Prostatitis is a medical condition in which your prostate gets swollen and soft. This of course is not the same as benign prostatic hyperplasia (BHP) or an enlarged prostate. This condition is also different from development of cancerous growth in prostate. Clinical studies have identified four unique types of prostatitis. One among these four types is chronic bacterial prostatitis. In general, those who have a medical history of infections in the urinary tract need to be more aware about this medical condition.
Prostate is a gland found close to the urinary bladder of men. This gland bears the shape of walnut. The main function of your prostate is to provide with a fluid in which sperms swim; essentially, the semen’s fluid comes from the prostate. When your prostate gets swollen, this medical condition is called prostatitis. When the signs show up very slowly and if they last for a fortnight or more, the condition is categorized as chronic prostatitis.
The four distinctive types of prostatitis are-
(a) Acute prostatitis – This occurs when bacteria gets into your prostate and causes an infection. It is the same strand of bacteria that triggers infections in your urinary tract. Often, these strands may get into the prostate during a biopsy or a clinical procedure. In some instances, strands that trigger syphilis, gonorrhea or other sexually transmitted infections can lead to acute prostatitis. Apart from these, a few medical conditions can also lead to acute prostatitis; these are formation of stones in your urinary bladder, usage of catheters (as part of cystoscopy), injury of the pelvic organs – especially near your scrotal bags, inflammation of urethra (medically referred as urethritis), etc. It has been observed that nearly 4% of people who had an incidence of acute prostatitis are likely to suffer from chronic prostatitis.
(b) Chronic pelvic pain syndrome – This is the most widely occurring prostatitis. Its signs are very similar to those of prostatitis caused by bacterial infections. However, main difference here is the absence of bacterial strands. Common triggers of chronic pelvic pains include damages to nerves in the pelvic area, high levels of stress and injuries or wounds on pelvic parts. A few medical research studies associate occurrence of chronic pelvic pain to a few autoimmune medical conditions as well as irritable bowel syndrome (IBS). These studies do not rule out the role played by infections in your urinary tract as well as changes in the chemical constitution of urine.
(c) Asymptomatic prostatitis – This condition may show up all of a sudden, without any issues associated with your urinary tract. It is often found out as a coincidental diagnosis while testing for higher amounts of antigens in prostatic secretions or while diagnosing reasons for infertility. As a noteworthy highlight, this condition is characterized by a marked presence of white cells of blood in prostatic fluids such as semen. This condition – if left to remain without any treatments – can bring about infertility related issues. Otherwise, very little facts are known about why some men – at their younger age – experience this condition. Several hypotheses do exist for its incidence. A few widely studied causes are – pain experienced in muscles and nerves of the pelvic floor, increase in pressure deep inside the urinary tract, discomforts in the pelvic region due to chemical imbalances or autoimmune medical conditions.
(d) Chronic bacterial prostatitis – Here, bacterial infections may persist for many months. This is categorized as an uncommon clinical condition. Bacterial strands trigger infections in your urinary tract; this in-turn can lead to infections in your urinary tract and bladder. Other symptoms include swelling of your prostate along with pain in your pelvic region. Bacterial infections that cause this condition are known to relapse over a period of time; it is hence categorized as a chronic clinical condition. It is the reason why your doctor may prescribe a long-term dosage of antibiotics to treat it.
Chronic prostatitis may occur to men of all age groups; however, it is more common among men aged between 40 to 50 years. Epidemiological studies indicate that about 5% of men are likely to suffer from its signs i.e., at least in one point or other in their lifetime. Most importantly, chronic prostatitis makes for more than 20% of problems reported at urologists’ offices.
Causes are very many – but, prostatitis caused by bacterial infections is treated by administration of antibiotics. There are no fixed patterns in which the medical condition shows up – i.e., in some instances, it may appear all of a sudden while in others it can appear very slowly; a few may persist for long as a chronic condition while in some types, it may last only for a shorter span of time. On the treatment offered to prostatitis, it may get well on its own or it may require a multimodal treatment approach.
Common signs associated with chronic bacterial prostatitis
Of all cases of prostatitis, less than 8% are caused by bacterial infections. Such infections can show up either as an acute or a chronic medical condition. But, among the chronic variants of prostatitis, more than 90% falls under chronic pelvic pain syndrome (CPPS) or medically called as chronic non-bacterial prostatitis. Thus, chronic bacterial prostatitis forms less than 9% of all chronic version of this clinical condition.
In general, the signs may take a fairly long time to show up. It is observed that it may usually take 4 to 5 months for the signs to show up. As mentioned above, bacterial strands in your prostate often lead to painful episodes. Doctors often look for signs such as presence of increased bacterial count in prostatic fluids along with spotting of white cells of blood in urinary secretions. However, white cells may be seen whenever your prostate is swollen; but, it cannot be entirely linked to bacterial infections. Hence, chronic bacterial infections assume only a fractional share in the total incidence of chronic prostatitis.
The other common signs of chronic bacterial prostatitis are #(1) unpleasant smell of urine, #(2) painful bowel movements, #(3) painful ejaculation during sexual intercourse,#(4) traces of blood seen in semen and / or urine, #(5) pains experienced while you urinate (this pain may resemble a burning sensation), etc. If you fail to treat these signs at the very start, you may notice more acute symptoms. If you notice these signs, it only means the condition has turned fairly acute – these acute signs are inability to urinate, formation of pus in prostate and blending of bacteria in prostate onto your blood.
Triggers of chronic bacterial prostatitis
As the name suggests, this condition is triggered by infections caused by bacterial strands. It has been noted that even when the signs are treated, several strands of infectious bacteria may survive deep inside your prostate. It is the main reason why you may get repeated episodes of infections. The carriers of infections are #(1) bacteria that cause sexually transmitted diseases such as gonorrhea, chlamydia, etc., #(2) strands of bacteria which result in infections in your urinary tract and #(3) strands called as Escherichia coli or a few other types of gram negative bacteria – associated with infections of urethra and testicles. You need to be aware that strands of Escherichia coli are closely linked with swelling of urethra (a medical condition called as urethritis).
If you have any of these medical conditions, the risks are found to be more. These are – narrowed opening of urethra, testicular infections (often seen in and around your balls) as well as enlargement of the prostate – this condition is called as benign prostatic hyperplasia (BHP).
How do you know if you have this medical condition?
This medical condition is diagnosed through a careful physical examination. If an examination reveals a lump in your groin, it is attributed to inflammation of lymph nodes in that area. Examination of prostatic secretions / discharge can also help ascertain an anomaly in your prostate. Your doctor may also gather essential information about your medical history – including those of your parents and other family members.
Soon after a thorough physical check-up, an examination of your rectum is done. It is mainly done to check the condition of your prostate. This examination is done by the insertion of a lubricated finger (with needful protection, by wearing a glove) to check the interiors of the rectum. This helps check symptoms of infections; the main symptom is the enlargement of your prostate or its softening.
A complete diagnosis is done with a few additional tests. These include testing of urine samples, blood or urine tests done to eliminate likelihood of sexually transmitted disorders and infections. The panel of tests may also contain tests done on samples of fluids discharged from your urethra; this is done to detect possible strands of bacteria.
How to treat chronic bacterial prostatitis?
This medical condition falls under the treatable spectrum. This is the good news. But, the not-so-good news is these infections may eventually return. It hence becomes very important to adhere to all appointments with the treating doctor. Above all, it is equally essential to take the medicines prescribed without missing the dosages recommended to you.
Administration of antibiotics remains as a standard medication option to treat chronic bacterial prostatitis. Dosages of antibiotics are prescribed for a period of 35 to 40 days (i.e., between five to six weeks). This is considered as the first phase of treatment. Due to persistent thriving of bacterial strands (such as Escherichia coli and other similar strands), infections are likely to relapse. You may hence need to extend the intake of antibiotics for 10 to 12 weeks or at times even more. Once you complete the schedule of dosage plan, the treating doctor may do a follow-up examination of infections. Medical specialists often state that infections are likely to last upto 9 to 10 months. In some cases, it can take even 12 months to completely get rid of all strands of bacteria and infections from your prostate. The most common drugs administered for the treatment of chronic bacterial prostatitis are –
Ciprofloxacin
This medication is widely administered for the case management of a range of infections caused by bacterial attack and spread. Most common applications of this drug include infections in the urinary tract, abdominal infections, topical infections – especially on skin, infections in bones, etc. Some of the side effects this drug may trigger are gas formation or flatulence, rashes on skin, drowsiness and nausea along with vomiting.
A few rare side effects of this drug are swelling of eyes, excessive sweating and stiffening of joints. This drug is known to interact with a wide range of medicines; such interacting medicines include medicines taken to treat diabetes, non-steroidal anti-inflammatory drugs (NSAIDs) such as naproxen, ibuprofen, etc., blood thinners such as warfarin and other such anticoagulant drugs.
If you have a medical history of hepatic dysfunction, you need to talk to your doctor. As the drug can impair the cells in liver, this precaution becomes essential. Also, this medication can decrease the presence of magnesium and potassium in your blood; so, if you are consuming drugs to enhance such chemicals in blood – it is highly recommended to talk to your doctor.
Sulfamethoxazole-trimethoprim
This drug is administered for treating a wide range of infections, mainly caused by bacteria. Its use is common for fighting infections in your ear, intestines, respiratory tract as well as urinary tract. At times, it is used in the case management of a few types of pneumonia.
This drug is however not administered onto children aged 2 years or less. It poses serious limitations in working against infections caused by viruses and other similar microbes.
Most common side effects of using this medication are indigestion, marked drop in appetite, nausea as well as vomiting. If you notice other side effects such as excessive sweating, blurring of eyesight, drowsiness, etc., you are advised to seek medical help without any delay. You are advised to visit the nearest poison control center if you observe symptoms like convulsions or arrhythmia (heartbeats in irregular intervals).
This drug may interact with other co-administered medications. Talk to your treating doctor if you are taking anticoagulant drugs or methotrexate. It is quite likely that this drug may interfere in the test results of a few diagnostic tests. As a result, some tests may yield misleading results. You are hence advised to tell your doctor about its intake prior to taking diagnostic tests. If you have a medical history of renal disorders, deficiency of vitamins, hypothyroidism, unstable levels of salts such as potassium in your blood, etc., you need to inform about it to your doctor. As this drug can adversely affect your blood sugar levels, tell your treating doctor if you are diabetic.
Allied treatment along with your medication plan
Soon after you have completed the dosage plan, your doctor will check for the following symptoms-
#1 – Presence of abscess. Upon spotting it, your doctor will drain it and dry it
#2- A condition called sepsis; this is when bacterial strands find their way into your blood. In such cases, your doctor will prescribe an intensive dosage of antibiotic treatment. In a few acute cases, your doctor may also recommend a stay in the hospital for needful recovery from this potentially dangerous medical condition
#3- Difficulties experienced while urinating or if you are unable to pass urine. In such instances, a catheter is used for emptying your urinary bladder.
#4- Presence of deposits of minerals or hardening of such minerals into stones. In this case, your treating doctor may recommend removal of the prostate. This however is an uncommon condition; but such treatment options do exist.
Options available to treat chronic bacterial prostatitis through home remedies
As mentioned, it often takes about 10 to 12 months to completely get rid of infections. So, apart from medications – you may also consider taking a few home remedies. These remedial measures taken at home can help minimize the signs associated with this condition. Most widely taken home remedies to treat chronic bacterial prostatitis are – (a) consumption of 2 to 3.5 liters of water on a daily basis, (b) intake of drugs that can soften your stool; this helps prevent difficulties in passing stool or avoid constipation, (c) intake of drugs to kill pain, (d) staying away from consuming spicy or hot food items, (e) refraining from juices (extracted from citric fruits like lemons, oranges, etc.), alcohol or caffeine-rich drinks and (f) taking baths in warm water frequently.
In sum, chronic bacterial prostatitis is a rare type of medical condition. Of all cases of prostatitis, less than 8% are caused by bacterial infections. Among chronic variants of prostatitis, more than 90% of the cases are chronic non-bacterial prostatitis. Hence, chronic bacterial prostatitis accounts for 10% or even less of the total disease burden. It is characterized by bacterial infections in your bladder and urinary tract.
This uncommon condition may also show up as an inflammation of the prostate. You may also experience pains in the pelvic floor. It is categorized as a chronic ailment because microbial infections often relapse and can persist over a long span of time. This condition is treated with dosages of antibiotics; the medication plan lasts several months and may reach upto 12 months in some instances.
Education: Master’s in Nursing (MSN) from Johns Hopkins University. Experience: 7 years writing for online health portals and nursing journals, specializing in patient education and chronic illness management.
