Chronic Pain

How to Manage Chronic Bacterial Prostatitis

What is it?

Prostatitis is any inflammation or irritation of the prostate gland. There are two main types of prostatitis, bacterial prostatitis and chronic pelvic pain syndrome or CPPS. Bacterial prostatitis is caused by a bacterial infection, while the cause of CPPS can be a mystery.

It is, in fact, common for the cause of the condition to be non-bacterial and nine out of ten cases are actually not due to infection at all. This is called chronic pelvic pain syndrome (CPPS) and is often confused with bacterial prostatitis. However, because the cause of CPPS is a bit of a mystery, it is common for the condition to be blamed on infection and an antibiotic prescribed for it.

The condition can also be chronic or acute. Acute conditions can be more severe, but have a limited duration. If the condition is chronic, it is ongoing, and lasts more than three months. The symptoms are largely the same, however, with acute conditions resulting in more severe symptoms, while chronic conditions will be more mild. Chronic conditions will come and go, and you will experience flare ups, followed by relatively comfortable periods. There are different types of prostatitis, but the condition is quite common. It affects between ten and twenty percent of men sometime in their lives. It generally affects men between thirty and fifty years of age, but it is capable of affecting men of every age.

Only men have a prostate gland, so naturally, prostatitis only affects men. The gland lies just beneath the bladder and the urethra, the tube through which urine passes from the bladder, runs through the middle of the gland. The prostate is normally the size of a chestnut, though when it is inflamed it will swell.  While the medical condition of prostatitis and an enlarged prostate are different things, an enlarged prostate can be a contributing factor in bacterial infection, since an enlarged prostate makes the growth of bacteria easier.

STDs are also known to contribute to bacterial prostatitis, especially chlamydia and gonorrhea. Obviously, there are various reasons to avoid contracting these diseases, but their possible contribution to prostatitis is one more.

What does it feel like?

As we’ve already pointed out, symptoms of acute versus chronic prostatitis are similar, but not as severe. Acute conditions can also cause fevers and chills. These symptoms arrive quickly and unexpectedly. By contrast, symptoms of a chronic condition arrive more slowly. Also, some men have no symptoms between flare-ups and may not even recognize that they have a chronic condition.  Because of the location of the prostate in the body, the most common symptoms involve the urinary tract. Some of these symptoms include:

  • Blood in the urine
  • Dysuria or burning and pain with urination
  • Difficulty starting to urinate or emptying the bladder
  • Foul-smelling urine
  • Weak urine stream

There are other symptoms of prostatitis as well which include:

  • Pain or achiness in the abdomen above the pubic bone, in the lower back, in the area between the genitals and anus, or in the testicles
  • Pain with ejaculation or blood in the semen
  • Pain with bowel movements

The condition can also coincide or the bacterial infection can spread to become an infection in or around the testicles, and so you may also have symptoms of that condition.

How to Manage Chronic Bacterial Prostatitis

How do they test for it?

To begin with, a health care provider will perform a physical examination. He or she may find enlarged or tender lymph nodes in your groin, fluid released from your urethra, or that you have a swollen or tender scrotum. If any of these are found, then the provider will need to examine you further for prostatitis.

The primary test used to find evidence of the condition is through the rectal examination. During this exam, the provider inserts a lubricated, gloved finger into your rectum. While this may be unpleasant, it remains the most effective way for a doctor to examine your prostate gland. During this exam the doctor may find that the prostate gland is large and soft, revealing a chronic prostate infection, or that it is warm, soft, swollen or tender, which reveals that you have an acute prostate infection.

During this examination, the health care provider may massage the gland in order to get it to release fluid from the urethra. This fluid will then be tested and examined to diagnose for an infection. The health care provider may also ask that you provide a urine sample. This sample will then be used for urinalysis and urine culture and tested for infection.

While this condition is not related to prostate cancer, the condition can also affect the results of the prostate-specific antigen test (PSA), a blood test that is used to screen for prostate cancer. It is also possible that your doctor will suggest further tests of your kidneys and urinary tract. Because this condition is infectious, your health care provider will want to make sure that the infection doesn’t involve any other part of your urinary tract. This may include doing an ultrasound scan of your kidneys to see if there are any abnormalities.

How is it treated?

Because this is a bacterial infection, antibiotics are the first line of treatment for the condition. As already noted, antibiotics are also often prescribed for a non-bacterial condition. Antibiotics understandably haven’t had much success in treating bacterial conditions, but some antibiotics may also possess anti-inflammatory properties, which can certainly be helpful.

However, we are focussing on bacterial prostatitis, and you will be prescribed antibiotics to take for at least four to six weeks. The infection can come back, so it’s quite common that you will be on a course of antibiotics for up to twelve weeks. Even after that amount of time, it is still possible that the infection can come back after you stop taking the medicine.

If your condition makes it hard to properly empty your bladder, you may need the help of a tube to empty it. The tube will be inserted either through the abdomen, which is called a suprapubic catheter or up through your body which is called an indwelling catheter.

Rarely surgery will be considered for prostatitis. Surgery is generally only considered when other measures haven’t worked, since the success rate for surgery is mixed, and can have many of its own side effects, in addition to the condition it is meant to cure.

Can I do something for it myself?

There will be measures that you and your health care provider take together to alleviate chronic bacterial prostatitis. However, there are also things you can do for yourself at home to manage symptoms and maximize the effectiveness of the medical measures that are being taken. Things you can do at home include:

  • Urinate often and empty your bladder completely. Check with your doctor first, but try to drink between sixty-four and a hundred and twenty-eight ounces of fluid per day. This will ensure that you urinate often and help flush bacteria out of your bladder. It will also help prevent constipation.
  • Take warm baths and other measures to relieve pain. If approved by your doctor, you can take nonsteroidal anti-inflammatory medications (NSAIDs), such as ibuprofen or naproxen, as pain relievers.
  • Take measures to make bowel movements more comfortable. Take fiber supplements or stool softeners, and you can also try to eat plenty of foods with high fiber. Also try to get some exercise every day. Start slowly and slowly increase to thirty minutes per day.
  • We all need to adjust our diet based on foods that agree with us, but this is doubly true for patients who suffer with prostatitis. With that in mind, avoid substances that irritate your bladder, such as alcohol, caffeinated foods and drinks, citrus juices, and hot or spicy foods.
  • Take the full course of antibiotics that have been prescribed. Carefully read the bottle instructions and take them accordingly. Also, try to take your pills at the same time every day. Antibiotics can cause side effects, such as nausea or vomiting, diarrhea, and other symptoms. Report the side effects to your doctor, but don’t just stop taking your pills.  Failure to take all of your antibiotics as prescribed will make it more likely to have the infection recur.
  • After you have finished taking the full course of antibiotic treatment, get checked by your health care provider to make sure the infection is gone.

While generally manageable, it may be necessary to call a doctor or nurse if certain conditions arise. If you are completely unable to pass urine, or if it is very difficult and painful, then you will need to call. In addition, if you have fever, chills, or pains which do not start to improve after thirty-six hours, you also need to call.

Further reading

“Prostatis-Surgery.” WebMD. http://www.webmd.com/men/tc/prostatitis-surgery

“Prostatitis-bacterial-selfcare.” MedlinePlus.

http://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000395.htm

“Prostatitis-bacterial.” MedlinePlus.

http://www.nlm.nih.gov/medlineplus/ency/article/000519.htm

“Chronic Prostatitis.” Patient.co.uk.

http://www.patient.co.uk/health/chronic-prostatitis

“Chronic Bacterial Prostatitis.” By Sunil K. Ahuja MD.

http://emedicine.medscape.com/article/458391-overview

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