The prostate. We have all seen the commercials and advertisements about prostate cancer, but do you know what the prostate actually is?

The prostate is a gland that sits below the bladder, about the size of a walnut, in men. The prostate is the gland that makes the fluid that mixes with sperm, which in turn creates semen!

What is Prostatitis?

Prostate congestion is also known as prostatitis, which is when the prostate gland gets swollen or inflamed.

There are actually three major types of prostatitis:

• Chronic bacterial prostatitis — with chronic bacterial prostatitis, a bacterial infection is the cause of the prostate being swollen and inflamed. Doctors can diagnose this by finding bacteria and white blood cells in a urine sample. White blood cells are the same cells that are present when you have a urinary tract infection.
• Chronic nonbacterial prostatitis. This is also called inflammatory chronic pelvic pain syndrome. This diagnosis can be made when a patient has the symptoms of chronic prostatitis, but does not have bacteria in their urine sample. It is hard to determine the causes of nonbacterial prostatitis. 
• Prostadynia. This form of prostatitis is also called non-inflammatory chronic pelvic pain syndrome. Prostadynia is determined when there are symptoms of prostatitis but no actual evidence of the condition. This is also a not well-understood condition yet, and studies and research is still being conducted to better understand it.  

Prostate congestion or chronic prostatitis can affect men of any age and background. In fact, about five percent of men will experience symptoms of chronic prostatitis throughout their lifetime. 

If your doctor suspects you may have prostatitis or a congested prostate, they will most likely refer you to a urologist. A urologist is a doctor that specializes in the urinary tract and its infections and diseases. 

Not all problems with the prostate are prostate congestion, prostatitis, or prostate cancer. Men can develop chronic prostate infections that have no symptoms, and are usually diagnosed if they discover they are infertile or have an enlarged prostate. 

Men can also get acute prostatitis which is when a bacterial infection of the prostate gland starts suddenly. Acute prostatitis is not as common as chronic one.

So what are the symptoms of a congested prostate, or prostatitis?

The biggest symptom is typically a swollen prostate gland. Since the prostate gland surrounds the urethra, it can cause pain when urinating. This can include a burning sensation, difficulty going pee, the feeling of needing to urinate frequently, and pain in the penis, whether during sex or otherwise. These symptoms are also very similar to a urinary tract infection. Because of symptom similarity, it can sometimes be harder to identify it. However, some men have more serious symptoms that interfere with their entire lifestyles. 

How do doctors diagnose this?

To diagnose prostatitis or a congested prostate, your doctor is going to ask you detailed questions about your symptoms and lifestyle. They will probably ask you about sexual lifestyle, and test you for sexually transmitted diseases and infections since some of these can mimic the symptoms of prostatitis. 

The physical examination is the least fun portion of diagnosing prostatitis. Your doctor will insert their finger (with gloves and lube!) in your rectum to feel whether your prostate is firm, swollen, tender, or normal. 

Your doctor will also collect a urine sample to test and look for bacteria and white blood cells. 

Bacterial prostatitis typically presents both bacteria and white blood cells in the sample. 

Non-bacterial will usually contain only white blood cells, and no bacteria. 

With prostatodynia, the urine sample will not have either of these. 

Once you are diagnosed, you can begin treatment for whatever is affecting your prostate. However, if you do not present for any prostate issues, the next step will be to screen for other things such as cystitis, prostate cancer, an enlarged prostate, or urethritis. This will require blood samples, more urine cultures, and potentially an ultrasound of your prostate. They may even need to do a biopsy of your prostate. 

How long do I have to live with prostatitis? 

It can take months before someone is diagnosed with chronic prostatitis. While prostatitis can respond very well to treatment, and some see symptoms disappear rapidly within days, others may experience symptoms for months, even years.  

How can I prevent prostatitis?

At this time, it seems that chronic prostatitis cannot be prevented. Essentially, you need to get screened immediately if you have any odd symptoms.

What is treatment like? 

Prostatitis typically involves bacteria. This means that antibiotics are used to treat it. However, this is usually a high dosage for an extended period of time, which can be a month or longer. It is harder to get antibiotics to the prostate, making this necessary.  

Since bacteria are sometimes present but do not show on urine culture, your doctor may still prescribe you antibiotics, just to be safe. However, antibiotics are not the cure for prostatitis in every man.

If antibiotics do not do the trick, there are various other alternative treatments are available that have shown to work, including:

• Alpha-blockers. These are prescribed to help relax the bladder muscles. This can help relieve the symptoms that make you feel as if you need to pee, or can’t void your urine. 
• NSAID’s (anti-inflammatory drugs) and muscle relaxers can be very helpful for those experiencing pain from their symptoms. 
• Taking a warm bath can help reduce the tension in your pelvic muscles that you may be experiencing. 
• Elimination diets that rid you from consuming caffeine and alcohol can help reduce and prevent further inflammation of the prostate.  
• Prostate massage and ejaculation can help reduce congestion in the prostate as well, according to some doctors.

However, not all of these treatments are proven to be effective, and some just work for certain people. You have to keep an open mind and try anything possible to relieve your symptoms, especially if they are affecting your life. Since the reason why men develop prostatitis is not clearly known, treatment can be very experimental. 

While some men may do fine with antibiotics, others may not find relief. If you try multiple things and don’t find relief, do not give up. 

What is the prognosis for those diagnosed with prostatitis?

Chronic prostatitis can be hard to cure, especially since its causes are unknown, and it presents differently in men. Some men do not respond to antibiotics, and some do. It can be difficult to treat and even just to manage the symptoms. However, if you keep working with your doctor and don’t give up, you will hopefully be able to be symptom-free. Also, chronic prostatitis has not been shown to increase the risk of developing prostate cancer in men, which is a positive thing.