What Is Prostatitis?
Prostatitis is a common condition that causes your prostate to become swollen and painful. Your prostate is a walnut-sized gland located below your bladder and in front of your rectum. It's part of the reproductive system of all men and people assigned male at birth (AMAB). Prostatitis can be temporary or long-lasting (chronic). It can cause uncomfortable symptoms, but it's usually not serious.
Types of Prostatitis
There are four types of prostatitis you could have:
Acute bacterial prostatitis. Your urinary tract is made up of your kidneys, bladder, the tubes that pass between them (ureters), and the urethra. If bacteria from the urinary tract find their way into your prostate, you can get an infection. Acute bacterial prostatitis is a severe condition.
Chronic bacterial prostatitis. This is a milder bacterial infection that can linger for several months. It's more common to get it if you've had acute bacterial prostatitis.
Chronic pelvic pain syndrome (CP/CPPS). This is the most common type of prostatitis. It's similar to chronic bacterial prostatitis, but it's not caused by bacterial infection.
Asymptomatic prostatitis. Men who have this type of prostatitis have an inflamed prostate but no symptoms. You may only learn you have it if your doctor does a blood test that checks your prostate health. Asymptomatic prostatitis isn't an infection, and you don't need any treatment.
Difference Between Prostatitis and an Enlarged Prostate
Both prostatitis and an enlarged prostate affect your prostate gland, but they are separate conditions. Prostatitis is inflammation, often caused by bacteria, that can bring on sudden or chronic pain. Enlarged prostate, sometimes called benign prostatic hyperplasia, is a gradual enlargement of your prostate.
Scientists don't fully understand what causes enlarged prostate, but they think it's related to changes in your hormones as you get older. Because of the inflammation, prostatitis is typically a more painful condition than enlarged prostate. The main symptoms of enlarged prostate are difficulty peeing, having a weak flow of pee, and a need to pee often and urgently.
Does prostatitis cause prostate cancer?
Prostatitis is a harmless condition. It doesn’t cause cancer or make you more likely to have cancer.
What Causes Prostatitis?
Prostatitis has different causes, depending on the type. Sometimes, the cause could be unknown.
Acute and chronic bacterial prostatitis. Acute and chronic bacterial prostatitis happen due to a bacterial infection of your prostate. Bacteria can get into your prostate when you:
- Have a bladder infection
- Have bladder stones
- Have prostate stones
- Have a sexually transmitted infection (STI)
- Have a urinary tract infection (UTI)
- Use a tube that drains urine from your bladder called a urinary catheter
- Have a pelvic injury
Chronic pelvic pain syndrome (CPPS). This type of prostatitis isn't well understood. Researchers are unsure why it happens, but they think some type of microorganism, aside from bacteria, may be to blame. Factors that are tied to chronic prostatitis include:
- Chemicals in the urine
- The immune system responding to a previous (UTI)
- Nerve damage in the pelvic area
- Damage to the pelvic floor
- Stress
- Autoimmune conditions, in which your immune system mistakenly attacks healthy tissues
What is the most common cause of prostatitis?
CPPS is the most common type of prostatitis, the cause of which isn't fully understood.
Prostatitis Risk Factors
You’re more likely to have prostatitis if:
- You have a history of frequent UTIs or bladder infections
- You’ve had prostatitis before
- You’ve had a pelvic injury
- You use a urinary catheter
- You’re older than 50 and have an enlarged prostate
Prostatitis Symptoms
Each of the four types of prostatitis has its own set of symptoms — or in the case of asymptomatic prostatitis, no symptoms.
Acute bacterial prostatitis symptoms
- Trouble peeing
- Urgent need to pee but only a little comes out, or you have to get to the toilet quickly to prevent an accident
- Urinary blockage (difficulty peeing or a weak urine stream)
- Peeing often in the night
- Cloudy urine
- Burning or pain while peeing
- High fever
- Chills
- Body aches
- Nausea and vomiting
- Pain around the base of your penis or behind your scrotum
As this is a severe condition, get medical care right away if you notice any of these symptoms.
Chronic bacterial prostatitis symptoms
- An urgent need to pee, often in the middle of the night
- Painful urination
- Pain when you ejaculate (release semen at orgasm)
- Pain in the genitals, groin, or lower belly
- A “heavy” feeling behind your scrotum
- Urinary blockage (difficulty peeing or a weak urine stream)
Chronic pelvic pain syndrome (CPPS) symptoms
The main symptom of CPPS is pain that lasts more than 3 months in at least one of these body parts:
Other symptoms include:
- Pain when you pee or ejaculate
- Frequent or urgent peeing
- A weak pee stream
Prostatitis Diagnosis
Your doctor will ask about your medical history, do a physical exam, and recommend tests to diagnose prostatitis.
During the physical exam, your doctor may look for:
- Any discharge
- Enlarged or tender lymph nodes in the groin
- Swelling or tenderness in the scrotum
They may also do a prostate exam to see if the prostate looks unusual, maybe swollen or tender, and recommend any additional tests.
Your doctor may refer you to a urologist to check for any urinary tract problems that may be causing your prostatitis. Your urologist will do tests such as:
- Urinalysis, to test your urine sample for an infection
- Blood tests, to check for infection or other prostate problems including prostate cancer
- Urodynamic tests, to check how well your bladder and urethra keep and release urine
- Cystoscopy, to look at the insides of your urethra and bladder.
- Transrectal ultrasound, to look at the prostates for any unusual signs that may mean problems such as prostate cancer
- Biopsy, to test a prostate tissue sample for prostate cancer
- Semen analysis, to examine the quality and quantity of your semen and sperm and to check for any signs of an infection
They may have to rule out other conditions that cause symptoms that look like prostatitis before confirming that you have the condition.
Treatment for Prostatitis
If you have prostatitis, your doctor can help you find ways to manage your symptoms and control your pain. Treatments can include these medications:
Antibiotics. If a bacterial infection is causing serious symptoms, your doctor may want you to go to the hospital and get antibiotics through an IV at first. Then, you may need to take them by mouth for up to a month. If your symptoms keep coming back, your doctor might suggest you stay on a low dose of antibiotics for the long term.
Over-the-counter pain relief. Your doctor may recommend medications such as acetaminophen (Tylenol) or ibuprofen (Advil).
Pain medicine. Antidepressants or anti-seizure medications are just two types of medicine that can be used to treat long-term prostate pain.
Supplements. Quercetin, a natural compound found in plants, has been shown to ease inflammation in some men who have prostatitis. A pollen extract called cernilton may also help. Talk to your doctor before trying any supplements or herbal remedies. They could make other medicines you’re taking not work as well.
Medications that improve sexual function. It’s common for prostatitis to lead to problems with your sex life. If you have trouble getting or keeping an erection, your doctor can prescribe a medicine such as sildenafil (Viagra) to help.
At some point, you may also need a different kind of treatment:
Urinary catheter. If you can’t pee, a nurse can insert a flexible tube into your urethra (the tube that removes urine from your body) to drain your bladder.
Prostate massage. This helps empty fluid from your prostate ducts (tubes). Having it done two to three times a week could help. Frequent ejaculation may help just as much.
Physical therapy. Sometimes, prostatitis is caused by a problem with your pelvic floor muscles. These support your bladder and bowel and help with sexual function. Your doctor may refer you to a physical therapist who can help you improve your strength and posture. They can also help you learn about habits you have that could be causing damage to your pelvic floor.
Mental health therapy. Stress may play a part in some types of prostatitis. Talk to a mental health counselor. They can help you learn to control stress so you can feel better.
Best antibiotic for prostatitis
Fluoroquinolones are a go-to treatment for chronic bacterial prostatitis. They work against many bacteria and work well in the prostate.
Your doctor may recommend other antibiotics such as tetracyclines, macrolides, and trimethoprim.
The best antibiotics for you will depend on the results of a test that shows the type of bacteria you have. Your doctor will choose the most effective antibiotic for that type of bacteria.
Prostatitis Lifestyle Changes
Lifestyle changes can make a difference, too. These options may help you start to feel better right away:
Watch your diet. Spicy food, caffeine, and alcohol can all make your symptoms worse. Be sure to drink plenty of water to stay hydrated.
Take “sitz baths.” Sitting in 2 to 3 inches of warm water can offer some relief from your symptoms.
Protect yourself. If you must sit at a desk or in a chair for a long time, sit on a cushion.
Be active when you can. Regular exercise may not only reduce your pain but also improve your outlook.
Prostatitis Complications
When prostatitis is left untreated, it may lead to complications such as:
- Bacterial infection in your blood
- Prostatic abscess or a pus-filled cavity in your prostate
- Sexual health-related problems
- Inflamed reproductive organs near your prostate
When to Contact Your Doctor
See a doctor if you have any symptoms of prostatitis, such as feeling the need to pee often, painful urination, lower back pain, chills, and more. They can tell you exactly why you might have these symptoms and recommend treatment.
Also, see a doctor immediately if you have symptoms such as
- Being unable to pee
- Painful, frequent, and urgent need to pee, with fever and chills
- Blood in your pee or semen
- Serious pain and discomfort in the lower part of your belly
Takeaways
Prostatitis is a condition in which your prostate becomes swollen, tender, and inflamed. It often happens due to a bacterial infection in the prostate. Researchers are still looking into why it happens in other cases. If you show symptoms, such as having trouble peeing and stomach pain, see a doctor. With a diagnosis, your doctor can recommend treatment.
