Acute bacterial prostatitis often occurs along with a urinary tract infection. Infected urine gets into the prostrate during urination or intercourse and infects the prostate. Sometimes the prostate is infected directly by bacteria traveling from the rectum. Most of the time, E. coli or other bacteria that are found in the rectum cause acute bacterial prostatitis.
Signs and Symptoms
The patient has the signs and symptoms of a urinary tract infection: fever, chills, back pain, urinary difficulties, and pain. On exam, the prostate gland may be tender, swollen and warm. Sometimes the prostate gets big enough to block the passage of urine. Prostate massage or vigorous digital examination should be avoided, because it might release bacteria into the bloodstream.
Diagnosis
The doctor makes his diagnosis based on the patient's symptoms and on urinalysis.
Treatment
Acute bacterial prostatitis is treated with antibiotics. If the antibiotics help, the patient may take them for two weeks or more, to prevent the infection from coming back.
If the infection is severe and the patient is very ill, he may be admitted to the hospital so that he can receive intravenous antibiotics and fluids. Sometimes a catheter is placed through the abdomen and into the bladder so that urine doesn't go down the urinary tract. This gives the prostate time to heal.
Complications
Sometimes the patient develops a prostate abscess. An abscess is a pus-filled infected pocket, and they can be difficult to treat. Antibiotics may not help, and the abscess usually has to be drained. This is done by inserting a needle into the prostate through the rectum or perineum and draining off the fluid. Sometimes the prostate gland has to be removed surgically to cure the abscess.
If the bacteria that caused the infection is not completely eradicated, the infection can come back and the patient can develop chronic prostatits.
Acute bacterial prostatitis is a serious illness, and has to be treated vigorously to prevent an abscess or chronic prostatitis.
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