A common prostate problem is prostatitis, or inflammation of the prostate gland, which may be acute (sudden and severe), or chronic (long-lasting) with symptoms that seem to come and go.

Prostate enlargement, or benign prostatic hyperplasia (BPH), is another condition that is very common, affecting as many as 50 percent of men between age 50 and 60, and up to 90 percent of all men above age 80. Because the prostate gland surrounds the urethra beneath the bladder, an enlargement of the prostate can narrow the urethra and cause irritation or even complete obstruction of the bladder.

Common symptoms of prostate problems are:

• Frequent and/or urgent urination
• Difficult urination
• Burning feeling during urination
• Weak urine stream
• Pain in the lower back and genital area
• Chills and fever, which may occur with acute bacterial prostatitis

These symptoms can also be caused by a variety of other conditions. If you experience any of these symptoms, you should consult your urologist for diagnosis and treatment as soon as possible.

Causes

Prostatitis
The most common form of chronic prostatitis is noninfectious and nonbacterial. Its exact causes are not known, but may include chemical or immunologic reactions or organisms other than bacteria. It is sometimes related to stress or irregular sexual activity. Nonbacterial prostatitis can occur without any noticeable symptoms.

Acute and chronic prostatitis may also be caused by infection due to bacteria that enter the prostate from the urethra.

Enlarged prostate
Prostate enlargement (BPH) is primarily a result of aging, seldom causing problems until relatively late in life. Its exact causes are not known, but some researchers have suggested that hormonal and chemical changes in the body may stimulate cell growth in the prostate.

Diagnosis

If prostatitis is suspected, your doctor will probably perform a digital rectal exam to detect swelling or tenderness in the prostate. A urine sample can be examined for bacteria or infection-fighting white blood cells.

If no bacteria are present, your doctor will probably perform tests to rule out other possible causes of your symptoms before arriving at a diagnosis of chronic noninfectious prostatitis.

If symptoms indicate that your prostate is enlarged, your doctor will use a digital rectal exam to get a general idea of its size and condition. You will be asked about your general medical condition, any medications you’re taking and any family history of prostate problems. A urine test may be used to rule out infection and some other urinary conditions; other tests such as a prostate-specific antigen (PSA) blood test may be administered to help rule out prostate cancer.

Treatment

Bacterial forms of prostatitis are treated with antimicrobial medication. Duration of treatment depends on the condition, with chronic bacterial prostatitis requiring a longer course of medication. After initial treatment, you may be prescribed a low dose of antimicrobials for up to six months in order to prevent recurrence of the infection.

No single solution exists for nonbacterial prostatitis, which does not respond to antimicrobials. Your doctor may recommend a variety of strategies in order to find a solution that works for you. This can include changes in diet and fluid intake, warm baths or medications to help relax the muscle tissue in the prostate.

A number of approaches are available for treatment of enlarged prostate (BPH). Drugs have been recently introduced that can prevent further enlargement or even shrink the prostate in some men. Other drugs may be used to help relax the muscles of the prostate and bladder outlet to prevent obstruction and improve urine flow.

Several procedures have been developed that use heat to destroy excess tissue in the prostate. Less invasive than standard surgery, these procedures use microwave energy, heated water or radiofrequency (RF) energy to focus heat on a very precise area while protecting surrounding tissue.

Many doctors believe that surgery is the best long-term solution for BPH, removing the enlarged tissue that causes pressure on the urethra and leaving the rest of the gland intact.

FAQ

What are some of the risk factors for BPH?
The only known risk factors for developing an enlarged prostate are age and family history.

Will prostatitis or an enlarged prostate lead to cancer?
No. Patients with prostatitis or an enlarged prostate (BPH) are not at higher risk for prostate cancer. However, early symptoms of BPH are similar to those of prostate cancer and should be evaluated promptly so that cancer can be ruled out. 

Is there any risk to my sexual partner?
No. Neither prostatitis nor BPH is contagious. There is no reason to discontinue normal sexual activity unless it is uncomfortable.

Are there any steps I can take to help prevent prostate problems?
Little can be done to prevent prostate enlargement, but there are some steps that may promote prostate health and decrease likelihood of prostatitis:

• Reduce your intake of meats, dairy products, sugars and starches
• Maintain a moderate level of exercise and physical activity
• Regular ejaculation also appears to contribute to prostate health