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Chronic Bacterial Prostatitis: What Men Need to Know
Published: Jul 22, 2024
Chronic bacterial prostatitis is a persistent infection of the prostate gland in men. It can cause ongoing urinary and pelvic symptoms that significantly impact quality of life.
What Causes It?
Chronic bacterial prostatitis occurs when bacteria enter the prostate, usually through the urethra. E. coli is the most common culprit, causing about 80% of cases. Other bacteria like enterococci can also be responsible. The infection may develop after a case of acute prostatitis or due to risk factors like urinary tract procedures, diabetes, or smoking.
What Are the Symptoms?
Symptoms can be subtle and may come and go. They often include urinary issues like frequent urination, pain or burning when urinating, and difficulty starting urination. Pelvic pain, especially in the perineum, lower abdomen, or testicles, is also common. Some men experience pain with ejaculation or blood in the semen. Recurrent urinary tract infections are another hallmark.
How Is It Diagnosed?
Diagnosis can be tricky and often requires seeing a urologist. The gold standard test involves comparing bacteria levels in urine samples taken before and after prostate massage. However, many doctors diagnose it based on symptoms and recurring urinary tract infections. Prostate exams and lab tests may also be done.
What's the Treatment?
Treatment usually involves a long course of antibiotics - typically 4-6 weeks or longer. Fluoroquinolones like ciprofloxacin are often the first choice due to their ability to penetrate prostate tissue. Other options include trimethoprim-sulfamethoxazole or doxycycline. Recurrences are common and may require repeated or prolonged antibiotic courses. Managing any underlying urinary obstruction is also important.
Frequently Asked Questions
It's treatable but often recurs, requiring repeated antibiotic courses.
Untreated, it may cause sexual dysfunction or spread to other parts of the urinary tract.
True bacterial prostatitis accounts for only about 10% of all prostatitis cases.
It can temporarily elevate PSA, potentially affecting prostate cancer screening.
Staying hydrated and avoiding irritants like caffeine or alcohol may provide some relief.
The Bottom Line
While challenging to treat, proper diagnosis and management can significantly improve quality of life for men with chronic bacterial prostatitis.
References
- Lipsky BA, Byren I, Hoey CT. Treatment of bacterial prostatitis. Clin Infect Dis 2010; 50:1641.
- Schaeffer AJ. Clinical practice. Chronic prostatitis and the chronic pelvic pain syndrome. N Engl J Med 2006; 355:2690.
- Krieger JN, Nyberg L Jr, Nickel JC. NIH consensus definition and classification of prostatitis. JAMA 1999; 282:236.
This article has been reviewed for accuracy by one of the licensed medical doctors working for Doctronic. Always discuss health information with your healthcare provider.
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