Acute prostatitis

What is acute prostatitis?

The prostate is a walnut-sized gland that sits below the bladder in men. This gland makes fluid that mixes with sperm to form semen. Because the prostate surrounds the urethra (the tube that carries urine out of the body from the bladder), conditions that cause the prostate to swell or enlarge may press on the urethra and cause pain or problems with urination.

Prostatitis is inflammation of the prostate gland. Acute prostatitis is inflammation of the prostate gland that results in sudden onset of symptoms. Acute prostatitis is caused by an infection, usually by bacteria that get into the prostate by traveling up the urethra or as a complication of a urinary tract infection or prostate biopsy. Some of these bacteria are the normal germs that live on and inside your body; other infections are transmitted through sexual contact.

Most men who will develop prostatitis have a normal prostate gland, although the infection may be more common in older men, as the gland gets larger with age. There is no known link between prostatitis and prostate cancer.

Symptoms of acute prostatitis

Typical symptoms of acute prostatitis include:

• burning or dribbling with urination
• difficulty starting the urine stream or total inability to pass urine at all
• cloudiness or blood in the urine
• pain above the penis, in or below the scrotum, in the back, or in the rectum
• fever and chills
• flulike symptoms including muscle aches and general weakness.

Diagnosing acute prostatitis

Your doctor will examine your prostate by gently inserting a finger into your rectum. When the prostate is infected, it usually feels swollen. When slight pressure is put on the gland, you may experience pain or a severe need to urinate. Your doctor also will perform a general physical examination to determine whether the infection may have spread to other organs such as the kidneys.

A next step will be to examine a urine specimen for evidence of infection such as white blood cells and bacteria. In a typical case of acute prostatitis, the urine will contain white blood cells. You may also have blood tests to check kidney function, blood cell count, and whether bacteria are present in the bloodstream. Your doctor may order an ultrasound or computed tomography (CT) scan if there is concern that your swollen prostate is causing urinary obstruction.

Expected duration of acute prostatitis

If treated promptly, the symptoms of prostatitis usually begin to improve within 24 to 48 hours. In more severe cases, symptoms of infection may linger for more than a week.

Preventing acute prostatitis

Most cases of prostatitis cannot be prevented. However, if an infection is caught early, it is more likely to respond quickly to treatment. In addition, some cases of prostatitis are caused by sexually transmitted bacteria. Many of these infections can be prevented by practicing safe sex.

Treating acute prostatitis

Acute prostatitis is treated with antibiotics. In severe cases, antibiotics will be given intravenously (into a vein). In less severe cases, antibiotics can be taken orally. Because it is difficult for antibiotics to get from the bloodstream into the prostate, these medications often are prescribed for three or more weeks.

If you are severely ill with prostatitis, your doctor may admit you to a hospital to give you intravenous antibiotics and fluids and to monitor your vital signs. Usually a stay of only a few days is needed. If the prostate is very swollen, it may be necessary to insert a catheter into the bladder to allow urine to drain. This catheter may need to be left in place for up to a week, but as the infection comes under control, you should be able to urinate normally again.

When to call a professional

Call a health care professional if you develop

• pain or difficulty with urination
• blood or cloudiness in your urine
• severe back or groin pain combined with fever
• a reaction to an antibiotic you have been given to treat your prostate infection, such as a rash, nausea with vomiting, or severe diarrhea.

Delaying treatment can allow the infection to spread. In severe cases, a man may become extremely ill and need to seek emergency care.

Prognosis

Most cases of acute prostatitis respond promptly to treatment. Your doctor may recommend a prolonged course of antibiotics. Even if you start to feel better, it is important to complete the full treatment. Symptoms of irritation or hesitancy as you pass urine may linger for a while, but eventually should go away completely.

Additional info

National Institute of Diabetes & Digestive & Kidney Disorders
https://www.niddk.nih.gov/

American Urological Association
https://www.urologyhealth.org/