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Prostatitis

What is prostatitis?

Prostatitis is inflammation of the prostate gland and sometimes the area around it. It is not cancer.

Only males have a prostate gland. It sits in front of the rectum and below the bladder. The gland wraps around the urethra, the tube that carries urine out of the body. The prostate makes the fluid part of semen.

Types of prostatitis

  • Chronic prostatitis. This is the most common type of prostatitis. Symptoms may get better and then come back without warning. Healthcare providers do not know why this happens. There is no cure, but you can manage symptoms.
  • Acute bacterial prostatitis. This is the least common type of prostatitis. It happens in men at any age. It often starts suddenly and has severe symptoms. It’s important to get treatment right away. You may find urination difficult and very painful. Other symptoms include fever, chills, lower back pain, pain in the genital area, frequent urination, burning during urination, or urinary urgency at night. You may also have aches and pains throughout your body.
  • Chronic bacterial prostatitis. This type is fairly uncommon. It is an infection that comes back again and again, and is hard to treat. Symptoms  are like a mild form of acute bacterial prostatitis. But they last longer. Often you have no fever.
  • Asymptomatic inflammatory prostatitis. This is prostatitis with no symptoms. Your healthcare provider often diagnoses it during an exam for another health problem. He or she may diagnose it if you have infection-fighting cells in your prostate fluid or semen.

What causes prostatitis?

Prostatitis is most often caused by bacteria. They spread from the rectum or from infected urine.

You cannot get prostatitis from another person. It is not an STD. But it can result from several STDs.

Who is at risk for prostatitis?

You can get prostatitis at any age, but some things raise your risk:

  • Recent bladder or urinary tract infection, or other infection in the body
  • Injury to the area between the scrotum and the anus
  • Abnormal urinary tract anatomy
  • Enlarged prostate
  • Recent test where a catheter or scope was put into the urethra

What are the symptoms of prostatitis?

These are the most common symptoms of prostatitis:

  • Need to urinate often
  • Burning or stinging while urinating
  • Pain when urinating
  • Less urine when you urinate
  • Rectal pain or pressure
  • Fever and chills (often only with an acute infection)
  • Pain in your lower back or pelvis
  • Discharge through the urethra during bowel movements
  • Erectile dysfunction or loss of sex drive
  • Throbbing sensations in the rectal or genital area

The symptoms of prostatitis may look like other medical conditions or problems. Always see your healthcare provider for a diagnosis.

How is prostatitis diagnosed?

Your healthcare provider will review your past health and sexual history. He or she will also do a physical exam. Other tests may include:

  • Urine culture. This test collects prostatic fluid and urine. They are checked for white blood cells and bacteria.
  • Digital rectal exam (DRE). In this test, the healthcare provider puts a gloved finger into the rectum to check the part of the prostate next to the rectum. This is done to look for swelling or tenderness.
  • Prostate massage. The healthcare provider massages your prostate gland to drain fluid into the urethra. This fluid is then checked under a microscope to look for inflammation or infection. This test is usually done during a digital rectal exam (DRE).
  • Semen culture. A semen sample is tested in the lab for bacteria and white blood cells.
  • Cystoscopy. A thin, flexible tube and viewing device is put into the penis and through the urethra. Your healthcare provider uses the device to look at your bladder and urinary tract for structure changes or blockages.
  • Transrectal ultrasound. A thin transducer is inserted into the rectum next to the prostate to show images of the prostate.
  •  CT scan. This is an imaging test that uses X-rays and a computer to make detailed images of the body. A CT scan shows details of the bones, muscles, fat, and organs.

How is prostatitis treated?

Your healthcare provider will figure out the best treatment based on:

  • How old you are
  • Your overall health and health history
  • How sick you are
  • How well you can handle specific medicines, procedures, or therapies
  • How long the condition is expected to last
  • Your opinion or preference

Treatment depends on what type of  prostatitis you have.

Chronic prostatitis

You may take antibiotics until infection can be ruled out. Depending on the symptoms, other treatments may include:

  • Medicines to help relax the muscles around the prostate and bladder, decrease inflammation, and ease pain
  • Prostate massage to release the fluid that is causing pressure in the prostate
  • Heat from hot baths or a heating pad to help ease discomfort

Chronic bacterial prostatitis

Treatment usually involves taking antibiotics for 4 to 12 weeks. This type of prostatitis is hard to treat and the infection may come back. If antibiotics don’t work in 4 to 12 weeks, you may need to take a low dose of antibiotics for a while. Rarely, you may need surgery to remove part or all of the prostate. This may be done if you have trouble emptying your bladder.

Acute bacterial prostatitis

For this type of prostatitis, you usually take antibiotics for 2 to 4 weeks. It’s important to take the full course of antibiotics, even when you don’t have symptoms. This is to stop the growth of antibiotic-resistant bacteria. You may also need pain medicines. You may be told to drink more fluids. In severe cases, you may need to stay in the hospital.

Always see your healthcare provider for more information about the treatment of prostatitis.

Key points about prostatitis

  • Prostatitis is inflammation of the prostate gland caused by infection. It can be one of several types.
  • Prostatitis is not contagious and is not an STD.
  • Any man can get prostatitis at any age. Symptoms of prostatitis may include urinating more often, burning or stinging during urination, pain during urination, and fever and chills. Your healthcare provider usually diagnoses prostatitis by your symptoms and by checking your urine and semen for signs of infection.
  • Antibiotics are used to treat prostatitis. In rare cases, you may need surgery.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
  • Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
  • Ask if your condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if you do not take the medicine or have the test or procedure.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.

Medical Reviewers:

  • Finke, Amy, RN, BSN
  • Greenstein, Marc, DO