$Unique_ID{BRK04140} $Pretitle{} $Title{Prostatitis} $Subject{Prostatitis Prostate Infection Acute Bacterial Prostatitis Chronic Bacterial Prostatitis Nonbacterial Prostatitis Prostatodynia Epidiymitis Acute Cystitis} $Volume{} $Log{} Copyright (C) 1990 National Organization for Rare Disorders, Inc. 767: Prostatitis ** IMPORTANT ** It is possible that the main title of the article (Prostatitis) is not the name you expected. Please check the SYNONYM listing to find the alternate names and disorder subdivisions covered by this article. Synonyms Prostate Infection Disorder Subdivisions: Acute Bacterial Prostatitis Chronic Bacterial Prostatitis Nonbacterial Prostatitis Prostatodynia Information on the following diseases can be found in the Related Disorders section of this report: Epidiymitis Acute Cystitis General Discussion ** REMINDER ** The information contained in the Rare Disease Database is provided for educational purposes only. It should not be used for diagnostic or treatment purposes. If you wish to obtain more information about this disorder, please contact your personal physician and/or the agencies listed in the "Resources" section of this report. Prostatitis is a common infection of the prostate gland, the gland near the penis that is situated at the base of the male urethra. The prostate secretes an alkaline fluid which is the major ingredient of ejaculatory fluid. Prostatitis is classified into four subcategories: acute bacterial, chronic bacterial, nonbacterial and prostatodynia. Symptoms Acute Bacterial Prostatitis is characterized by chills, high fever, low back pain and pain in the joints or muscles. Affected individuals usually have problems with urination including frequency, urgency, difficulty and pain in urinating along with excessive urination at night. There may be a discharge from the urethra. The prostate gland is usually tender and swollen when examined by a physician's gloved finger in the rectum. Inflammation of the bladder (acute cystitis) usually accompanies Acute Prostatitis. Complications of untreated Acute Bacterial Prostatitis may include the formation of abscesses which may rupture into the urethra or rectum, kidney inflammation and infection of the long tightly coiled tube (epididymis) which carries sperm from the testicle to the ejaculatory duct. Infection of the testicle (orchitis) and shock may also occur. Chronic Bacterial Prostatitis is one of the most common causes of urinary tract infections in men. Affected individuals usually show no symptoms until the infection is advanced. As with Acute Bacterial Prostatitis, the majority of patients complain of frequency and urgency in urination, excessive urination at night and painful or burning urination. Most also experience low back pain. Secretions from the urethra, particularly at night, are common and the prostate gland is usually tender. Chronic Bacterial Prostatitis infections may involve the scrotum, producing intense discomfort, swelling and severe tenderness. There may be pain in the area of the prostate or rectum and decreased sexual desire with premature ejaculation. Nonbacterial Prostatitis is even more common than Bacterial Prostatitis and symptoms are usually indistinguishable from Chronic Bacterial Prostatitis. Most patients have no history of urinary tract infections. Prostatodynia refers to a condition characterized by painful and burning urination with no evidence of inflammation. Symptoms of Prostatodynia are also similar to, but more severe than, those of Chronic Bacterial Prostatitis. In rare cases, the pain may be incapacitating. Causes Bacterial Prostatitis is most commonly caused by the bacteria, Escherichia coli (E. coli), and more rarely by Enterococcus. Infection may be introduced through the urethra, usually by the flowing back of infected urine into the ducts of the prostate. It can also be caused by the invasion of rectal bacteria or by infection spread through the bloodstream from another area of the body. Whether or not bacterial prostatitis may be sexually transmitted is uncertain. The causes of Nonbacterial Prostatitis and Prostatodynis are unknown. Affected Population Prostatitis is a common disorder occuring in men most frequently over 50 years of age. Related Disorders Symptoms of the following disorders can be similar to those of Prostatitis. Comparisons may be useful for a differential diagnosis: Epididymitis is an infection of the long tightly coiled tube called the epididymis, which is located behind each testicle. The tube carries sperm from the testicle to the ejaculatory tract. Symptoms may include fever, chills and pain in the scrotum. Infected men may need to urinate frequently, and urination may be painful. (For more information on this disorder, choose "Epididymitis" as your search term in the Rare Disease Database). Acute Cystitis is an infection of the bladder. The most common cause of bladder infection in men is Chronic Bacterial Prostatitis. Symptoms may include burning or painful urination, excessive urination at night, urgency and frequency in urination and low back pain. Therapies: Standard Treatment of Bacterial Prostatitis is determined by the results of bacterial cultures and the overall condition of the individual. Treatment may require hospitalization with bed rest and the administration of analgesics and fluids with antibiotics such as ampicillin or amoxicillin. As prevention against the future development of Chronic Bacterial Prostatitis, trimethoprim- sulfamethoxazole may be administered for 30 days. Treatment of serious Acute Bacterial Prostatitis may require intravenous antibiotics until the acute phase of the infection has been overcome, followed by one month of oral antibiotic therapy. Less serious cases of Acute Bacterial Prostatitis usually respond to three to four weeks of treatment with oral antibiotics. Chronic Bacterial Prostatitis is more resistant to treatment which usually consists of trimethoprim-sulfamethoxazole or indanyl carbenicillin sodium for four weeks. Cultures are then repeated. A longer period of therapy may be required if cultures are still positive. If the infection persists after 12 weeks of therapy, a different medication may be tried. Some individuals do not respond completely to antibiotic treatment. In these cases, symptomatic infection may be treated as it occurs, or preventive measures taken to avoid recurrent episodes of cystitis which is the major source of symptoms. Antibiotics are of no value in treating Nonbacterial Prostatitis or Prostatodynia. Hot sitz baths and anticholinergic drugs may provide relief from symptoms. Some patients may find relief with periodic massage of the prostate. Therapies: Investigational This disease entry is based upon medical information available through July 1990. Since NORD's resources are limited, it is not possible to keep every entry in the Rare Disease Database completely current and accurate. Please check with the agencies listed in the Resources section for the most current information about this disorder. Resources National Organization for Rare Disorders (NORD) P.O. Box 8923 New Fairfield, CT 06812-1783 (203) 746-6518 National Kidney and Urologic Disease Information Clearinghouse Box NKUDIC Bethesda, MD 20892 (301) 468-6345 References INTERNAL MEDICINE, 2nd Ed.: Jay H. Stein, ed.-in-chief; Little, Brown and Co., 1987. Pp. 1547-1548. THE MERCK MANUAL, Volume 1, 14th Ed.: Robert Berkow, M.D., ed.-in-chief; Merck Sharp & Dohme Laboratories, 1982. Pp. 1615-1616. PROSTATITIS. C. Stewart; EMERG MED CLIN NORTH AM (August, 1988: issue 6(3)). Pp. 391-402. CHRONIC BACTERIAL PROSTATITIS: 10 YEARS OF EXPERIENCE WITH LOCAL ANTIBIOTICS. L. Baert et al.; J UROL (October, 1988: issue 140(4)). Pp. 755- 757. MEASUREMENT OF URINARY ANTIBODIES TO CRUDE BACTERIAL ANTIGEN IN PATIENTS WITH CHRONIC BACTERIAL PROSTATITIS. L.M. Shortliffe et al.; J UROL (March, 1989: issue 141 (3)). Pp. 632-636.