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What Is Prostatitis And How Is It Treated?

Prostatitis Can Cause Painful Or Uncomfortable Symptoms, But Various Types Of Treatment Can Help. Pros...

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Prostatitis can cause painful or uncomfortable symptoms, but various types of treatment can help.

Illustration showing a normal prostate gland on the left and a prostate with prostatitis on the right, with the enlarged gland causing a compressed urethra.

Prostatitis, or inflammation of the prostate, is more common than you might think — it accounts for roughly two million doctor visits every year. The troubling symptoms include burning or painful urination, an urgent need to go (especially at night), painful ejaculations, and also pain in the lower back and perineum (the space between the scrotum and anus).

Prostatitis overview

There are four general categories of prostatitis:

Acute bacterial prostatitis comes on suddenly and is often caused by infections with bacteria such as Escherichia coli that normally live in the colon. Men can suffer muscle aches, fever, and blood in semen or urine, as well as urogenital symptoms. Acute inflammation can cause the prostate to swell and block urinary outflow from the bladder. A complete blockage is a medical emergency that requires immediate treatment. Depending on symptom severity, hospitalization may be necessary.

Chronic bacterial prostatitis results from milder infections that sometimes linger for months. It occurs more often in older men and the symptoms typically wax and wane in severity, sometimes becoming barely noticeable.

Chronic nonbacterial prostatitis, also called chronic pelvic pain syndrome (CPPS), is the most common type. CPPS can be triggered by stress, urinary tract infections, or physical trauma causing inflammation or nerve damage in the genitourinary area. In some men, the cause is never identified. CPPS can affect the entire pelvic floor, meaning all the muscles, nerves, and tissues that support organs involved in bowel, bladder, and sexual functioning.

Asymptomatic inflammatory prostatitis is diagnosed when doctors detect white blood cells in prostate tissues or secretions in men being evaluated for other conditions. It generally requires no treatment.

Both acute and chronic bacterial prostatitis can cause blood levels of prostate-specific antigen (PSA) to spike. This can be alarming, since high PSA is also indicative of prostate cancer. But if a man has prostatitis, then that condition — and not prostate cancer — may very well be the reason for the rise in PSA.

Prostatitis treatments

Fortunately, research advances are leading to some encouraging developments for men suffering from this condition.

Antibiotics called fluoroquinolones are effective treatments for acute and chronic bacterial prostatitis. A four-to six-week course of the drugs typically does the trick. However, bacterial resistance to fluoroquinolones is a growing problem. An older drug called fosfomycin can help if other drugs stop working. PSA levels will decline with treatment, although that process may take three to six months.

CPPS is treated in other ways. Since it is not caused by a bacterial infection, CPPS will not respond to antibiotics. Medical treatments include nonsteroidal anti-inflammatory drugs such as ibuprofen, alpha blockers including tamsulosin (Flomax) that loosen tight muscles in the prostate and bladder neck, and drugs called PDEF inhibitors such as tadalafil (Cialis) that improve blood flow to the prostate.

Specialized types of physical therapy can provide some relief. One method called trigger point therapy, for instance, targets tender areas in muscles that tighten up and spasm. With another method called myofascial release, physical therapists can reduce tension in the connective tissues surrounding muscles and organs. Men should avoid Kegel exercises, however, which can tighten the pelvic floor and cause worsening symptoms.

Acupuncture has shown promise in clinical trials. One study published in 2023 showed significant improvements in CPPS symptoms lasting up to six months after the acupuncture treatments were finished. Mounting evidence suggest that CPPS should be treated with holistic strategies that also consider psychological factors.

Men with CPPS often suffer from depression, anxiety, and other mental health issues that can exacerbate pain perception. Techniques such as mindfulness and cognitive behavioral therapy for CPPS can help CPPS sufferers develop effective coping strategies.

Comment

"An accurate diagnosis is important given differences in how each of the four categories of prostatitis is treated," said Dr. Boris Gershman, a urologist at Beth Israel Deaconess Medical Center and assistant professor of surgery at Harvard Medical School. PSA should also be retested after treating bacterial forms of prostatitis, Dr. Gershman added, to ensure that the levels go back to normal. If the PSA stays elevated after antibiotic treatment, or if abnormal levels are detected in men with nonbacterial prostatitis, then the PSA "should be evaluated in accordance with standard diagnostic approaches," Dr. Gershman said.

Harvard Health Publishing

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Deepika Padukone Enters The Hollywood Walk Of Fame: A World Icon Among Legends

In A Historic Announcement, Bollywood Megastar Deepika Padukone Has Been Added To The List Of Newest Inductees To Be Presented Wit...

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In a historic announcement, Bollywood megastar Deepika Padukone has been added to the list of newest inductees to be presented with a star on Hollywood’s legendary Walk of Fame. Her addition not only reflects on her illustrious career but also represents a milestone towards further representation of South Asians in global entertainment. The Hollywood Walk of Fame, woven into Hollywood Boulevard and Vine Street, honors individuals who have made important achievements in the fields of film, television, music, radio, live theatre, and sports entertainment. With more than 2,700 stars awarded since its inception over 60 years ago, the Walk continues to be one of the most prestigious recognitions in the industry. This year’s honorees were selected from hundreds of nominations and ratified by the Hollywood Chamber of Commerce’s Board of Directors on June 14. In addition to Padukone, the list consists of top television and entertainment names, including The Office writer Greg Daniels, Buffy the Vampire Slayer actress Sarah Michelle Gellar, celebrity chef Gordon Ramsay, and actors Bradley Whitford and Noah Wyle. While these names honor achievements in Western media, Padukone’s addition is a representation of increasing internationalism in entertainment. The very fact that she is on the list attests to a significant change in culture: one embracing more inclusive and globally diverse storytelling. Deepika Padukone came on the scene in 2007 in her leading role in Om Shanti Om, immediately capturing hearts for her poise, skill, and screen presence. Since then, she has produced a sequence of critically acclaimed and commercially successful performances in movies such as Piku, Bajirao Mastani, Padmaavat, Chhapaak, and Gehraiyaan. Her choices have always walked that tightrope between mainstream popularity and deeply emotional and bold characters who push against the norms. In 2017, she made her Hollywood debut opposite Vin Diesel in xXx: Return of Xander Cage. While many saw this as her international breakthrough, it was just the beginning of a larger global journey. Her frequent appearances on global red carpets, from the Met Gala to the Cannes Film Festival, have helped cement her position as a true cross-cultural star. Her work to decriminalize mental illness in India has gained worldwide acclaim, leading to her receiving the TIME100 Impact Award. Her bravery to be so publicly honest about such intensely personal struggles has encouraged millions and compelled significant discourse around mental health in South Asia. What distinguishes Padukone is not only her acting prowess but also her deliberate attempts to break stereotypes and promote more inclusive storytelling on the world stage. She recently challenged the Oscars for consistently overlooking Indian cinema, calling on the international entertainment industry to recognize the richness and diversity of Indian storytelling. Her Walk of Fame induction, therefore, has nothing to do with celebrity and everything to do with transformation. It is a gesture of recognition to those whose voices have been too often ignored and a step toward a more inclusive entertainment landscape. Padukone’s star on the Walk of Fame is not only a reflection of hope for Indian stars but also for artists and audiences across the world who hope to have their stories and their cultures heard in the international market. Her success contributes to the impetus building for increasing South Asian presence in Hollywood and global media. With this distinction, Deepika Padukone is joining a league of legends, but more significantly, she is pushing open the door even further for those who come after her. She represents a new form of international stardom: one that’s as motivated by cause as it is by popularity. The official ceremony to unveil the star of Padukone will take place next year, with fans from all over the world set to celebrate with her. With her continued ability to juggle demanding acting roles with campaigning and international acclaim, there is little difficulty in seeing that she has hardly begun. In honoring Deepika Padukone, the Hollywood Walk of Fame does not simply celebrate a career; it honors a movement. A movement towards diverse films, empathetic storytelling, and a universe where stars shine through cultures and continents.

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