Acute prostatitis presents as a bacterial infection of the prostate causing severe pain while passing urine and also symptoms like frequency and fever. The duration of symptoms in acute prostatitis is usually shorter and settle with antibiotic treatment. Patients who have acute prostatitis may get reoccurring episodes of this and go into a condition called chronic bacterial prostatitis, if the infections persist in the prostatic tissue. Since it is difficult to get enough antibiotics into the prostatic tissues, prostatitis requires a longer or an extended course of antibiotic treatment with a group of antibiotics called fluroquinolones for a total period of four to six weeks. The bacterial infection in the prostatitis can be confirmed only in a small percentage of patients by routine methods and usually the treatment is given in a presumed basis (empirical treatment). Of course the empirical treatment is based on the clinical symptoms and presentation and diagnosis made by a medical practitioner.
Typical symptoms of prostatitis are pain when passing urine and also pain in the perineum which is a common site of pain. The next common site of pain is a pain in the scrotum and testes. The pain can also be felt in the bladder area and the lower back in a small proportion of patients. The urinary symptoms which are present during prostatitis are the frequent need to urinate and difficulty urinating due to weak stream or straining or pain during urination. A clinical examination by a urologist or other medical practitioner will confirm prostatitis by a finger examination of the prostate through the back passage where the prostate will be found to be tender. This will confirm the clinical diagnosis of prostatitis upon which the practitioner will start the patient on antibiotic treatment.
Urine culture and tissues which were expressed by examination can also be sent for culture and can show bacterial infection in a small proportion of patients. After the extended course of antibiotic treatment, if the symptoms of prostatitis continue to persist or return on a recurrent basis without any response to antibiotics then a chronic pelvic pain will be diagnosed. This can be treated by pain killers and also investigations to look for other causes of the pain and usually these painful conditions are associated with backache and that needs to be treated on its own merits.