Acute inflammation of the prostate (acute prostatitis)


What is it about ?

The prostate is a walnut-sized gland that sits just below the bladder, in front of the rectum. It surrounds the urethra, the duct that goes from the bladder to the penis. The prostate produces part of the semen.

Prostatitis is an inflammation of the prostate tissue, usually caused by bacteria entering the prostate through the urethra (bacterial prostatitis). Prostatitis can also occur after a prostate biopsy. Ultimately, the inflammation spreads to the bladder. Inflammation of the prostate may be acute (onset suddenly) or chronic.

What is its frequency?

Each year, about 2 in 1,000 men are affected by an episode of acute prostatitis. The risk of developing prostatitis increases with age.

How to recognize it?

Acute prostatitis is associated with a feeling of intense discomfort and a high fever. The hallmark symptom of prostatitis is the constant urge to urinate, combined with difficulty urinating (dysuria) or painful urination. You may also feel a burning sensation in the lower abdomen while urinating. In very severe cases it is sometimes impossible to urinate because the prostate is very swollen and inflamed.

How is the diagnosis made?

The doctor will pay attention to your story and description of your symptoms, and perform a physical examination. Since prostatitis can also be the result of a sexually transmitted infection (STI), the doctor will take this possibility into account. He will only do a digital rectal examination (palpation of the prostate through the anus) in case of doubt. This exam can be painful when the prostate is inflamed.

The doctor will also ask you to urinate in a small pot. He will dip a test strip in the urine to check for any signs of bacterial contamination. He will eventually send the urine to the laboratory for analysis. The germ responsible for the infection (pathogenic germ) will be identified there. You may also need a blood test.

What can you do ?

If you recognize the symptoms, make an appointment with your GP immediately. Prostatitis does not heal spontaneously and requires specific treatment. If you have a sterile pot at home, you can already collect the urine and bring it to the clinic.

What can your doctor do?

Acute prostatitis is always of bacterial origin. It therefore requires treatment with an antibiotic (antibiotic therapy). The specific germ is not yet known at the time of diagnosis. Quinolone, a class of antibiotic, is routinely prescribed while waiting for test results. If the laboratory subsequently provides more information on the causative bacteria, the treatment may be changed. In total, the treatment lasts at least three weeks. In the event of severe illness or inability to urinate, hospitalization is required. The antibiotics will be given to you in the hospital by infusion and a catheter may be put in to pass the urine.

Want to know more?

Source

Foreign clinical practice guide ‘Acute bacterial prostatitis’ (2000), updated on 09/15/2017 and adapted to the Belgian context on 04/15/2018 – ebpracticenet