Q-My doctor thinks I may have an infected prostate and wants to conduct a series of tests on me. He used a term I didn`t understand to describe the exact condition he suspects. How serious is an infected prostate and what condition do you think he was referring to?
A-A variety of conditions fall under the overall diagnosis of
``prostatitis,`` which refers to an inflammation of the prostate gland. The tests will help him determine the exact form of prostatitis you may be suffering from. The condition usually begins as an inflammation of the outer, or peripheral zone of the prostate, and in severe cases can expand to its inner, or periurethral zone.
Although it`s not known precisely how the condition originates, researchers theorize that bacteria may travel up the urethra (the canal that carries urine from the bladder through the penis) to the prostate either on its own or via a catheter. Other theories hold that the bacteria may originate in infected urine, blood, or even the rectum (traveling through the lymphatic system to reach the prostate).
Since the symptoms associated with prostatitis are often vague, it`s necessary for your doctor to take a series of urine samples and prostatic secretions to pinpoint the precise condition you may have. Prostatitis can be classified into four distinct clinical types.
Acute bacterial prostatitis involves frequent, painful or sleep-interrupting urination and low back pain. Fever and chills also may be present, while the prostate itself is unusually tense and tender. The condition is treated with antibiotics, bed rest, plenty of liquids and hospitalization if necessary.
Chronic bacterial prostatitis is usually the result of a recurring urinary tract infection (triggered by the same microorganism). Its symptoms may include painful ejaculation in orgasm, or blood present in the semen. Chronic bacterial prostatitis is treated similar to thebacteria responsible. Often, the symptoms can be controlled with antibiotics.
Non-bacterial prostatitis is marked by a dull pain in the pelvic area, and shares symptoms of urinary pain with the bacterial forms of the disease. Its cause or causes are open to debate, with cystitis and carcinoma originating in the bladder suspected. Antibiotics and anti-inflammatory drugs are administered, while patients have found that cutting back on alcohol, caffeine, and spicy foods often alleviates symptoms.
The symptoms of prostatodynia (it means ``painful prostate``), the fourth type of prostatitis, vary widely. The condition may be the result of a neuromuscular abnormality (such as unusual spasms of the urethral sphincter), or it may have its roots in emotional stress. While antibiotics are ineffective, various medications have been used to treat it, including muscle relaxants such as diazepam.
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Dr. Allan Bruckheim welcomes questions from readers. Although he cannot respond to each one individually, he will answer those of general interest in his column. Write to Dr. Bruckheim, P.O. Box 119, Orlando, Fla. 32802-0119.