Acute inflammation of the prostate (acute prostatitis)
Acute bacterial prostatitis usually occurs as a result of infected urine flowing back into the prostatic ducts. Clinically, the condition usually presents with the patient feeling generally unwell, fever, chills, pain when passing urine, frequent passage of small amounts of urine and pain in the perineum and anus, especially during bowel movements. Occasionally it can also cause acute urinary retention (inability to pass water).
Urine tests will detect both the urinary organisms responsible for the condition and inflammatory cells, and blood tests find both an increase in inflammatory cells and an increase in PSA levels. Digital rectal examination of the prostate will find that the prostate is swollen due to inflammation and very painful on palpation. In rare cases an acute abscess will be palpable.
To prevent prostatitis from becoming chronic, treatment involves a sufficiently long course of antibiotics.
Depending on individual symptoms, for example if there is an abscess or if the patient feels very ill with a high fever, patients may need to be admitted to hospital for administration of intravenous antibiotics. If the patient is unable to empty his bladder completely and there is urine left in the bladder after passing water (residual urine), to ensure that microorganisms are eliminated from the urine and therefore from the prostate it may be necessary to insert a suprapubic catheter (a catheter inserted through a hole in the abdomen).
Once the prostatitis has been resolved, patients should see a urologist for specialist follow-up to identify any specific causes, such as incomplete bladder emptying as a result of benign enlargement of the prostate.