Prostatitis is swelling of the prostate gland. Prostate tissue becomes inflamed. This problem can be caused by an infection with bacteria.
Acute prostatitis starts quickly. Long-term (chronic) prostatitis lasts for 3 months or more.
Ongoing irritation of the prostate that is not caused by bacteria is called chronic nonbacterial prostatitis.
Any bacteria that can cause a urinary tract infection can cause acute bacterial prostatitis.
Infections spread through sexual contact can cause prostatitis. These include chlamydia and gonorrhea. Sexually transmitted infections (STIs) are more likely to occur from:
In men over age 35, E coli and other common bacteria most often cause prostatitis. This type of prostatitis may begin in the:
Acute prostatitis may also be caused by problems with the urethra or prostate, such as:
Men age 50 or older who have an enlarged prostate have a higher risk for prostatitis. The prostate gland may become blocked. This makes it easier for bacteria to grow. Symptoms of chronic prostatitis can be similar to symptoms of an enlarged prostate gland.
Symptoms can start quickly, and can include:
Symptoms of chronic prostatitis are similar, but not as severe. They often begin more slowly. Some people have no symptoms between episodes of prostatitis.
Urinary symptoms include:
Other symptoms that may occur with this condition:
If prostatitis occurs with an infection in or around the testicles (epididymitis or orchitis), you may also have symptoms of that condition.
During a physical exam, your health care provider may find:
The provider may perform a digital rectal exam to examine your prostate. During this exam, the provider inserts a lubricated, gloved finger into your rectum. The exam should be done very gently to reduce the risk of spreading bacteria into the blood stream.
The exam may reveal that the prostate is:
Urine samples may be collected for urinalysis and urine culture.
Prostatitis may affect the results of the prostate-specific antigen (PSA), a blood test to screen for prostate cancer.
Antibiotics are often used to treat prostate infections.
Often, the infection will not go away, even after taking antibiotics for a long time. Your symptoms may come back when you stop the medicine.
If your swollen prostate gland makes it hard to empty your bladder, you may need a tube to empty it. The tube may be inserted through your abdomen (suprapubic catheter) or through your penis (indwelling catheter).
Get checked by your provider after you finish taking your antibiotic treatment to make sure the infection is gone.
Acute prostatitis should go away with medicine and minor changes to your diet and behavior.
It may come back or turn into chronic prostatitis.
Complications may include:
Call your provider if you have symptoms of prostatitis.
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Reviewed by:
Dr Helen Huins, 29 Jun 2015
There are two main types of chronic prostatitis. ‘Chronic bacterial prostatitis’ is caused by persistent (chronic) infection with a germ (a bacterial infection). ‘Chronic prostatitis/chronic pelvic pain syndrome (CPPS)’ has a cause which is not fully understood. Chronic prostatitis typically causes pain in the lower pelvic region of men. Urinary symptoms such as frequency of passing urine and pain on passing urine may also be present. Treatment can be difficult and may include antibiotics and other medicines. Symptoms may last a long time, although they may ‘come and go’ or vary in severity.
The prostate gland is only found in men. It lies just beneath the bladder. It is normally about the size of a chestnut. The urethra is the tube that passes urine from the bladder and it runs through the middle of the prostate. The prostate helps to make semen but most semen is made by another gland (the seminal vesicle).
Prostatitis means that you have inflammation of your prostate gland. Prostatitis can be sudden-onset (acute) or persistent (chronic). It can also be caused by an infection (infective) or be non-infective.
For the diagnosis of chronic prostatitis, symptoms need to have been present for at least three months. In acute prostatitis, symptoms usually come on and go away much more quickly. There are two main types of chronic prostatitis:
The rest of this leaflet is just about chronic prostatitis.
Chronic prostatitis is actually quite common. About 2 men in 10 will have chronic prostatitis at some point during their life. Chronic prostatitis most commonly affects men between the ages of 30-50 but men of any age can be affected.
About 9 in 10 men with chronic prostatitis have chronic prostatitis/chronic pelvic pain syndrome (CPPS). About 1 in 10 men with chronic prostatitis have chronic bacterial prostatitis, so this is rare in comparison to chronic prostatitis/CPPS.
Chronic bacterial prostatitis is a type of infective prostatitis. It is caused by a persistent (chronic) infection with a germ (a bacterial infection) of the prostate gland. A man with chronic bacterial prostatitis will usually have had recurring urine infections. Chronic bacterial prostatitis is usually caused by the same type of germs (bacteria) that causes the urine infections. The prostate gland can harbour infection and therefore recurring infections can occur. Chronic bacterial prostatitis is not a sexually transmitted infection.
Men with chronic bacterial prostatitis tend to have symptoms that wax and wane. During a flare-up, you can have pain and discomfort. You feel this mainly at the base of your penis, around your anus, just above your pubic bone and/or in your lower back. Pain may spread to your penis and testicles (testes). Passing stools (faeces) can be painful. You may also have symptoms from a urine infection, such as pain when you pass urine, passing urine frequently or an urgent desire to pass urine.
These symptoms are similar to the symptoms of acute bacterial prostatitis. However, men with a flare-up of chronic bacterial prostatitis tend to be less ill than those with acute prostatitis. For example, a high temperature (fever) is less likely and you are less likely to have general aches and pains.
If you have chronic bacterial prostatitis, your symptoms will generally ease when treated with antibiotics. However, unless the antibiotics completely clear the infection from the prostate gland, you are at risk of the infection coming back (flaring up) again. In between flare-ups, you may have some mild residual pain and some mild urinary symptoms (such as passing urine frequently or an urgent desire to pass urine).
Chronic prostatitis/CPPS is a persistent (chronic) discomfort or pain that you feel in your lower pelvic region – mainly at the base of your penis and around your anus. It is usually diagnosed if you have had pain for at least three months within the previous six months.
The cause of this type of chronic prostatitis is not fully understood. Many theories have been put forward as to the cause. These include:
The term prostatitis really refers to inflammation and/or infection of the prostate gland. However, the exact cause of this form of chronic prostatitis is not known and there is a variable response to antibiotics and anti-inflammatory painkillers. For these reasons, some doctors prefer to use the term ‘chronic pelvic pain syndrome’ (CPPS). Using this term does not necessarily imply that the problem definitely stems from a problem with the prostate gland.
Symptoms have usually been present for at least three months within the previous six months.
The symptoms include:
If your doctor suspects that you have chronic prostatitis, they may refer you to a specialist (usually a urologist) for further assessment. If you are referred to a specialist, a sample of fluid (‘secretions’) from the prostate may be collected to rule out infection in your prostate. To do this, a doctor can gently massage your prostate, with a gloved finger in your rectum. By doing this, fluid from the prostate is pushed out into the urethra and comes out from the penis to be collected and tested for germs (bacteria). If you have chronic pelvic pain syndrome (CPPS), no bacteria are found in the the prostate fluid or urine.
The treatment of chronic prostatitis can be difficult. However, in most people, symptoms improve over months or years.
If your GP suspects that you have chronic prostatitis, as mentioned above, they will usually refer you to a specialist for further assessment. In the meantime, your GP may suggest one or more of the following whilst you are waiting for your appointment with a specialist:
Reassurance and explanation are also sometimes helpful. Some people worry that they may have a serious disease such as prostate cancer. Worry and anxiety can make symptoms worse. Therefore, it may be useful to know that you have chronic prostatitis and not some other disease. However, you will have to accept that pain or discomfort are likely to continue for some time.
Various treatments have been tried for chronic prostatitis. They may benefit some people but so far there are few research studies to confirm whether they help in most cases. They are not ‘standard’ or routine treatments but a specialist may advise that you try one.
For chronic bacterial prostatitis, possible treatments may include the following:
For chronic prostatitis/chronic pelvic pain syndrome (CPPS), possible treatments may include the following:
Research continues to try to find better treatments for chronic bacterial prostatitis and chronic prostatitis/CPPS.
It is difficult to give an outlook (prognosis). Your symptoms may last a long time, although they may ‘come and go’ or vary in severity. Painkillers can keep discomfort to a minimum.
Most men diagnosed with chronic prostatitis/chronic pelvic pain syndrome (CPPS) tend to have an improvement in their symptoms over the following six months. In one study, about a third of men had no further symptoms one year later. In another large study, one third of men showed moderate to marked improvement over two years.
Acute prostatitis happens when your prostate gland becomes suddenly inflamed. The prostate gland is a small, walnut-shaped organ located at the base of the bladder in men. It secretes fluid that nourishes your sperm. When you ejaculate, your prostate gland squeezes this fluid into your urethra. It makes up a large portion of your semen.
Acute prostatitis is usually caused by the same bacteria that cause urinary tract infections (UTIs) or sexually transmitted diseases (STDs). Bacteria can travel to your prostate from your blood. It can enter your prostate during or after a medical procedure, such as a biopsy. It can also be caused by infections in other parts of your genitourinary tract.
If you have acute prostatitis, you may develop:
Any bacteria that causes UTIs can cause prostatitis. Bacteria that commonly cause UTIs and prostatitis include:
Some bacteria that cause STDs, such as chlamydia and gonorrhea, can also cause acute bacterial prostatitis. Other conditions that can lead to acute bacterial prostatitis include:
Factors that increase your risk of UTIs, STDs, and urethritis also increase your risk of acute prostatitis. For example, these risk factors include:
Other risk factors include:
Your doctor will likely start by asking questions about your medical history. They’ll also conduct a physical examination.
They’ll probably conduct a digital rectal examination (DRE). During this procedure, they’ll gently insert a gloved and lubricated finger into your rectum. Your prostate is located in front of your rectum, where your doctor can easily feel it. If you have acute bacterial prostatitis, it will likely be swollen and tender.
During a DRE, your doctor may also massage your prostate to squeeze a small amount of fluid into your urethra. They can collect a sample of this fluid for testing. Laboratory technicians can check it for signs of infection
Your doctor may also feel the lymph nodes in your groin, which may be enlarged and tender.
They may also conduct or order additional tests, such as:
Your doctor will likely prescribe antibiotics for four to six weeks to treat acute bacterial prostatitis. Your treatment may last longer if you have recurrent episodes. The specific type of antibiotic will depend on the bacteria causing your condition.
Your doctor may also prescribe alpha-blockers to help relieve symptoms. These drugs relax your bladder muscles. They can help decrease urinary discomfort. Examples include doxazosin, terazosin, and tamsulosin. Your doctor may also recommend over-the-counter pain relievers, such as acetaminophen and ibuprofen.
Your doctor may advise you to adjust your daily habits to help relieve symptoms. For example, they may encourage you to:
Acute prostatitis usually goes away with antibiotics and lifestyle adjustments. In some cases, it may recur and become chronic prostatitis. Ask your doctor for more information about your specific condition, treatment options, and outlook. They may advise you to take certain steps to lower your risk of recurring infections.