Prostatitis is an infectious or inflammatory condition of the prostate that can cause very bothersome symptoms. Symptoms can include urinary frequency, urgency, burning, and pelvic pain. The condition can be difficult to treat and can become chronic.
Evaluation includes a digital rectal examination to palpate the prostate, which is often boggy or tender during an active infection, and a urinalysis to determine if a bacterial infection is present and to determine which antibiotics are appropriate.
If an initial urine sample is negative, further samples after prostate massage can also be performed to try and express bacteria from the prostate. Imaging of the prostate with ultrasound may also be used to make sure that a cavity of infection (abscess) is not present. Prostatitis can also be non-bacterial and due to inflammation.
Treatment of prostatitis often begins with antibiotics, often for at least 2-4 weeks, if it is caused by a bacterial infection. Other useful medications include anti-inflammatories such as ibuprofen, and alpha-blockers such as Flomax or Uroxatral to relax the prostate smooth muscle. In chronic cases with persistent pelvic pain, occasionally anti-depressants or muscle relaxants may be used.