Prostatitis
What is prostatitis?
Prostatitis is a disorder of the prostate gland typically involving inflammation of the prostate and sometimes the surrounding area.
There are 4 types of prostatitis:
Acute bacterial prostatitis: sudden and typically severe symptoms with bacterial infection
Chronic bacterial prostatitis: on going bacterial infection with symptoms that are usually less severe
Chronic prostatitis/chronic pelvic pain syndrome (CPPS): ongoing pelvic pain and urinary tract symptoms without any signs of an infection.
Asymptomatic inflammatory prostatitis: signs of an inflamed prostate without symptoms, typically found with other urinary tract testing
Causes:
Bacterial versions are caused by a bacterial infection that may occur from bacteria traveling through the urethra and into the prostate or via a spread from other parts of the urinary and reproductive systems. Chronic versions may occur when treatment for acute cases has failed to kill the bacteria or if course of treatment was not long enough.
Chronic prostatitis/CPPS has unknown exact causes but may include multiple factors. Some proposed mechanisms include a non-bacterial microorganism, the immune system’s response to a previous infection, nerve damage within the pelvic region, psychological stress or potentially be related to chemicals present in the urine.
Demographics:
This is the most common urinary tract problem for men under the age of 50 and the third most common for men over 50, and prostatitis accounts for about 2 million visits to medical providers in the United States every year.
Chronic prostatitis can occur in any age group and affects 10-15% of the US male population.
Symptoms:
Symptoms can include painful or difficult urination, including frequent or urgent urination and a weak or interrupted urinary stream. This can also include pain throughout the groin, pelvic and lower abdomen and/or genitals.
Chronic prostatitis/Chronic pelvic pain syndrome can include pain lasting 3 or more months local to the pelvic area including genitalia or spread out to the abdomen and lower back and may be intermittent or develop gradually.
Commonly men will experience pain either during or after ejaculation and other potential changes in sexual function.
Bacterial prostatitis symptoms are usually sudden and severe when acute and involve possible flu-like symptoms as well as potential urinary retention or blockage and presence of a UTI. When bacterial and chronic the symptoms can be similar to acute bacterial prostatitis but less severe/milder and often develop slower and last 3+ months.
Chronic bacterial prostatitis may also occur after previous treatment for acute prostatitis or a UTI.
Treatment:
Treatment will depend on the type of prostatitis present but is typically focused on reduction of pain/discomfort, inflammation, and other symptoms present. Antibiotics are typically prescribed to rid any bacterial or potential bacterial component to help rule out infection as well as other potential medications to help reduce inflammation and relax the muscles if spasming, especially if this is contributing to difficulty with urination.
Alternative treatment methods may also include sitz baths and heat therapy to help with pain as well as physical therapy techniques to help address pelvic floor relaxation and restored function.
Specific physical therapy treatment may include myofascial release, biofeedback, dry needling to improve muscle tension, pelvic floor muscle exercises for down-training and coordination, transcutaneous electrical stimulation (TENS) and bladder retraining including appropriate hydration and reduction of irritants.
If you or someone you love is experiencing pelvic pain or has been experiencing chronic urinary or UTI-like symptoms, please call our clinic! We would love to work with them.
Our therapists have Board Specializations in Orthopedics and Pelvic Health to provide you with a holistic program to treat your concerns and individualize the above recommendations to YOU!
Sources:
https://www.mayoclinic.org/diseases-conditions/prostatitis/symptoms-causes/syc-20355766
Barry MJ, Collins MM. Benign prostatic hyperplasia and prostatitis. In: Goldman L, Schafer AI, eds. Goldman’s Cecil Medicine. 24th ed. Philadelphia: Saunders; 2011: 805–810.
Murphy AB, Macejko A, Taylor A, Nadler RB. Chronic prostatitis: management strategies. Drugs.2009;69(1):71–84.
