Prostatitis, Chronic Pelvic Pain Syndrome

Symptoms

Prostatitis is an inflammatory condition of the prostate that can occur in either an acute or chronic form. Acute prostatitis is less common but typically causes more pronounced symptoms, including frequent urination, painful urination, urethral discharge, fever, chills, dull pain in the perineum, and pain in the groin or lower abdomen during bowel movements or sexual intercourse. Erectile dysfunction, pain during orgasm, and blood in the semen may also occur.

The urinary symptoms and pain described above can also occur in chronic prostatitis, although they are usually milder. Because these symptoms may resemble those of more serious conditions, it is important not to delay seeking medical attention.

Who is at risk?

Examination and diagnosis

Because the prostate is a sensitive organ and the symptoms of prostatitis can be non-specific, diagnosing the condition requires a comprehensive evaluation.

The examination typically includes a medical history, a physical examination with a digital rectal examination (DRE), an ultrasound of the urinary tract and reproductive organs, and laboratory tests of urine, a urethral swab, and, when appropriate, semen samples.

Treatment

When prostatitis is caused by a bacterial infection, antibiotics are the cornerstone of treatment. Chronic bacterial infections usually require a longer course of antibiotics at lower doses.

Treatment of chronic pelvic pain syndrome is highly individualised, as the exact cause is often difficult to determine. Depending on the underlying factors, treatment may include alpha blockers to improve bladder emptying and relieve pelvic floor dysfunction, anti-inflammatory medication, and pain relief.

In severe cases, when an enlarged and swollen prostate obstructs the flow of urine, surgical treatment may be necessary.