• Why does prostatitis tend to affect younger men?
• My doctor has referred to different categories of prostatitis. What are they and which one have I got?
• How uncomfortable are the tests for prostatitis?
• What treatment is right for me and are there any side–effects?
• If the symptoms resolve with treatment, what are the chances of them returning?
• Can I help myself to avoid the chances of a repeat attack?
• Is prostatitis sexually transmitted?
• Does having chronic prostatitis make me more likely to have other prostate problems?

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Why does prostatitis tend to affect younger men?

No one knows why some men get prostatitis and others do not.  The prostate is certainly more prone to inflammation than almost any other part of the body, and one theory is that urine may track backwards into the prostate during urination, causing an inflammatory response.  We still don't know why younger men seem to be more prone to the disease, or why is becomes chronic in some men but not in others.

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My doctor has referred to different categories of prostatitis.  What are they and which one have I got?

An American body, the National Institutes of Health, has recently produced the following classification of prostatitis:

As to which category you belong, the important considerations are whether the problem is acute (comes on quickly) or chronic and relapsing (where you have the symptoms for a long time or have regular bouts), and whether it is caused by a specific infection.  In order to answer this second question, a sample of prostatic secretions obtained by massaging the prostate may be sent to the laboratory for analysis (the lower tract localization test or LTLT).  Occasionally, in patients with acute prostatitis, an abscess can develop within the gland.  Usually this responds to antibiotics but occasionally the pus may need to be drained surgically, usually through the urethra (the tube through which urine passes from the body).

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How uncomfortable are the tests for prostatitis?

Testing for prostatitis often involves a prostatic massage.  This is unquestionably uncomfortable, but not actually painful.  Urine is subsequently sent for analysis to rule out infection as the cause of your symptoms.  You'll also probably have transrectal ultrasound, which has a similar level of discomfort.  Occasionally, a test known as 'urodynamics' is needed, which involves passing a small catheter into the bladder via the penis and the insertion into the rectum of a small tube to monitor pressure.  The bladder is then filled with a fluid that will show up on X-ray, and you'll he asked to pass urine.  While you're doing this, the pressure in the bladder is recorded and the process can be visualized on an X-ray screen.  In this way, your doctor can check whether there is anything obstructing the urine flow.  A PSA and other blood tests are also requested, to rule out other problems such as prostate cancer or diabetes.

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What treatment is right for me and are there any side-effects?

If there is a bacterial cause of your prostatitis, you'll be given a prolonged course of antibiotics.  Even when there are no signs of bacteria, some men still respond to antibiotics.  You'll also probably be prescribed an anti-inflammatory drug to try to reduce the inflammation.

Ciprofloxacin is an antibiotic commonly prescribed for prostatitis and if you are taking this, avoid sunbathing, as it can increase the sensitivity of your skin.  Anti-inflammatory drugs can cause indigestion or even peptic ulcers and bleeding in the stomach.  Report any stomach pains to your doctor and stop taking the tablets.

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If the symptoms resolve with treatment, what are the chances of them returning?

Unfortunately, quite high, as prostatitis has a pronounced tendency to recur.  If you do suffer further attacks, see your doctor straight away as prompt treatment can help to stop the infection or inflammation from taking hold.

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Can I help myself to avoid the chances of a repeat attack?

The usual health advice is appropriate here – lots of exercise and a healthy diet.  A healthy immune system should help you fight off infections.  Some doctors advise their patients with a history of prostatitis to take vitamins D and E, selenium and zinc supplements, but there is little hard evidence to support their usefulness in avoiding prostatitis.

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Is prostatitis sexually transmitted?

In some cases it is, theoretically at least.  In practice, however, prostatitis seldom results from sexual activity, so there is little logic in treating your partner (though very occasionally this may be recommended depending on the bacterial cause).  Ano-rectal sex could certainly cause prostatitis, as can catheterisation.

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Does having chronic prostatitis make me more likely to have other prostate problems?

In theory, long-term inflammation could promote the development of cancer, but there is no evidence to suggest that this actually happens.  Similarly, there is nothing to suggest that BPH is more common among prostatitis sufferers.

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