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$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.