When is prostatitis an emergency?

Common knowledge and awareness of the prostate and what it does is relatively low in the UK. In a recent survey, Prostate Cancer UK revealed that of the 2000 men they surveyed, only 50% knew where the prostate was in their bodies. Considering 10-15% of men are estimated to develop symptoms of prostatitis at some point in their lives, it is important to know what you should be looking for, and make sure you act to receive the appropriate treatment. Mr Andrew Ballaro, expert urologist specialised in the treatment of prostatitis, explains symptoms to watch for, and when prostatitis should be considered an emergency.

What is the prostate?

The prostate is actually a gland which is an important part of the male reproductive system. It is roughly the size of a walnut. The prostate is found between the penis and bladder, and it produces prostate fluid, one of the main components of semen. It also affects urinary flow and ejaculation.  

What is prostatitis?

Simply put, prostatitis refers to swelling, or inflammation of the prostate. Many problems with the prostate affect older men, such as prostate enlargement, but prostatitis can occur at any age, most commonly affecting men between the ages of 30 and 50. Sometimes prostatitis is caused by bacterial infection, but sometimes there is no clear cause.

Prostatitis is usually divided into two main types as follows:

• Chronic prostatitis: this is the most common type of prostatitis. This type can last for months, and can come back (is recurring). Symptoms can come and go, and they vary in severity. This type is not usually caused by infection, but the cause isn’t often clear.
• Acute prostatitis: this form of prostatitis is much less common, affecting very few men in comparison to chronic prostatitis. In acute prostatitis, symptoms are severe and appear quickly, developing rapidly. Acute prostatitis is caused by bacterial infection, and is considered to be a medical emergency.

What are the symptoms?

Prostatitis symptoms vary from man to man, and they also vary depending on the cause of the condition. Symptoms include:

• Pain in the abdomen, lower back, or groin
• Pain in the testicles or in the penis
• Pain while urinating
• Pain while ejaculating
• Blood in semen
• Cloudy urine, or blood in the urine
• A need to pee more frequently, especially at night
• Difficulty when starting to urinate, or dribbles/affected stream while urinating
• Chills and possible fever

In acute prostatitis, these symptoms will be sudden, and painful. Acute prostatitis most commonly presents with sudden symptoms of chills, a fever, a severe burning sensation while peeing, or difficulty draining the bladder. In this case, you should seek medical help right away, as acute prostatitis is considered a medical emergency.

If it is left untreated, complications can develop, varying from man to man. These can include the inability to pass urine, and an abscess on the prostate. So it is imperative that men seek medical help if confronted with sudden prostatitis symptoms.

What is the treatment for prostatitis?

In the case of acute prostatitis, as it is caused by bacterial infection, a course of antibiotics is usually prescribed. It is important to finish the course of antibiotics, even if your symptoms go away. After the course is finished you will be tested to see if any trace of bacteria remains in or near the prostate.

Sometimes the cause of chronic prostatitis is not clear, so treatment is advised on a case by case basis. Your healthcare provider will perform tests to try and determine the type of prostatitis, and the cause of symptoms. If the chronic prostatitis is caused by a bacterial infection, antibiotics will be prescribed.

A type of medication called alpha-blockers may also be prescribed, which help to relax the muscles in the prostate and at the base of the bladder, helping with problems and pain felt while urinating.

To help with pain, over-the-counter painkillers can be taken, and you can try some remedies to ease symptoms, such as taking a hot bath, or using a hot water bottle. Sometimes relaxation and breathing exercises can help. Sometimes we advise the patient to make some changes to their diet, as some food and drink can irritate, including spicy or acidic foods, or fizzy drinks.

Am I at risk from prostatitis?

Prostatitis can occur in men across all ages, and there is not always a clear cause. It is not preventable in most cases, but practising safe sex can help reduce the risk of developing prostatitis caused by infection.

Other factors can increase the risk of developing prostatitis, including:

• An enlarged prostate gland
• A recent urinary tract infection
• A prior history of prostatitis
• Recently having had a urological procedure which used a urinary catheter
• A urinary tract abnormality

While prostatitis is relatively common, it can be treated and managed successfully – the key to getting the right treatment (or management in the case of long-term prostatitis) is getting the right diagnosis. 

If you are worried that you are experiencing symptoms of prostatitis, make an appointment to see Mr Ballaro in London or Brentwood.