Prostatitis is swelling of the prostate gland. The prostate is a walnut-sized gland in men that surrounds the urethra. It produces a fluid that is part of semen.
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There are 4 types of prostatitis:
- Acute bacterial prostatitis
- Chronic bacterial prostatitis
- Chronic pelvic pain syndrome
- Asymptomatic inflammatory prostatitis
Acute and chronic bacterial prostatitis are caused by an infection. A bacteria enters the prostate—usually from the urinary tract or rectum.
The causes of chronic pelvic pain syndrome and asymptomatic inflammatory prostatitis are not clearly understood. In some people, it is possible that a cause may not be found.
Risk Factors ^
Prostatitis is most common in men who use catheters. Other factors that may increase your risk of prostatitis include:
- Unprotected sex
- Phimosis—inability of the foreskin to fully retract over the head of the penis
- Narrowing of the urethra, the tube that carries urine from the bladder to the outside of the body
- Enlarged prostate
- History of urinary tract infections
Symptoms depend on the category of prostatitis syndrome. In many people, symptoms may not appear. In others, they may appear as another condition.
Symptoms may include:
- Needing to urinate frequently and/or urgently
- Pain or burning while urinating
- Difficulty urinating
- Lower abdominal pain or pressure
- Penile, rectal, or perineal discomfort
- Lower back pain
- Fever or chills
- Erectile dysfunction
You will be asked about your symptoms and medical history. A physical exam will be done. A digital rectal exam may be done as part of the physical exam.
Your bodily fluids and tissues may be tested. This can be done with:
- Urine tests
- Prostate massage
- Prostate biopsy
Treatment depends on the type of prostatitis:
Acute and chronic bacterial prostatitis are treated with oral antibiotics. Antibiotics may be given over 4-12 weeks. The antibiotics may be given through an IV for severe infections.
Other medications to help manage symptoms include:
- Stool softeners
- Anti-inflammatory medications
- Pain medication
- Alpha-blockers or 5-alpha reductase inhibitors to help with urine flow
Your doctor may recommend that you avoid alcohol and caffeinated beverages.
Antibiotics may be recommended if an infection is possible. Other treatments to manage symptoms include:
- Alpha-blockers or 5-alpha reductase inhibitors
- Anti-inflammatory medications such as ibuprofen
- Pain medication
- Warm sitz baths
- Repeated prostate massages
To help reduce your chance of prostatitis:
- Practice safe sex. Protect yourself from sexually transmitted diseases (STDs) by using condoms.
- Emptying your bladder regularly and as soon as you feel the urge
You may also be able to reduce your risk of chronic pelvic pain through exercise. If allowed by your doctor, do moderate exercise for at least 30 minutes, 4 days a week.
Urology Care Foundation
Canadian Urological Association
Men's Health Centre
Acute bacterial prostatitis. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T115750/Acute-bacterial-prostatitis. Updated March 18, 2016. Accessed September 14, 2016.
Chronic bacterial prostatitis. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T905991/Chronic-bacterial-prostatitis. Updated March 21, 2016. Accessed September 14, 2016.
Propert KJ, McNaughton-Collins M, et al. A prospective study of symptoms and quality of life in men with chronic prostatitis/chronic pelvic pain syndrome: The National Institutes of Health Chronic Prostatitis Cohort Study. J Urol. 2006;175:619-623.
Prostatitis. National Kidney and Urologic Diseases Information Clearinghouse website. Available at: http://www.niddk.nih.gov/health-information/health-topics/urologic-disease/prostate-problems/Pages/facts.aspx. Updated July 2014. Accessed March 8, 2016.
Prostatitis (prostate infection). Urology Care Foundation website. Available at: http://www.urologyhealth.org/urology/index.cfm?article=15. Accessed March 8, 2016.
Sharp VJ, Takacs EB, et al. Prostatitis: diagnosis and treatment. Am Fam Physician. 2010 Aug 15;82(4):397-406.
5/18/2015 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Zhang R, Chomistek AK, et al. Physical activity and chronic prostatitis/chronic pelvic pain syndrome. Med Sci Sports Exerc. 2015 Apr47(4):757-764.
Last reviewed March 2016 by Adrienne Carmack, MD Last Updated: 5/18/2015