroidal anti-inflammatories.
Symptoms are similar to those of acute bacterial prostatitis.
These are:

  • Urination
  • Pain during and after micturition
  • Pain after ejaculation
  • Backache
  • Testicular pain
  • Muscle and joint pain

Chronic bacterial prostatitis does not cause erectile dysfunction, while benign prostatic hyperplasia is a possible cause. (Source)

3. Chronic abacterial prostatitis This is the most common form of prostatitis

There is no bacterial infection on the prostate or urinary tract.
It occurs almost eight times more often than bacterial prostatitis.
It can affect men at any age.
The observed symptoms are listed below:

  • Pain during and after urination
  • Pain in the genital area
  • Discomfort at defecation
  • Pain during ejaculation
  • Fatigue
  • Erectile dysfunction

Diagnosis of prostatitis

As a rule, infections of the prostate are diagnosed by clinical examinations of the organ, because an enlarged prostate can indicate a possible infection.
During rectal palpation, the doctor may feel the swollen prostate and the patient may feel pressure pain.

To confirm the diagnosis:

  • Urine tests
  • Blood analyses to obtain knowledge of the levels of the prostate-specific antigen (PSA). An elevated PSA value is also present in a prostate tumor and benign prostatic hypertrophy (benign prostate enlargement).
  • Blood culture
  • Echography
  • CT
  • Magnetic resonance tomography

The diagnosis can be confirmed by a special procedure, the 3-glass sample.
For this, the morning urine is used, which is divided into three samples:

  • First urine, the first 10 ml of emptying.
  • Midstream urine, another 200 ml of emptying, then the patient must interrupt the flow of urine.
  • The third sample is taken after a prostate massage.

These samples shall be examined; the following results are possible:

  1. If the first sample contains significantly more bacteria than the others, this may indicate inflammation of the urethra.
  2. If the third sample contains a significantly larger amount of bacteria than the others, the patient suffers from acute prostatitis.
  3. In a bladder infection, the bacterial count in all three samples is about the same.

However, a study by Budía A et al. on 895 patients shows that sperm is the most reliable sample for diagnosing chronic bacterial prostatitis.

Differential diagnosis
He gives diseases that can be confused with prostatitis:

  • Urethral stenosis
  • Benign prostatic hyperplasia
  • Urethritis
  • Stones
  • Hamorrhoids
  • rhagades

Treatment of prostatitis

What antibiotics must be taken in case of infection of the prostate?

Antibiotics for infections of the prostate

Cotrim is the name of an antibiotic that contains a mixture of two potent active ingredients, sulfametoxazole and trimethoprim.

Gyracip, and Tavanic
research shows that this antimicrobial agent has great success in treating patients with prostate infection.
Gyracip and Tavanic belong to the group of fluoroquinolones and help very well to stop and prevent an exacerbation of symptoms.

Ampicillin belongs to the group of penicillins and has been used since 1961 for the effective treatment of many bacterial infections, including prostatitis.

This drug belongs to the group of cephalosporins. More specifically, prostatitis provoked by Escherichia coli is often treated with cefalexin.

Doxycycline Often doxycycline
(which belongs to the group of tetracyclins) is used to eliminate prostatitis.

As a rule, acute bacterial prostatitis is treated with antibiotics, which are administered endovenously up to 24 hours after the fever disappears.
Then the doctor will order to continue antibiotic therapy orally (in tablet form) for 4 weeks to prevent the development of chronic bacterial prostatitis.

The doctor may also prescribe nonsteroidal anti-inflammatory drugs for the severe pain.

Recurrent infections of the prostate

Infections of the prostate, which recur at regular intervals, indicate that the antibiotic has not had any success in eliminating the bacteria.
This can happen because:

  • the intake was suddenly interrupted;
  • the antibiotic itself was not effective.

In such circumstances, and to prevent relapse of infection, one can increase the duration of taking antibiotics to 6-8 weeks or use another antibiotic (such as doxycycline) capable of penetrating the prostate and completely and not partially destroying the bacteria.
In some cases, patients can also be treated with antibiotics for many months before the infection disappears.
In severe cases of prostatitis that cause unbearable discomfort, antibiotics can also be administered intravenously.

In the urinary system, the appearance of foreign bodies (such as bladder or kidney stones) can be a reason for recurrent infections of the prostate.
Overall, the determination of the bacterial strain and the intake of the appropriate antibiotics are important to prevent recurrent infections.

Therapy for chronic prostatitis
Treatment of this disorder is very difficult.
It is observed that antibiotics are not effective in chronic prostatitis. Therefore, for the treatment of prostatitis, one should consider other drugs.

Some medications (Viagra, Cialis, etc.) can cause erection in men with prostatitis, but these drugs have serious side effects and should be taken under medical supervision.

If the bacterial cultures are negative, the doctor may prescribe a combination of:

  1. alpha-blockers (tamsulosin),
  2. phytotherapeutic anti-inflammatories (quercetin and bee pollen).

If these do not show success, there are neuromuscular therapies such as:

  1. physiotherapy of the pelvic muscles,
  2. Amitriptyline
  3. Gabapentin.

Natural remedies for prostatitis

In addition to therapy to prevent the recurrence of this condition, it is very important to drink plenty of water, refrain from certain strenuous activities such as horseback riding, cycling and jogging, and maintain prostate health.
Some men can ride a bike if they use a saddle with a recess for the prostate.

According to a scientific study published on Pubmed, certain foods or drinks can increase symptoms, most notably:

  1. spicy food,
  2. Coffee
  3. Chili
  4. alcoholic beverages
  5. Tea.

On the other hand, the symptoms are alleviated by:

  1. psyllium husks,
  2. Water
  3. Herb tea
  4. Polycarbophilic.

Saw Palmetto
Saw Palmetto is a natural remedy that:

  • improves prostate health,
  • Urinary symptoms heal.

According to scientific studies, saw palmetto can bind to the cell receptors of the lower urinary system and relieve symptoms of:

  1. Prostatitis
  2. hyperactive bladder,
  3. Hyperplasia.


The researchers state that it has no known pharmacological interactions and does not cause adverse side effects. Saw palmetto is commercially available in the form of capsules.
In middle-aged and advanced men, recreational exercise can reduce the risk of chronic prostatitis.

Diet and nutrition for prostatitis

Benefits of red wine in maintaining prostate health:
Red wine is one of the few beverages that bring benefits to the prostate.
At least four glasses of red wine a week can reduce the risk of prostate cancer by half.

One study looked at the type of alcohol consumed by two groups (each group consisted of over 700 men). One group consisted of men who had prostate cancer, while the second group was formed only by healthy individuals.
The study shows a significant decrease in the risk of prostate cancer in people who drank red wine. The researchers discovered that men who drink four to seven glasses of red wine a week have a 48% lower risk of cancer. Men who drink only 1 glass of red wine a week have a 6% lower risk of developing prostate cancer.
The study also showed that increased consumption of red wine (up to 8 glasses in a week) reduces the likelihood of developing aggressive cancer by 61%.

What foods to avoid
The prostate and all body organs function poorly in obese people who consume many of the following foods:

  1. trans fats and saturated fats,
  2. sweets,
  3. Dairy products
  4. Pork
  5. fried food.

In particular, according to the blood group diet, problems of the prostate can be caused by:

  1. milk and dairy products,
  2. Tomatoes (in persons of blood group A and B).

How long does prostatitis last? Recovery times

Recovery times depend on the cause of prostatitis.
With a bacterial infection, antibiotics can cure in a matter of weeks, while chronic or recurrent prostatitis can last for years.

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