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prostatitis, acute

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Prostatitis; acute

Alternative Names
acute bacterial prostatitis, prostate gland infection, infection of the prostate gland

Definition
Acute bacterial prostatitis is a sudden severe infection of the prostate gland caused by bacteria.

What is going on in the body?
The prostate gland is located at the base of a man's penis. It secretes substances into the semen that aid in fertility. The fluid in the prostate is normally sterile. Bacteria from urine can enter the prostate by way of the urethra, which is the tube through which urine flows from the bladder to the tip of the penis. These bacteria can multiply and rapidly cause bacterial prostatitis. This disease is almost always accompanied by an infection in the urinary tract from the same organism.

What are the signs and symptoms of the infection?
Symptoms are usually severe and come on suddenly. Symptoms can include:
  • fever and chills
  • overall ill feeling
  • muscle and joint pain
  • low back pain
  • pain in the area between base of the penis and the rectum
  • need to urinate frequently
  • urgent need to urinate
  • need to wake up during the night to urinate, which is called nocturia
  • painful urination
  • poor urine stream


What are the causes and risks of the infection?
Bacteria commonly found in the intestines, known as coliform bacteria, are usually responsible for urinary infections in older men. Conditions that make men more prone to urinary infections can contribute to prostatitis. One of these is the blockage of the outflow of urine from the bladder due to an enlarged prostate gland.

What can be done to prevent the infection?
When urine is not completely voided, it is a target for bacteria. This exposure can cause an infection in the prostate. Therefore, treating blockages that limit the flow of urine out of the bladder is a helpful strategy. This can reduce the amount of urine that is left in the bladder after urination and cut down on the risk of urinary infection.

How is the infection diagnosed?
A doctor will ask the man about his symptoms and do a physical examination. The doctor will feel the prostate by means of a rectal examination. If the man has prostatitis, the gland will be tender and swollen. A urine sample will reveal large numbers of bacteria and white blood cells, the infection fighting cells of the body. A massage technique is sometimes used for other types of prostate problems. This is not used in the setting of acute bacterial prostatitis.

What are the long-term effects of the infection?
Acute bacterial prostatitis can lead to the spread of bacteria into the bloodstream, which is called bacteraemia. This can cause septic shock. Septic shock is dangerously low blood pressure that occurs as a result of a systemic or full body infection. A pocket of pus or an abscess can also form in the prostate.

What are the risks to others?
This condition cannot be passed to other people.

What are the treatments for the infection?
Medication is the primary treatment for this condition. Oral medications such as trimethoprim-sulphamethoxazole or any drugs in the fluoroquinolones group can be used. These include ciprofloxacin and norfloxacin. These drugs are taken for roughly 4 weeks. Sometimes, the man is so ill that he must be put in the hospital to receive intravenous antibiotics.

Acute bacterial prostatitis combined with an enlarged prostate may lead to the inability to urinate and urinary retention. In this case, urine is extracted from the bladder through a small tube called a catheter. The placement of a catheter through the urethra can cause complications when a person has acute bacterial prostatitis

What are the side effects of the treatments?
Many antibiotics cause stomach or skin problems. A man should discuss possible side effects with his doctor or pharmacist.

Author: Stuart Wolf, MD
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request


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