Prostatitis - the painful prostate > What is prostatitis ?
Prostatitis literally means ‘inflammation of the prostate’. In fact, by no means every patient suffering from prostatitis actually has an inflamed prostate, so the name is rather misleading. In the UK, the condition accounts for almost one-quarter of all consultations with a urologist.
Patients with prostatitis often suffer pain and discomfort in the area around and between the anus and scrotum, and just above the pubic bone. Men with the condition may have to urinate frequently and this can be very inconvenient. There may also be a burning sensation at the time of urination and/or some discomfort during or after ejaculation (see the table below for a more complete list of symptoms). Although prostatitis is often considered to be the result of a bacterial infection in the prostate, inflammation, when present, more commonly occurs spontaneously. Some studies suggest that in the absence of infection, inflammation may result from urine being forced backwards up the prostatic ducts at the time of urination. Recently, the question has been raised as to whether, in the long run, inflammation can lead on eventually to prostate cancer. This is possibly because the inflammatory cells that infiltrate the prostate release chemicals that cause oxidative stress and thereby damage DNA in prostate cells.
Even when infection is the source of inflammation, it may be difficult to eradicate because the bacteria responsible tend to be inaccessible to antibiotics. This is because they usually lurk deep inside the prostate (for example, the bacteria may be inside the tiny stones that form in the prostatic ducts).
| Classification of prostatitis (National Institutes of Health, USA) |
| Category I - acute bacterial prostatitis |
| Acute bacterial prostatitis is usually caused by a bacterial urinary tract infection and is the least common, but most severe, form of prostatitis. Sufferers can feel generally unwell. |
| Category II - chronic bacterial prostatitis |
| Chronic bacterial prostatitis is a chronic or recurrent infection of the prostate that may be present for several years before any symptoms develop. The symptoms may be less aggressive but are recurring. |
| Category III - chronic (abacterial) prostatitis |
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| Chronic (abacterial) prostatitis is the most common form of prostatitis and is a recurring (relapsing) condition. It is difficult to pinpoint a specific cause for this condition, but it is thought that an abnormal immune system reaction or a chemical reaction to urine flowing backwards into the prostatic ducts could play a major role. Earlier suggestions that some sexually transmitted conditions, such as Chlamydia or Mycoplasma might be responsible have been disproved. |
| Category IV - asymptomatic inflammatory prostatitis |
| Some men feel discomfort that appears to come from their prostate or the surrounding area without any infection being present. Although there are many theories as to its cause, more research is required, as the inflammation could possibly lead to more serious problems, such as prostate cancer. |
Risk factors
Men who have an increased risk of prostatitis include those who have a previous history of the problem or long-term catheterization and those who have urinary tract infections that remain untreated. Some unconventional forms of sex may also spark off a bout of prostatic infection.
Prostatitis most commonly affects men in the age range 30-50 years, but a man of any age can be affected. In fact, most men afflicted have no identifiable risk factors.