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Urology (Expert Forum)
Re: Chronic Prostatitis
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
Re: Chronic Prostatitis
by DP__0, Jan 01, 1995 12:00AM
Posted By DP on October 15, 1998 at 01:52:56:
In Reply to: Re: Chronic Prostatitis posted by HFHS M.D.-AK on September 21, 1998 at 16:58:55:
Hello,
I posted a message on 9/01/98 and have a followup question.
Can Prostatitis be passed back and forth between partners?
My wife and I would like to know if I am going to have to use
precautions and for how long?
Also, what medications are available for sitting discomfort?
Any help would be appreciated.
Thank you.
________
Dear Steve,
Men with prostatitis syndromes are frequent patients in the urologic office. Initially, they should be screened with urine analysis, urine culture, urine cytology, and uroflowmetry. If no bacterial pathogen is found then a special urine analysis with three samples should be performed. There are several types of prostatitis, infectious prostatitis, either acute or chronic. There is another category that is a little less specified, known as nonbacterial prostatitis or a third category known as prostadynia. The three part urine sample with prostate massage would put you into a category of which type of prostatitis you have. I will briefly discuss each type below.
Acute bacterial prostatitis accounts for less than 5% of cases. Symptoms would include fever ,chills, malaise, and myalgia. Local symptoms are frequency, urgency, low back pain and outlet obstruction(difficulty urinating). Digital rectal exam is exquisitely tender. The most common pathogens are E. coli, Klebsiella, Proteus mirabilis, Enterobacter, and Staphylococcus aureus.
Chronic Bacterial prostatitis is defined by recurrent Urinary tract infection and persistence of pathogenic bacteria in prostatic fluid. Primary complaints consist of genitourinary pain(61%),dysuria or painful urination(16%), clear urethral discharge(12%), recurrent UTI(9%), and sexual dysfunction(1%). Physical exam is usually normal, however the three part urine analysis shows a high number of white cells on one of the three samples(>10WBC/HPF in the EPS) The most common organism found is E.coli in 80% of cases. Chronic bacterial prostatitis is simply a bacterial infection that recurs and is chiefly due to the ductal structure of the prostate you were born with.
Treatment with Bactrim or one of the Fluoroquinolones for 4-6 weeks is successful 30-50% of the time.
Nonbacterial prostatitis is an inflammatory condition of unknown etiology. The symptoms are similar to those with chronic prostatitis and this group of patients outnumber all other patients with prostatitis. Again the physical exam is unremarkable however on the three part urine test there is not only high numbers of white blood cells, but all lipid laden macrophages. These are cells not characteristically seen in the prostate secretions filled with fat. There may be a chemical irritation as a basis of this disease.
A trial of antibiotics should be tried but conservative measures such as over the counter anti-inflammatory agents(Motrin, Advil, Aleve), hot sitz bathes and support should be offered.
Prostadynia is a term used to define patients with proststitis type pain without specific findings related to the prostate. Typically these patients are younger and have variable urinary complaints. There is no etiology of this disease established and therefore a generalized work-up should be done. Again conservative measures should be performed in addition to some limited dietary restriction of caffeine,alcohol, and spicy foods. Other talked about treatments include Zinc and Saw palmetto however neither of these therapies have been proven.
As you can see the prostate infection can go on for a long time. At different times, the urinary problem may subside with antibiotics however it will often return. My recommendations are, follow with a urologist and make sure you get a full coarse of therapy. After a full course of therapy you should not be able to pass a urinary tract infection to her. If she is getting infections after intercourse, she should see her doctor for advice. You should not be getting infections from her, you may be having recurrence of your own disease that was not successfully treated.
This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
Sincerely,
HFHS M.D.-AK
*keyword:Prostatitis
HFHS,
Thank you for your informative response. I've noticed a sudden change recently, my symptons last 2 days seem to be in line with acute bacterial infection because of the accompanied fevers/sweating (In fact that's why I woke up to investigate). Additional symptoms occurred approximately a week ago with sudden change of consistency in semen (globby) which in result made ejaculation more laborious and somewhat painful.I have also abstained for longer periods than usual (3-5 days) prior to the change in semen. Dull pain is also present. Are all these symtoms for one illness or separate issues? I am 27. Other dietary changes just prior to this include mineral supplements, amino acid (for weight training) and drinking alot of green tea.. I mention those because I'm not aware of any potential side affects that relate to my current problem. Again - everything seemed to have happened suddenly...
DP - Confused
In Reply to: Re: Chronic Prostatitis posted by HFHS M.D.-AK on September 21, 1998 at 16:58:55:
Hello,
I posted a message on 9/01/98 and have a followup question.
Can Prostatitis be passed back and forth between partners?
My wife and I would like to know if I am going to have to use
precautions and for how long?
Also, what medications are available for sitting discomfort?
Any help would be appreciated.
Thank you.
________
Dear Steve,
Men with prostatitis syndromes are frequent patients in the urologic office. Initially, they should be screened with urine analysis, urine culture, urine cytology, and uroflowmetry. If no bacterial pathogen is found then a special urine analysis with three samples should be performed. There are several types of prostatitis, infectious prostatitis, either acute or chronic. There is another category that is a little less specified, known as nonbacterial prostatitis or a third category known as prostadynia. The three part urine sample with prostate massage would put you into a category of which type of prostatitis you have. I will briefly discuss each type below.
Acute bacterial prostatitis accounts for less than 5% of cases. Symptoms would include fever ,chills, malaise, and myalgia. Local symptoms are frequency, urgency, low back pain and outlet obstruction(difficulty urinating). Digital rectal exam is exquisitely tender. The most common pathogens are E. coli, Klebsiella, Proteus mirabilis, Enterobacter, and Staphylococcus aureus.
Chronic Bacterial prostatitis is defined by recurrent Urinary tract infection and persistence of pathogenic bacteria in prostatic fluid. Primary complaints consist of genitourinary pain(61%),dysuria or painful urination(16%), clear urethral discharge(12%), recurrent UTI(9%), and sexual dysfunction(1%). Physical exam is usually normal, however the three part urine analysis shows a high number of white cells on one of the three samples(>10WBC/HPF in the EPS) The most common organism found is E.coli in 80% of cases. Chronic bacterial prostatitis is simply a bacterial infection that recurs and is chiefly due to the ductal structure of the prostate you were born with.
Treatment with Bactrim or one of the Fluoroquinolones for 4-6 weeks is successful 30-50% of the time.
Nonbacterial prostatitis is an inflammatory condition of unknown etiology. The symptoms are similar to those with chronic prostatitis and this group of patients outnumber all other patients with prostatitis. Again the physical exam is unremarkable however on the three part urine test there is not only high numbers of white blood cells, but all lipid laden macrophages. These are cells not characteristically seen in the prostate secretions filled with fat. There may be a chemical irritation as a basis of this disease.
A trial of antibiotics should be tried but conservative measures such as over the counter anti-inflammatory agents(Motrin, Advil, Aleve), hot sitz bathes and support should be offered.
Prostadynia is a term used to define patients with proststitis type pain without specific findings related to the prostate. Typically these patients are younger and have variable urinary complaints. There is no etiology of this disease established and therefore a generalized work-up should be done. Again conservative measures should be performed in addition to some limited dietary restriction of caffeine,alcohol, and spicy foods. Other talked about treatments include Zinc and Saw palmetto however neither of these therapies have been proven.
As you can see the prostate infection can go on for a long time. At different times, the urinary problem may subside with antibiotics however it will often return. My recommendations are, follow with a urologist and make sure you get a full coarse of therapy. After a full course of therapy you should not be able to pass a urinary tract infection to her. If she is getting infections after intercourse, she should see her doctor for advice. You should not be getting infections from her, you may be having recurrence of your own disease that was not successfully treated.
This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
Sincerely,
HFHS M.D.-AK
*keyword:Prostatitis
HFHS,
Thank you for your informative response. I've noticed a sudden change recently, my symptons last 2 days seem to be in line with acute bacterial infection because of the accompanied fevers/sweating (In fact that's why I woke up to investigate). Additional symptoms occurred approximately a week ago with sudden change of consistency in semen (globby) which in result made ejaculation more laborious and somewhat painful.I have also abstained for longer periods than usual (3-5 days) prior to the change in semen. Dull pain is also present. Are all these symtoms for one illness or separate issues? I am 27. Other dietary changes just prior to this include mineral supplements, amino acid (for weight training) and drinking alot of green tea.. I mention those because I'm not aware of any potential side affects that relate to my current problem. Again - everything seemed to have happened suddenly...
DP - Confused
