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Enlarged Prostate - Overview

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Prostatitis

Prostatitis is inflammation of the prostate gland. There are three types of prostatitis:

• Acute (severe) infectious prostatitis: This may be caused by a bacteria or virus. The symptoms come on suddenly and may be severe. They include fever and chills, low back pain, frequent and painful urination, decreasing or less forceful urinary stream and urinary retention (the bladder does not empty urine completely).

• Chronic (long-lasting) infectious prostatitis: This also may be caused by a bacteria. Stress, caffeine, nicotine, or alcohol may worsen the condition. Symptoms may include repeat bladder infections, frequent urination, and pain in the lower abdomen or low back.

• Noninfectious prostatitis: This form of prostatitis is not caused by a bacteria and therefore antibiotics are not helpful. This is the most common type of prostatitis. It may be exacerbated by stress and/or irregular sexual activity. Stress may cause the pelvis muscles to tighten and cause pain. Increased pressure during voiding may cause urine to back up into the ducts resulting in a form of chemical prostatitis. The prostate gland produces fluid for semen and infrequent ejaculation may cause the ducts to become clogged with secretions.

Prostatitis is not contagious to your sexual partner. The symptoms of prostatitis are similar to those of benign prostatic hyperplasia (enlargement of the prostate) or urethritis (inflammation of urethra). It is important to see your physician for a prostate examination so that the proper treatment may be initiated.

Prostate Enlargement

Benign enlargement of the prostate gland, also known as Benign Prostatic Hyperplasia (BPH), is a common but incompletely understood consequence of aging. The clinical symptoms of frequency, urgency and decreased force of urinary stream, also known as lower urinary tract symptoms (LUTS) are also associated with advancing age.

That an enlarging prostate and the development of LUTS are both age dependent is indisputable. Autopsy studies have demonstrated that up to 80% of 80-year-old men will have historic evidence of BPH. Approximately 40% of those same men will demonstrate an enlarged prostate on physical examination; however, only 25-30% of 80 year old men will have symptomatic BPH and pursue treatment.

Bladder Outlet Obstruction

The static component of bladder outlet obstruction may be attributed to the physical enlargement of the prostate as it encroaches on the prostatic urethra and bladder outlet. The dynamic portion of the obstruction is more likely related to the relative tension of prostatic and bladder neck smooth muscle. It is particularly useful when formulating a strategy for the treatment of bladder outlet obstruction to consider whether the detrusor itself is intact. A variety of conditions, most notably diabetes mellitus, may result in a detrusor muscle that is ineffective in generating pressures high enough to overcome even normal resistance at the bladder outlet.