The prostate is a relatively small gland, but it can cause big problems if it grows or becomes infected. Prostatitis and benign prostatic hyperplasia (BPH) are two common conditions that affect the prostate. Although both can lead to pain and difficulty urinating, these conditions often have different causes.
Read on to learn more about these two conditions.
Is It Prostatitis or BPH?
The prostate gland is part of your reproductive system. The walnut-shaped gland’s main job is to add fluid to semen. This gland is underneath your bladder and near your urethra. The urethra is the duct or tube that carries urine from your bladder to the opening at the end of your penis.
Prostatitis refers to pathological inflammation or infection of the prostate. It can be caused by an injury to the prostate or by bacteria that got into the prostate from your urine or during sex. Prostatitis can be acute or chronic. Acute prostatitis tends to start quickly. Chronic prostatitis comes and goes over time.
BPH occurs when you have an enlarged prostate. It becomes more common as men age. As the prostate enlarges, it squeezes and blocks your urethra, making it hard to empty your bladder completely.
Prostatitis is more likely to affect men ages 50 or younger. BPH usually occurs in men over age 50.
Symptoms of Prostatitis
- pus-like discharge from the penis
- burning or pain during urination
- a frequent need to urinate
- pain in the groin or pelvic area
- painful orgasms
Chronic bacterial prostatitis typically causes these three symptoms:
- difficulty urinating
- pain in your bladder, testicles, or penis
- painful orgasms
Symptoms of BPH
Your symptoms don’t always relate to the size of your prostate. A slightly enlarged prostate can sometimes cause more severe symptoms than a very enlarged gland.
The symptoms of BPH may include:
- the need to urinate many times during the day and night
- an urgent need to urinate
- trouble starting a urine stream (hesitancy)
- a weak or dribbling urine stream
- unintentional loss of urine, also known as incontinence
- an inability to urinate
- pain during urination
When to See a Doctor
See your primary care provider if you’re having pain, burning, or trouble urinating. They may refer you to a urologist, a doctor who treats men’s health disorders including prostate problems.
During the exam, the doctor may insert a gloved, lubricated finger into your rectum. This test is called a digital rectal exam (DRE). It helps your doctor see if your prostate is swollen or enlarged. During the DRE, your doctor may remove a small sample of fluid from the prostate to check for infection. Your doctor may also test your blood, semen, and urine.
Your doctor may do an ultrasound, which is a scan that uses sound waves to create a picture of your prostate. Urodynamic tests are used to find urinary problems by seeing how well you empty your bladder.
Treatment Options for Prostatitis
The treatment you get for prostatitis depends on the cause. Antibiotics are often used to treat bacterial prostatitis. You may get antibiotics through your vein if you have a more severe infection. You may have to take antibiotics for two weeks or longer until the infection clears up.
Other treatments you and your doctor may consider include:
- alpha-blockers, which are medicines that relax muscles around the prostate and help you urinate more easily
- anti-inflammatory medicines and pain relievers to make you more comfortable
- prostate massage
You can also soak in a warm bath or sit on a cushion to ease pressure on your prostate.
Treatment Options for BPH
BPH is treated with medications that shrink the prostate and reduce urinary symptoms.
Drugs called 5-alpha reductase inhibitors block a substance that contributes to prostate growth called dihydrotestosterone (DHT). These drugs include dutasteride (Avodart) and finasteride (Proscar). Drugs called alpha-blockers can help relax the prostate and bladder neck, and improve urine flow. These drugs include doxazosin (Cardura), tamsulosin (Flomax), and terazosin (Hytrin).
Your doctor may prescribe one of these drugs or a combination of certain ones.
If medications don’t help or your symptoms are severe, your urologist may recommend a noninvasive procedure using one of the following to destroy the extra prostate tissue and widen the urethra:
- microwave energy
- electric current
Surgery is a longer-term solution. During BPH surgery, the doctor uses an electric loop or laser to cut away the excess prostate tissue.
Outlook for Prostatitis and BPH
You can usually use antibiotics to treat acute prostatitis. You should start to feel better within a couple of weeks. Chronic prostatitis can be more difficult to treat. Even after treatment, your symptoms can return over and over again.
You may need to try more than one treatment to relieve the symptoms of BPH. Your doctor may recommend that you keep taking medicine in the long term to keep your symptoms under control. Some of the treatments used to shrink the prostate and relieve urinary symptoms can cause side effects such as incontinence and erectile dysfunction. Discuss the possible benefits and risks of the treatment you choose with your doctor so you’ll know what to expect.