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I have had prostatitis three times in the past five years. Can you tell me the cause of this condition, and how to prevent it in the future?


The prostatitis you experienced is a chronic condition that affects the male prostate gland, which is a walnut-sized organ at the base of the bladder, in front of the rectum, and on top of the base of the penis. Prostatitis develops when bacteria enters the prostate gland and causes an infection with inflammation, swelling and pain. Because urine from the bladder travels through the prostate gland (through the urethra), many men have a burning feeling when they urinate, difficulty starting to urinate or a weak stream when they have prostatitis.

Often, a man can have prostatitis even when no identifiable bacteria is found. This is called non-bacterial prostatitis. Many men, especially those in their 60s, also have benign (noncancerous) enlargement of the prostate gland. Only your doctor can determine whether there is also prostate cancer.

We are not really sure what causes the condition. The difficulty in initiating the urinary stream and the burning, associated with an elevation of the PSA (prostate-specific antigen) is compatible with prostatitis. Theories abound about what precipitates an episode of prostatitis. Overdistension of the bladder, for example, that may occur when you "hold" your urine longer than normal has been linked to precipitating an episode of prostatitis. Bikers may experience an episode after a bike ride due to pressure placed on the prostate gland when riding, especially when using a narrow seat. Excessive straining while having a bowel movement, too, may precipitate an event. Sometimes the presence of bladder stones or other objects in the bladder can precipitate an event. If your episode was associated with any of these activities, it may be wise to avoid such situations in the future.

The real problem with repeated episodes of prostatitis is the development of so-called acute urinary retention. During a bout of prostatitis you may be unable to urinate despite a great urge to do so. There is complete blockage of the urinary passage. If this occurs, a catheter will have to be placed through the penis into the bladder to relieve the blockage until the swelling and inflammation go down. Repeated bouts of prostatitis are usually treated with medicines that can help relax the muscles of the bladder and prostate, antibiotics, and medicines that shrink the size of the prostate gland. Repeated episodes usually require a detailed urological evaluation as well.

Online Medical Reviewer: Faculty of Harvard Medical School
Date Last Reviewed: 3/13/2007
Date Last Modified: 3/14/2007
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