Prostatitis

Diagnosis

Several conditions can cause symptoms like those of prostatitis. Your healthcare professional may send you to a specialist in urinary and reproductive system conditions, called a urologist. Diagnosis involves a physical exam, review of your symptoms and medical history, and tests.

Test for diagnosing bacterial infections

Diagnostic tests to assess for infection may include:

• Digital rectal exam. With this procedure, a healthcare professional puts a gloved finger that's oiled into your rectum to see if there's inflammation of the prostate.
• Urine test. A urine sample is tested for infection and what type it is.
• Blood test. Blood samples may show signs of infection and other prostate conditions.
• Prostatic specimen test. Sometimes, a healthcare professional gently massages the prostate during a rectal exam. This is to release prostate fluid into the urethra. A urine sample collected after the massage is tested to check for infection in the prostate fluid. This test is not for acute bacterial prostatitis because it can spread germs in the blood.

Other tests

If the first tests show no sign of infection, you may have other tests, including:

• Urodynamic tests. These tests measure how well the bladder and urethra hold and release urine. These tests can help show the source of issues with urinating.
• Imaging. Imaging tests can show something that isn't usual in the prostate and growths or other issues in the pelvic region that may be causing pain.

Treatment

Treatment for prostatitis depends on the type you have and your symptoms.

Treating infection

For acute or chronic bacterial prostatitis, you take antibiotics. Acute prostatitis may need antibiotics given through a tube in a vein, called an IV, in the hospital for a short time.

The course of antibiotic treatment is most often 4 to 6 weeks. Sometimes it can be longer. Take all the medicine to get rid of the infection and lower the risk of chronic bacterial prostatitis.

Treating urinary symptoms

Medicines called alpha-blockers help relax the bladder neck and the muscle fibers where the prostate joins the bladder. This treatment might ease symptoms, such as pain while urinating or trouble urinating.

Alpha-blockers most often treat people with chronic prostatitis, also called chronic pelvic pain syndrome. Alpha-blockers also can ease urinary symptoms of bacterial infections.

Treating pain

Your healthcare professional may prescribe pain medicine or suggest medicines you can get without a prescription. These include acetaminophen (Tylenol, others) and ibuprofen (Advil, Motrin IB, others).

Managing psychological symptoms

Your healthcare professional may advise that you see a mental healthcare professional. This can help you manage stress, depression or worry that may be linked with long-term pain.

Lifestyle and home remedies

Do the following to help ease some symptoms of prostatitis:

• Soak in a warm bath, called a sitz bath, or use a heating pad.
• Don't have or limit alcohol, caffeine, and spicy or high-acid foods. They can irritate the bladder.
• Drink plenty of water. This will make you urinate more and help flush bacteria from your bladder.

Alternative medicine

Alternative therapies that show some promise for easing symptoms of prostatitis include:

• Biofeedback. You use this mind-body technique to help you control some of your body's work, such as heart rate and muscle responses. During biofeedback, you're connected to electrical pads that help you learn how your body responds.
• Acupuncture. This treatment involves putting very thin needles through your skin at certain points on your body. Acupuncture may help ease pain.
• Herbal treatments. Some studies suggest that rye grass pollen extract, also called cernilton, may help manage the pain of chronic prostatitis, also called chronic pelvic pain syndrome. There isn't enough proof that other herbal treatments ease symptoms of prostatitis.

Talk about your use of alternative medicine practices and herbal treatments with your healthcare professional before trying any.

Preparing for your appointment

Your healthcare professional will review your symptoms and medical history with you. Be ready to answer the following questions:

• When did your symptoms begin?
• Are your symptoms constant, or do they come and go?
• Do you have pain? Where?
• Do you have pain when urinating?
• Do you have trouble urinating, such as dribbling, or trouble starting a stream of urine or keeping it going?
• Have you seen bloody or cloudy urine?
• Have you had sudden, urgent needs to urinate?
• Are you urinating more often than usual?
• How often do you need to urinate in the night?
• Do you have pain when ejaculating?
• Have you been diagnosed with bacterial prostatitis or a urinary tract infection in the past? When?
• Did you take all the pills for that infection?
• Have you had a recent injury to your groin?
• What medicines, dietary supplements, herbal products and vitamins do you take?