Prostatitis vs BPH: What’s the Difference?

A surgeon uses an anatomical model of the prostate to describe treatment options to a patient.

Prostatitis vs BPH: What’s the Difference?

Wondering about the difference between prostatitis and benign prostatic hyperplasia (BPH)? You’re in the right place to learn more about the similarities and differences between these two conditions.

The prostate is a small gland, similar in size to a walnut, found in the pelvis. It sits below the bladder and surrounds the urethra.

As the Mayo Clinic explains, the main function of the prostate is to generate a fluid that contributes to seminal fluid. This contribution helps to protect and transport sperm as it leaves the body and travels toward an egg. The prostate also closes the connection between the bladder and urethra during ejaculation, helping sperm move through the urethra.

Prostatitis and BPH are both conditions that affect the prostate. They share some symptoms, such as increased frequency of urination. However, these two conditions are distinct.

Let’s take a closer look at prostatitis vs. BPH through this review of the causes, symptoms, diagnostic processes, and treatment options related to each condition.

A model of the bladder and prostate sit next to a stethoscope.

Prostatitis vs. BPH: Foundational Information on BPH and Prostatitis

What is BPH?

BPH is a medical condition related to the common and natural growth of the prostate gland over time. When this continuing growth doesn’t cause pain or discomfort, doesn’t otherwise interfere with everyday life, and isn’t so bad that the bladder is being damaged, it’s not a cause for concern.

Because BPH tends to progress slowly over years and only refers to excessive growth of prostate tissue and is not caused by an external source, such as infection, or by a disease such as cancer, it is sometimes not given the same level of attention as other prostate diseases.

The transitional zone of the prostate is the exclusive site of BPH. The transitional zone of the prostate has two lobes, with one on each side of the urethra. As this zone of the prostate continues to grow, it can apply increased pressure on both sides of the urethra.

Learn more about the zones of the prostate and how they relate to BPH and prostate cancer.

That increased pressure can lead to a variety of symptoms, many of which are related to urination.

Specific symptoms include general difficulty with urination, needing to strain to empty the bladder, and incomplete bladder emptying. A weak urine stream, delayed onset of urination, and needing to wake at night to urinate (called nocturia), and urinary tract infections are also possible, among other symptoms.

It’s important to note that some of these symptoms are also caused by other conditions related to the prostate. There is some crossover when comparing prostate cancer vs. BPH symptoms, for example.

A physician consults with a patient holding his groin, demonstrating discomfort related to a prostate issue.

Is BPH Life-Threatening?

BPH is generally not seen as life-threatening. Instead, it can cause significant quality-of-life issues. BPH and its symptoms can disrupt sleep, work, and social life.

In some cases, however, untreated BPH can lead to more serious issues. These include infections as well as bladder and kidney damage. Treating BPH can help to reverse symptoms as well as prevent these more serious issues from occurring or growing in severity.

Diagnosing BPH

BPH diagnosis generally begins with a physical exam and symptom-related questions from a physician. A digital rectal exam, urine test, and blood test may also be used, as the Mayo Clinic explains.

Johns Hopkins Medicine points out that a urinalysis is commonly performed for patients displaying symptoms of BPH. Other tests, such as a urine culture, may also be performed to help rule out related issues, such as a urinary tract infection.

Measuring prostate-specific antigen (PSA) levels, a protein made by the prostate, can also help to identify a specific issue. However, prostate cancer, BPH, and prostatitis can all lead to elevated PSA levels, according to the Urology Care Foundation.

When diagnosing BPH vs. prostate cancer, PSA levels should be carefully measured. The National Cancer Institute explains that measuring free (unattached to other proteins) PSA, bound (not attached to other proteins) PSA, and total PSA may help to distinguish between the two conditions.

High total and free PSA levels could indicate BPH. A high total PSA and lower free PSA level may indicate prostate cancer. However, this usually needs to be confirmed with additional testing.

Treating BPH

Deciding on a specific course of treatment for BPH requires consultation with your physician. It also depends on age, severity of symptoms, overall health, and similar personal factors.

With that said, there are several potential treatment options for BPH. These include:

  • Observation. If BPH doesn’t cause significant discomfort or complications in everyday life, waiting to see if symptoms resolve or get to the point where treatment is needed is a common option.
  • Prescription medication. Certain medications may treat BPH. Johns Hopkins Medicine explains that two medications, 5-alpha-reductase inhibitors, and alpha-adrenergic blockers, have shown positive results in the short term.
  • Surgery. Several surgical options are in use to treat BPH. These include transurethral resection of the prostate (TURP), laser focal therapy, and transurethral ultrasound ablation procedure (TULSA-PRO), among others. Focal laser therapy and TULSA-PRO are recognized as being minimally invasive and leading to low blood loss during the procedure. Prostate Laser Center published a study in JVIR (the top interventional radiology journal) about laser focal therapy for BPH.

What is Prostatitis?

Prostatitis refers to an inflammation of the prostate and sometimes the areas around it. Prostatitis in general can cause urinary symptoms such as painful urination and increased frequency of urination.

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDKD) explains that there are several types of prostatitis:

Chronic Prostatitis

Chronic prostatitis is also called chronic pelvic pain syndrome. The exact cause of this type of prostatitis is not completely understood. The NIDDKD explains that the potential cause may be a non-bacterial microorganism.

Chronic prostatitis can lead to persistent pelvic discomfort, according to Harvard Health.

Acute Bacterial Prostatitis

A bacterial infection — specifically a urinary tract infection, as the Cleveland Clinic details — is the source of acute bacterial prostatitis. The acute condition is characterized by a sudden onset and a short duration.

Acute bacterial prostatitis symptoms include many related to difficult or painful urination, as well as fever, chills, nausea, and vomiting. Sometimes it is painful to sit.

Chronic Bacterial Prostatitis

Chronic bacterial prostatitis is also caused by a bacterial infection, which persists in the prostate gland. It tends to develop slowly and persist for a much longer period of time than the acute condition.

Symptoms of this type of prostatitis are largely related to pain and difficulty with urination. These symptoms are similar to those of the acute version of the condition. Chronic prostatitis can be very difficult to treat effectively.

Asymptomatic Inflammatory Prostatitis

This form of prostatitis does not lead to symptoms. It may be discovered when diagnosing other issues related to the prostate.

Diagnosing Prostatitis

Some prostate conditions have symptoms in common, such as BPH vs. prostate cancer symptoms. Determining the exact cause of symptoms caused by prostate conditions is crucial for effective treatment. Through exams and a variety of tests, physicians can narrow down the potential causes of prostate-related issues to make a diagnosis.

Diagnosis of prostatitis often includes a physician reviewing a patient’s personal and family medical history. A physical exam that includes a digital rectal exam (DRE) can help to detect inflammation and pain. The physician may also check for swelling and tenderness in the lymph nodes and scrotum.

Testing is also an important part of diagnosing prostatitis. Urinalysis and urine cultures can help to identify signs of infection such as bacteria. Blood tests, such as PSA tests, may be used to help diagnose prostatitis vs. BPH and prostate cancer. Semen cultures can reveal the presence of bacteria as well as white blood cell levels, Johns Hopkins Medicine explains.

There are also more invasive methods used to diagnose prostate issues such as prostatitis. A cystoscopy uses a tube with an attached viewing apparatus inserted into the urethra. The goal is to look into the urinary tract and identify potential blockages, narrowings, or other abnormalities within it.

Transrectal ultrasound is another method of diagnosis. This diagnostic tool is used to examine the prostate and look for abnormalities within the prostate. Sometimes a version of ultrasound called doppler may be used to look for areas of increased blood flow which suggest inflammation.

A Note About Transrectal Ultrasound, Biopsies, Prostatitis & Prostate Cancer

If the results of initial testing for a prostate issue indicate the potential for prostate cancer, a transrectal ultrasound-guided (TRUS) biopsy is a traditional method for further diagnosis.

However, a TRUS biopsy presents some significant limitations in detecting both clinically significant and clinically insignificant cancers. It also relies on random sampling instead of targeted locations for taking biopsy samples.

The use of multiparametric MRI (mpMRI) for biopsies is an emerging and effective option. An mpMRI allows for targeted biopsies through either ultrasound fusion with a previously obtained MRI or real-time visualization of the target and placing a needle directly into it. With high quality mpMRI biopsies, more clinically significant and fewer clinically insignificant cancers can be identified.

Treatments for Prostatitis

The decision of how to treat prostatitis requires consultation with your physician, including taking your current state of health into account. With that said, treatment options for the forms of prostatitis include:

  • Chronic prostatitis: Pain medication and other comfort-oriented options such as applying heat. Alpha-blockers, as the Mayo Clinic explains, can be used to relax the bladder neck, and associated muscles.
  • Bacterial prostatitis: Antibiotics, alpha-blockers, and pain medication. Johns Hopkins Medicine points out that, in rare instances, those suffering from chronic bacterial prostatitis may require a procedure or surgery.

Prostatitis vs. BPH: Final Thoughts

The key difference in the nature of prostatitis vs. BPH is the underly cause of the disease, inflammation versus excess growth.

Symptoms and diagnostic procedures for both conditions have a degree of overlap. However, treatment is significantly different in many cases.

Prostate Laser Center helps patients with BPH and prostate cancer access MRI guided, minimally invasive treatment options for their conditions.

Don’t ignore your prostate health. Learn the difference between prostatitis and BPH. To learn more about treatment options for BPH, request a consultation today.

NOTE: The information provided on this website is general medical information and does not establish a physician-patient relationship. Please discuss your particular situation with a qualified medical professional.

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