Prostatitis and BPH (benign prostatic hyperplasia) are distinct conditions affecting the prostate gland. Although both conditions involve the prostate, they have different causes, symptoms, treatments, and outlooks.

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Although prostatitis and BPH both affect the prostate gland, they are different conditions. The prostate is the small gland located below the bladder and in front of the rectum in males.

Prostatitis refers to the inflammation of the prostate. It can affect anyone of any age and it is the most common urinary tract condition to affect males under age 50. There are a few types of prostatitis:

  • acute or chronic bacterial prostatitis, which is prostatitis that develops as a result of a bacterial infection
  • chronic prostatitis or chronic pelvic pain syndrome, which is prostatitis that has no known exact cause
  • asymptomatic inflammatory prostatitis, which is prostatitis that does not cause symptoms

BPH, also known as prostate gland enlargement, is a noncancerous condition characterized by the enlargement of the prostate gland. It is the most common prostate issue affecting males over age 50. The exact cause is not understood.

This article looks at the similarities and differences between the two conditions.

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Both prostatitis and BPH can have overlapping symptoms, making a comprehensive medical evaluation necessary for an accurate diagnosis.

Prostatitis often has a sudden onset, with symptoms appearing rapidly and intensely. BPH, on the other hand, tends to develop gradually over time, with symptoms gradually worsening.

Symptoms of prostatitis

Some of the symptoms of prostatitis include:

  • pelvic pain or discomfort, ranging from mild to severe, that may be present in the lower abdomen, lower back, groin, or perineal area
  • pain or burning sensation during urination
  • frequent urination, often with an urgent need to urinate
  • difficulty initiating urination or weak urine flow
  • pain or discomfort in the genital area or testicles
  • blood in the urine or semen
  • painful ejaculation
  • flu-like symptoms, such as fever, chills, and body aches

Symptoms of BPH

Symptoms of BPH may include:

  • increased frequency of urination, especially during the night
  • difficulty initiating urination
  • weak urine flow or a hesitant, interrupted flow
  • urgency to urinate
  • dribbling at the end of urination
  • the sensation of the bladder not emptying completely
  • urinary tract infections due to incomplete bladder emptying

Individual experiences may vary, and not all symptoms may be present in every case.

Doctors may carry out many different tests to diagnose prostatitis or BPH. They may include:

  • Physical examination: This often includes a digital rectal examination (DRE). This is when the doctor inserts a gloved finger into the rectum to feel the size, shape, and texture of the prostate gland. A DRE can help identify signs of inflammation, tenderness, or abnormalities.
  • Urine tests: Urinalysis may check for signs of infection or other abnormalities in the urine.
  • Prostate fluid or semen analysis: In some cases, doctors may take a sample of prostate fluid or semen and analyze it to identify the presence of bacteria or inflammatory markers.
  • Imaging tests: Depending on the situation, doctors may carry out imaging tests such as ultrasound, MRI, or cystoscopy to assess the size of the prostate, detect any obstructions, or rule out other conditions. A cystoscopy is a procedure used to see the inside of the urethra and bladder.

In addition, doctors will also review a person’s medical history. They will ask questions about symptoms, their duration, and any factors that could contribute to the condition, such as recent infections or urinary tract issues.

The specific diagnostic approach may vary based on individual circumstances, and additional tests may be necessary.

It is essential for people to consult with a healthcare professional for a proper evaluation and accurate diagnosis of prostatitis or BPH.

Treatment approaches for prostatitis and BPH can vary based on the specific type and severity of the condition.

Treatment for prostatitis

Treatment options may include:

  • Acute or chronic bacterial prostatitis: Treatment for bacterial prostatitis typically involves a course of antibiotics to target the specific bacteria causing the infection. For chronic bacterial prostatitis, people may need longer courses of antibiotics, often lasting several weeks or months. The choice of antibiotics is based on the results of urine and prostate fluid cultures.
  • Chronic prostatitis or chronic pelvic pain syndrome: Treatments may include pain relievers, alpha-blockers to relax the muscles around the prostate and bladder, physical therapy — such as pelvic floor muscle exercises — and lifestyle modifications, including stress reduction and dietary changes. In some cases, doctors may suggest anti-inflammatory medications or prostate massage.
  • Asymptomatic inflammatory prostatitis: No specific treatment is typically required for this type of prostatitis.

Treatment for BPH

Treatment options for BPH include:

  • Watchful waiting: In cases where symptoms are mild or not significantly affecting daily life, doctors may recommend regular monitoring of symptoms and periodic checkups to assess any changes in the condition.
  • Medications: Several medications can help manage the symptoms of BPH. Alpha-blockers relax the muscles of the prostate and bladder neck, improving urine flow. 5-alpha reductase inhibitors can help shrink the prostate gland over time. Some cases may need combination therapy with both types of medications.
  • Minimally invasive procedures: These can relieve individuals with moderate to severe symptoms. They may include transurethral resection of the prostate (TURP), laser therapy, transurethral incision of the prostate, and others. These procedures aim to remove or reduce excess prostate tissue to alleviate urinary symptoms.
  • Surgery: In more advanced cases or when other treatments have not been effective, surgical interventions such as open prostatectomy or robotic-assisted prostatectomy may remove part or all of the prostate gland.

The healthcare professional will take the size of the prostate into account when deciding between minimally invasive treatment options, TURP, or an open or robotic simple prostatectomy.

The outlook for acute prostatitis is generally good and resolves after a person takes antibiotics. Although chronic prostatitis can be challenging to treat, a person will typically recover. However, this can take months or years.

It is not possible to cure BHP. However, medications and surgery can help to treat the symptoms.

Individual experiences can vary, and it is important to consult with a healthcare professional for an accurate diagnosis, personalized treatment plan, and ongoing care.

People should speak with a doctor if they experience any symptoms related to their prostate.

A healthcare professional is the best resource for accurate diagnosis, appropriate treatment, and personalized advice.

They can evaluate symptoms, conduct necessary tests, and provide guidance based on a person’s specific situation.

The National Institute on Aging notes that people should contact a doctor if they develop the following symptoms:

  • a frequent urge to urinate
  • blood in the urine or semen
  • painful or burning urination
  • the need to get up many times during the night to urinate
  • painful ejaculation
  • dribbling of urine
  • pain or stiffness in the:
    • lower back
    • hips
    • upper thighs
    • pelvic area
    • rectal area

Prostatitis and BPH are two distinct conditions affecting the prostate gland.

Prostatitis involves prostate inflammation, which can be caused by infection or other factors. BPH, on the other hand, refers to the noncancerous enlargement of the prostate gland.

A person may find it difficult to tell the difference between the two. If a person experiences any symptoms relating to their prostate, they should contact a doctor.