May 2019

PCRI’s Executive Director, Mark Scholz, MD, differentiates between two related, but commonly confused conditions of the prostate: Benign prostate hypertrophy and prostatitis. He describes each condition, their treatment options, and the ways in which they can confuse the process of diagnosing prostate cancer.

:09 BPH stands for benign prostate hypertrophy and it means that the prostate gland is getting larger. Prostatitis, on the other hand, means that there is inflammation of the prostate.

:45 Both prostatitis and BPH can occur with or without symptoms. When doctors talk about asymptomatic cases of prostatitis or BPH it is usually in regard to a rising PSA. Since PSA is used as an indicator of prostate cancer, it is important to know whether the rising PSA is a result of asymptomatic prostatitis or BPH, or if it is a result of prostate cancer. 

1:34 BPH and prostatitis can occur at the same time. There is speculation that BPH is the result of prostatitis, but that is unconfirmed. 

1:53 Some forms of symptomatic prostatitis come from bacterial infections and can be treated with antibiotics like Cipro or Levaquin; however, this is rare. More often there are no symptoms, and the biggest issue is determining the source of the rising PSA. 

2:24 BPH can cause urinary problems. (Oftentimes, however, BPH is blamed for urinary problems that are actually occurring in the bladder.) There are a variety of treatments available when a large prostate blocks urinary flow. Common pills are Flomax, Rapaflo, Proscar, and Dutasteride as well as a variety of herbal options. There are also interventions available such as Transurethral resection (TURP), Rezume, and Urolift. 

3:30 The appropriate treatment will be determined based on the underlying cause, and so an accurate diagnosis must be made to distinguish between prostatitis and BPH. Fortunately, treatments for both BPH and prostatitis are very effective. 

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