Treat Acute Bacterial Prostatitis Before It Gets Any Worse
The prostate is perhaps the underdog of reproduction. While men are aware of their penis and testicles, the prostate gland often gets overlooked, never thought about until something goes wrong.
"A lot of people don't have a sense of their prostate," said Gregory Hall, M.D., an internal medicine physician at University Hospitals in Cleveland and the medical director for University Hospitals Cutler Center for Men. "So when they start to feel that sort of deep pain in their groin, or even below the groin, they're not sure if it's their bowels. They're not sure what it is."
A common source of this deep, under-groin pain is acute bacterial prostatitis, an infection of the prostate gland that causes inflammation and urinary tract issues. Untreated, it can also cause systemic problems, including fevers, chills and nausea.
While the condition is easily treatable, it's still important for men to know the causes, symptoms and treatment options available for acute bacterial prostatitis, so if or when they experience obscure pelvic pain, they know what to expect.
Causes of acute bacterial prostatitis
As men age, their prostate naturally tends to get larger, but this enlargement can develop into benign prostatic hyperplasia (BPH) in some men. BPH can result in a decreased urinary stream, but if it's not accompanied by a fever or pain in the pelvic area, it's probably not a reason to worry about an infection, Hall explained.
"It's pretty easy to diagnose, but if you don't catch it in time, it could become a chronic infection, which is going to last a good bit longer than maybe you'd want it to," he said.
As the name suggests, bacterial prostatitis is the result of a bacterial infection in the prostate that leads to inflammation and a litany of other issues. Bacteria can infect the prostate in several different ways, however.
Any bacteria that can cause a urinary tract infection can cause acute bacterial prostatitis. Infections spread through sexual contact, including chlamydia and gonorrhea, can also cause prostatitis.
In some cases, acute bacterial prostatitis develops as a result of E. coli, a stool-related bacteria, meaning it can stem from bowel-related issues such as diarrhea or constipation. It can also develop from unprotected anal sex as the bacteria can travel through the urethra to infect the prostate.
In other cases, certain lifestyle factors—daylong sitting, for example—can cause irritation in the prostate gland that leads to inflammation and infection. Other conditions, such as BPH, bladder stones and urethral strictures, can similarly cause irritation, along with bacterial overgrowth.
A good rule of thumb with all prostate matters is to see a doctor if you feel something is amiss.
Some men might not be keen on the idea of a rectal exam, but University Hospitals urologist Jonathan Shoag, M.D., is a proponent of prostate-specific antigen (PSA) screenings to help detect prostate issues early.
"I think every man should have their PSA checked by their primary care doctor," said Shoag, who is also an assistant professor of urology at Case Western Reserve University School of Medicine. "They don't necessarily need to see a urologist in the early stages. Any man with an elevated PSA—and it's very age-dependent—should be further evaluated, but often, medications work really well."
Symptoms of acute bacterial prostatitis
One major reason for getting regular screenings is how similar the symptoms of acute bacterial prostatitis, prostate cancer and BPH can seem.
"You tend to see urinary troubles: urgency, frequency, waking up at night," Shoag explained. "It might not be cancer, but it can definitely impair your quality of life in either case. But most men will develop that with age."
Even beyond those similarities, though, acute bacterial prostatitis is painful in a unique way: deep in the groin or below it, as Hall mentioned. It's not uncommon for men to ignore that pain in the hope it will go away, so they don't have to see a doctor.
It's an infection, though, so ignoring it generally only lets it develop into something worse. The infection might also mean you have a fever, nausea, dizziness or possibly discharge.
Treatment options for acute bacterial prostatitis
Bacterial prostatitis is fairly easy to treat with an antibiotic, Hall said. "But I think what surprises people is the length of time they're on that antibiotic," he added.
The antibiotics used to treat acute bacterial prostatitis are effective, but in many cases, they can take up to a month to completely eliminate the infection.
"It's really unusual. What else do we treat for 30 days?" Hall said. "Even pneumonia, 10 days. Upper respiratory bronchitis, seven days. So it is unusual, but the prostate's a very dense organ. It takes a while for the antibiotics to really get in there and get that infection."
On some occasions, Hall said he's had to extend the treatment beyond 30 days. These were instances where a patient may have had medical procedures or a prostate biopsy that opened up their body to a greater risk of infection.
If after a month the antibiotics haven't done their job, an abscess becomes a possibility. When that's the case, a patient needs to see a specialist who can perform a procedure to drain the abscess, because antibiotics might not be able to treat it.
However, the biggest issue isn't that the condition is difficult to treat; it's getting people to actually take the antibiotic every day for a month or longer, Hall explained.
"If you get it diagnosed in a timely fashion and then you're good about taking antibiotics for a month—which isn't easy, but people do it—you should expect a full resolution and no issues," he said.
