Prostatitis – Diagnosis and Treatment
Diagnosis
Methods for Finding Bacteria or Infections
Doctors start diagnosing prostate or urinary infections with a few key steps.
Physical Checks: Doctors perform a digital rectal examination (DRE). They insert a gloved finger into the rectum to feel the prostate for swelling, lumps, or tenderness. This helps them spot signs of prostatitis, prostate abscess, or inflammation.
Urine Lab Tests: Testing urine samples can show bacteria such as Escherichia coli, Klebsiella, or Enterococcus. Urinalysis can reveal a urinary tract infection or bacteria linked to chronic bacterial prostatitis.
Blood Testing: Blood samples can show infection or high inflammation in the prostate. Blood cultures may find severe infections, such as acute bacterial prostatitis.
Prostate Fluid Testing: During a rectal exam, doctors may apply gentle pressure to the prostate to release some fluid. Testing this fluid, along with urine collected after the massage, can help identify the bacteria causing the infection. Doctors avoid this test in cases of acute prostate infection because it can be risky.
Additional Ways to Find Prostate Problems
Doctors may recommend more tests if basic checks do not explain the symptoms or if they suspect nonbacterial prostatitis or chronic pelvic pain syndrome.
Bladder and Urine Flow Checks: Urodynamic studies measure how the bladder and urethra work. These tests can help find urination problems linked to prostate or pelvic pain syndrome.
Imaging and Scans: Transrectal ultrasound and other imaging methods can show the size and shape of the prostate gland. These tests can also spot unusual growths, cystitis complications, or a prostatic abscess.
Other specialist tests: If symptoms continue, doctors may suggest cystoscopy, a prostate biopsy in rare cases, or check prostate-specific antigen (PSA) levels to look for other prostate issues.
Treatment
Medication for Infections
Doctors usually treat bacterial prostatitis with antibiotics. Severe cases may require IV antibiotics in a hospital.
The typical treatment lasts 4 to 6 weeks, but it can be longer if the infection is hard to clear. Patients should finish all prescribed antibiotics to prevent the infection from returning or becoming chronic.
Easing Urinary Difficulties
People who have trouble urinating, such as urgency, frequency, or retention, may receive alpha-adrenergic blockers. These medicines help relax the muscles at the base of the bladder and in the prostate.
This treatment can ease symptoms by reducing urinary obstruction, making it easier and less painful to urinate.
Reducing Discomfort
Doctors often use pain relievers to treat pain from prostatitis, such as perineal pain or painful ejaculation. Both prescription and over-the-counter options like acetaminophen or ibuprofen can help manage discomfort during flare-ups.
Support for Emotional Well-being
If prostatitis causes stress, anxiety, or low mood, mental health specialists can help. Psychotherapy or counseling can support people struggling with long-lasting pain or emotional effects.
Lifestyle and Home Remedies
Simple steps at home may ease prostatitis symptoms. People often find relief by soaking in a warm sitz bath or using a heating pad. Drinking enough water each day helps flush bacteria from the body.
It is helpful to avoid or limit alcohol, caffeine, and spicy or acidic foods, since these can make urinary symptoms worse.
Alternative Ways to Manage Symptoms
Some people use alternative methods to help with prostatitis symptoms. Biofeedback uses special sensors and a monitor to help people learn to relax their pelvic muscles. Some patients find this can reduce pain or discomfort.
Acupuncture involves placing thin needles at specific spots on the body. Some men report less pain after acupuncture sessions.
Certain herbal supplements have been explored, such as ryegrass pollen extract (Cernilton), which may help with long-term pelvic pain. However, strong evidence for most herbal remedies is lacking.
Before trying any alternative therapies, people should speak with a healthcare provider. A doctor can help decide what is safe and may work with standard treatments.
Getting Ready for Your Doctor Visit
Before you see a healthcare provider, think about your symptoms and medical history. Be ready to explain when your symptoms started and whether they are steady or come and go.
Tell your doctor if you feel any pain, such as when you urinate, in a specific area, or during other activities.
Doctors often ask about:
- When symptoms began
- If pain is present and where you feel it
- Changes in urination (urgency, frequency, dribbling, or nighttime trips)
- Issues like cloudy or bloody urine
- Pain with ejaculation
You may find it helpful to use a table like the one below to organize your information:
| Question | Notes |
|---|---|
| When did symptoms start? | |
| Are symptoms constant or occasional? | |
| Is there pain when urinating or ejaculating? | |
| Any previous infections or injuries? | |
| Medicines, supplements, or vitamins being used |
Bring a list of your current medicines, supplements, and vitamins.
If you have received treatment for related infections, such as bacterial prostatitis or UTIs, remember when that treatment happened and whether you finished all your medications.
Mention any recent groin injuries to your doctor. Be clear and honest so your doctor can give you the best care.
