Prostatitis

At Montefiore Einstein Urology, you can access exceptional care for prostatitis. As a global leader in urology, we are an academic-based, national and international referral site for the most complex and high-risk cases. For more than a century, we have been at the forefront of innovation, research and clinical care for genitourinary (GU) conditions.

Ranked in the top 1% of all hospitals in the nation for urology according to U.S. News & World Report, Montefiore Einstein continues to make advances in the diagnosis and treatment of GU conditions. Our multidisciplinary team of world-renowned specialists is passionate about uncovering the latest diagnostic approaches and treatments that can improve outcomes.

At Montefiore Einstein Urology, you can expect compassionate, personalized, research-driven treatment plans that meet the highest standards for quality and safety. In addition, we offer patients a full range of support services, from nutritional guidance to rehabilitative therapies.

When you need prostatitis care, turn to our dedicated multidisciplinary team for a personalized treatment plan.

There are four types of prostatitis:

• Acute bacterial prostatitis: The least common type of prostatitis, acute bacterial prostatitis is a bacterial infection that causes sudden, severe symptoms like fevers and chills.
• Asymptomatic inflammatory prostatitis: This type of prostatitis is characterized by an inflamed prostate that doesn’t cause any symptoms and doesn’t need treatment.
• Chronic bacterial prostatitis: A bacterial infection that can last for several months, symptoms of chronic bacterial prostatitis are usually less severe than acute bacterial prostatitis and develop gradually.
• Chronic prostatitis or chronic pelvic pain syndrome (CP/CPPS): The most common type of prostatitis, CP/CPPS is a chronic condition that isn’t caused by bacteria. Symptoms can include pelvic pain and urinary tract symptoms that come and go.

The most common causes of the different types of prostatitis are:

• Acute and chronic bacterial prostatitis: These two types of prostatitis are caused by a bacterial infection of the prostate. Acute bacterial prostatitis typically comes on suddenly and lasts a short time, while chronic prostatitis develops slowly and can last many years. These infections may also be caused when bacteria travel from the urethra into the prostate.
• Asymptomatic inflammatory prostatitis has no known cause. It is generally discovered during an exam for other medical conditions and is not treated.
• Chronic prostatitis: The exact cause of chronic prostatitis is unknown. It may relate to chemicals in the urine, the immune system’s response to a previous urinary tract infection (UTI) or nerve damage in the pelvic region.

Prostatitis is diagnosed based on a comprehensive physical exam and a review of the patient’s personal and family medical histories. The following diagnostic tests may also be used:

• Blood tests
• Cystoscopy
• Transrectal ultrasound or MRI
• Urinalysis
• Urodynamic tests

Treatment for prostatitis depends on the type of the condition. Treatment is typically not required for asymptomatic prostatitis.

Chronic Prostatitis/Chronic Pelvic Pain Syndrome
Although antibiotics do not help treat nonbacterial prostatitis, your physician may prescribe them until the urologist can rule out a bacterial infection. Other treatments include the following medications:

• 5-alpha reductase inhibitors such as finasteride (Proscar) and dutasteride (Avodart)
• Chondroitin sulfate and similar medications
• Glycosaminoglycan
• Muscle relaxants or benzodiazepines including cyclobenzaprine (Amrix, Flexeril) and clonazepam (Klonopin)
• Neuromodulators including amitriptyline, nortriptyline (Aventyl, Pamelor) and pregabalin (Lyrica)
• Nonsteroidal anti-inflammatory drugs, or NSAIDs, including aspirin, ibuprofen, and naproxen sodium
• Silodosin (Rapaflo)

Chronic Bacterial Prostatitis
Chronic bacterial prostatitis is treated with an extended course of antibiotics—up to six months—to prevent recurrent infection. Alpha-blockers may also be used to treat chronic prostatitis. These medications help relax the bladder muscles near the prostate and mitigate symptoms including painful urination. Men may require surgery to treat urinary retention caused by chronic bacterial prostatitis. Surgical removal of scar tissue from the urethra can often improve urine flow and reduce urinary retention.