Causes of Acute and Chronic Prostatitis

Many men experience prostatitis (swelling and inflammation of the prostate gland) at some point in their lives. Acute prostatitis is typically caused by bacteria that have entered the prostate. In contrast, chronic prostatitis may be bacterial in nature, or it may have some other, unknown cause.

Diagnosing Prostatitis with Prostate MRI

Targeted, multiparametric MRI offers an effective means of diagnosing prostatitis. For the patient, the simple procedure involves nothing more than donning a bathrobe with underwear left on and lying on an MRI bed that is then inserted into an MRI scanner. In particular, the procedure involves no digital rectal examination and no insertion of a device into the rectum. The MRI scan itself provides detailed information about the prostate that enables your doctor to distinguish between acute and chronic prostatitis.

For more on this subject, please refer to Prostate MRI.

Symptoms of Acute Prostatitis

Acute prostatitis is characterized by considerable discomfort. In fact, most men who experience it need no special encouragement to arrange an appointment with a urologist. One advantage of the clear symptoms is that it is not difficult for a urologist to arrive at a diagnosis.

Most cases of acute prostatitis affect the entire prostate gland. The associated swelling leads to an overall enlargement of the prostate. This enlargement usually causes considerable pain, a feeling of pressure in the area of the perineum and a burning sensation during urination.

Range of Symptoms

  • Significantly elevated PSA level
  • Elevated levels of inflammation markers in the blood
  • More frequent urge to urinate and reduced urine flow
  • Burning sensation during urination
  • Pain in the bladder region
  • A sensation of pressure in the perineum
  • A sensation of pressure and pain in the pelvic region
  • Fever
  • Chills

Treatment of Acute Prostatitis

Urologists typically prescribe a high-dose antibiotic to treat prostatitis. After beginning treatment, you can expect your symptoms to subside quickly, with the pain disappearing and the elevated levels of PSA and inflammation markers dropping back into the normal range.

If your PSA level does not drop significantly by the end of the antibiotic treatment, you are advised to undergo further testing to determine whether the elevated level is related to another prostate disease such as BPH or prostate cancer.

Symptoms of Chronic Prostatitis

In contrast to acute prostatitis, the clinical symptoms of chronic prostatitis are often less clear cut, and the treatment options vary. The symptoms are typically less intense and often occur sporadically. This can make it difficult to arrive at a reliable diagnosis of chronic prostatitis.

Chronic prostatitis usually affects the peripheral zone of the prostate. In this regard, it may be bilateral or restricted to only one side of the peripheral zone. Some patients may also exhibit multiple, circumscribed areas of infection in the peripheral zone.

Possible Symptoms

  • Slightly to moderately elevated PSA level
  • Sensation of pressure and pain in the perineum and the area of the pubic bone
  • Pain on ejaculation
  • Pain in the area of the bladder
  • Pain and burning during or after urination
  • Pain and discomfort in the groin
  • Frequent urge to urinate
  • Erectile dysfunction

Treatment of Chronic Prostatitis

Antibiotics are usually not an effective means of treating chronic prostatitis. Moreover, isolated sites of inflammation often evade detection and go untreated.

Patients with many sites of inflammation may experience erectile or urinary dysfunction. Effective treatment is available in the form of MRI-guided procedures.