Prostatitis Diagnosis & Treatment

Prostatitis

What is Prostatitis?

Prostatitis is a condition characterised by inflammation or swelling of the prostate gland, a small, walnut-sized organ located below the bladder in men. This gland plays an essential role in producing seminal fluid, which nourishes and transports sperm.

Prostatitis can affect men of all ages but is most commonly seen in men under 50. The condition often causes discomfort and pain in the pelvic area and can impact urinary function. Symptoms vary widely, depending on the type and severity of prostatitis, ranging from mild pelvic discomfort to severe urinary and systemic symptoms.

Prostatitis is generally categorised into four types:

Acute Bacterial Prostatitis — A sudden, severe bacterial infection that leads to intense symptoms, including fever, chills, and significant pelvic pain. This type requires urgent medical care.
Chronic Bacterial Prostatitis — A recurrent bacterial infection in the prostate, causing intermittent or persistent urinary and pelvic symptoms.
Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) — The most common form of prostatitis, presenting with chronic pelvic pain without a clear bacterial infection. Its causes are not well understood, which makes diagnosis and treatment challenging.
Asymptomatic Inflammatory Prostatitis — Characterised by prostate inflammation without noticeable symptoms, often discovered incidentally during tests for other medical conditions.

Each type of prostatitis requires a specific approach for diagnosis and treatment, with management strategies tailored to reduce symptoms, address the underlying cause, and improve overall quality of life.

What causes Prostatitis?

Prostatitis occurs when inflammation or infection disrupts the normal function of the prostate gland, leading to discomfort and pain. The underlying mechanism behind prostatitis varies depending on its type but generally involves immune and bacterial responses that trigger inflammation in the prostate tissue.

Type of Prostatitis	Mechanism	Details
Acute & Chronic Bacterial Prostatitis	Bacterial Invasion and Immune Response	Bacteria enter the prostate, usually via the urinary tract, triggering an immune response. Immune cells attack the bacteria, leading to inflammation, swelling, and irritation of surrounding nerves, which causes pain and urinary symptoms.
Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS)	Non-Bacterial Inflammation	Inflammation occurs without a bacterial infection. It may result from autoimmune responses, stress, injury, or nerve dysfunction. Persistent immune activity leads to chronic pain and discomfort in the pelvic area.
Asymptomatic Inflammatory Prostatitis	Asymptomatic Inflammatory Mechanism	Signs of inflammation are present in the prostate tissue without noticeable symptoms. This inflammation is often discovered during tests for other conditions. The exact cause of inflammation is unclear, though immune cell activity is detected.

What are the symptoms of Prostatitis?

Prostatitis symptoms can vary depending on the type and severity of the condition, ranging from mild discomfort to intense pain and urinary difficulties. Here are the common symptoms associated with prostatitis:

Pain or burning sensation during urination
Frequent urge to urinate, especially at night
Difficulty starting urination or weak urine flow
Pelvic, lower back, or genital pain
Painful ejaculation
Flu-like symptoms (fever, chills, body aches) in acute bacterial prostatitis
Discomfort or pressure in the area between the scrotum and rectum (perineum)

These symptoms can greatly impact daily life, and it’s essential to seek medical evaluation for accurate diagnosis and treatment.

Who is at risk of Prostatitis in Singapore?

While prostatitis can affect men of all ages, certain factors increase the likelihood of developing this condition. Here are the key risk factors:

Age

Men under 50 are more commonly affected, although prostatitis can occur at any age.

Previous Prostatitis Episodes

A history of prostatitis can increase the risk of recurrence.

Urinary Tract Infections (UTIs)

Men with frequent UTIs have a higher risk of prostatitis due to bacterial transfer.

Bladder Outlet Obstruction

Conditions that block urine flow, such as an enlarged prostate, can contribute to prostatitis.

Recent Urinary Procedures

Procedures like catheterization can introduce bacteria into the prostate.

Sedentary Lifestyle

Prolonged sitting, common among office workers in Singapore, may increase the risk due to pressure on the prostate area.

Pelvic Trauma

Injuries, especially from cycling or horseback riding, can irritate the prostate.

Weakened Immune System

Men with compromised immunity are more susceptible to infections, including prostatitis.

How is Prostatitis diagnosed?

At Allen Sim Urology, we take a thorough and personalised approach to diagnosing prostatitis. Here’s how we assess and diagnose prostatitis:

01. Medical history and symptom review

We begin by discussing your symptoms in detail, including pain levels, urinary issues, and any past instances of similar discomfort. Understanding your history helps us tailor the diagnostic process.

02. Physical Examination

A digital rectal exam (DRE) allows us to assess the size, shape, and sensitivity of the prostate. This exam can reveal tenderness or swelling indicative of prostatitis.

03. Urine and blood tests

We conduct laboratory tests to check for signs of infection or inflammation. Urine samples can help identify bacterial causes, while blood tests provide insights into overall health.

04. Prostatic specimen test

This involves collecting prostate fluid or tissue samples, often via a prostate massage or biopsy, to identify signs of infection or inflammation. This test helps detect bacterial presence and assess inflammatory markers for accurate diagnosis of prostatitis.

05. Imaging tests

In some cases, the doctor may perform an Ultrasound or MRI to visualise the prostate and surrounding tissues, especially if an obstruction or structural issue is suspected.

Each diagnostic step at Allen Sim Urology is designed to provide a clear understanding of your condition, which enables us to recommend the most effective treatment plan.

What are the treatment options for prostatitis in Singapore?

At Allen Sim Urology, we offer a range of treatment options to help manage and relieve prostatitis symptoms, tailored to each patient’s needs and the specific type of prostatitis they are experiencing. Here’s how we approach treatment:

Antibiotics

For bacterial prostatitis, antibiotics are often the first line of treatment. Our doctor selects the most effective type and duration based on your infection type to ensure complete eradication of bacteria.

Anti-inflammatory medications

To manage pain and inflammation, we may recommend non-steroidal anti-inflammatory drugs (NSAIDs). These medications can provide relief from discomfort and help improve daily functioning.

Alpha-Blockers

These medications relax the muscles around the prostate and bladder neck, helping to ease urinary symptoms by improving urine flow.

Physical therapy

For patients with chronic pelvic pain or muscle tension contributing to prostatitis, physical therapy techniques focused on the pelvic floor can be highly beneficial.

Lifestyle and dietary modifications

Simple changes, like reducing caffeine or avoiding prolonged sitting, can make a significant difference. We provide personalised advice to support lifestyle adjustments that may reduce symptom flare-ups.

Prostate massage

In some cases, prostate massage therapy may be used to relieve symptoms by easing fluid buildup in the prostate.

Other pain management options

For those with chronic or severe pain, additional options like nerve block injections or neuromodulation therapy may be considered to improve comfort and quality of life.

At Allen Sim Urology, our goal is to create a treatment plan that addresses both symptoms and underlying causes, so you can regain comfort and well-being.

If you’re experiencing persistent pelvic pain, urinary difficulties, or other prostatitis symptoms, schedule a consultation with Allen Sim Urology for a comprehensive assessment and personalised treatment plan.

Frequently Asked Questions (FAQs)

01. Can prostatitis affect sexual function?

Yes, prostatitis can impact sexual function, leading to painful ejaculation, erectile dysfunction, or decreased libido. These symptoms vary depending on the type and severity of prostatitis.

02. Is prostatitis contagious?

Prostatitis itself is not contagious and cannot be transmitted to a partner. However, if the condition is caused by a sexually transmitted infection (STI), the underlying infection may be transmissible.

03. How long does it take to recover from prostatitis?

Recovery time varies based on the type of prostatitis. Acute bacterial prostatitis may improve within a few weeks with appropriate antibiotic treatment, while chronic forms can persist for months and may require ongoing management.

04. Can prostatitis lead to prostate cancer?

There is no direct evidence linking prostatitis to an increased risk of prostate cancer. However, chronic inflammation may warrant regular monitoring by a healthcare provider.

05. Are there any complications associated with untreated prostatitis?

Untreated prostatitis can lead to complications such as bacterial infection in the bloodstream (bacteremia), prostatic abscess, or chronic pelvic pain. Prompt medical attention is essential to prevent these outcomes.

06. Is it safe to engage in sexual activity with prostatitis?

Sexual activity is generally safe for men with prostatitis and does not typically worsen the condition. However, some men may experience pain during ejaculation, which can affect sexual enjoyment.

07. Can stress contribute to prostatitis?

Stress is believed to play a role in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), potentially exacerbating symptoms. Stress management techniques may be beneficial in alleviating discomfort.

08. Are there preventive measures for prostatitis?

While not all cases are preventable, maintaining good hygiene, staying hydrated, practising safe sex, and avoiding prolonged sitting can reduce the risk of developing prostatitis.