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A variety of conditions affect the prostate that are collectively known as prostatitis. Acute bacterial prostatitis develops suddenly as the result of infection with bacteria responsible for urinary tract infections. Fever, chills, discharge and difficulty urinating develop along with urgency. Pain centers on the genital area and lower back or abdomen. Treatment with a week or so of antibiotics resolves the problem.

In a small number of cases acute bacterial prostatitis merges into chronic bacterial prostatitis with similar but milder symptoms that fluctuate in severity and continue for months. Treatment with antibiotics less certainly cures the condition.

Asymptomatic prostatitis occurs in men without symptoms whose condition is only incidentally discovered during evaluation for some other condition. These men may be diagnosed while testing for prostate cancer or through semen analysis in pursuit of the reason for infertility.

Unfortunately the most common abnormality known as chronic prostatitis / chronic pelvic pain syndrome bedevils large numbers of men who travel from doctor to doctor in search of a cure that continues to evade them. At present it appears bacteria are not integral to the condition. In fact legitimate arguments exist regarding whether the prostate is actually involved in the disease.

Recently the NIH suggested the umbrella term urologic chronic pelvic pain syndrome may be more appropriate since typical symptoms also exist in women. Some suggest that this may be a functional condition in the same family as the chronic fatigue syndrome, irritable bowel syndrome and perhaps fibromyalgia.

Symptoms may suggest prostate enlargement with frequency, urgency, weak stream and nighttime urination. Others complain of psychological dysfunction with anxiety and depression. At times prostate tenderness, pelvic soreness and sexual dysfunction may supervene.

Treating such non-specific complaints without obvious pathology is bound to fail. Men typically receive repeated courses of antibiotics or drugs meant to increase urinary flow - Flomax, Uroxatral, Rapaflo. Some receive anti-inflammatory drugs in the naproxen or ibuprofen family. Other popular remedies that offer little benefit include chondroitin sulfate, bioflavonoids, saw palmetto, quercetin and Viagra.

It will take at least several more years before arriving at a clearer understanding of the precise nature of this common condition. For now, the only constant seems to be almost certain exasperation.
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