Prostatitis

Prostatitis is one of the most common prostate conditions in young and middle-aged men. Prostatitis shares many of the same signs and symptoms as BPH and prostate cancer, but these are sometimes accompanied by fever, chills, lower back pain or pelvic pain, as well as discharge through the urethra. Prostatitis can come on suddenly with severe effects, or become a chronic problem with symptoms reappearing and resolving themselves at random.

What are the different types of prostatitis?

The following classifications of prostatitis are offered by the National Kidney and Urologic Disease Information Clearinghouse, a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK):

Acute bacterial prostatitis

The least common of all types of prostatitis, acute bacterial prostatitis occurs in men at any age and often with sudden and severe symptoms, most commonly difficulty or extremely painful urination. Other symptoms of acute bacterial prostatitis include fever, chills, lower back pain, pain in the perineum (genital area between the legs), frequent urination, burning during urination, and/or urinary urgency at night, coupled with aches and pains throughout the body. Acute bacterial prostatitis is easy to diagnose, so it's important that you seek treatment promptly.

Chronic bacterial prostatitis

Fairly uncommon but difficult to treat, chronic bacterial prostatitis is a recurrent infection of the prostate with similar but less intense symptoms than acute bacterial prostatitis. Symptoms of chronic bacterial prostatitis generally last longer and often fever is absent, unlike during an acute infection.

Chronic prostatitis/chronic pelvic pain syndrome

Chronic prostatitis/chronic pelvic pain syndrome is the most common form of the disease but also one of the least understood forms of prostatitis. Symptoms may resolve and then reappear without warning. The infection may be considered inflammatory or noninflammatory. An inflammatory infection is diagnosed when urine, semen and other secretions are absent of a known infecting organism, but do contain infection-fighting cells. Noninflammatory infections are those in which infection and infection-fighting cells are both absent.

Asymptomatic inflammatory prostatitis

Asymptomatic inflammatory prostatitis may be diagnosed when infection-fighting cells are present, but common symptoms of prostatitis, such as difficulty with urination, fever, and lower back and pelvic pain, are absent. A diagnosis of asymptomatic inflammatory prostatitis is often made during an examination for other conditions, such as infertility or prostate cancer.

What causes prostatitis?

Prostatitis is an infection that usually occurs when bacteria enters the prostatic ducts or as a result of a backward flow of infected urine.

Prostatitis is not contagious and is not considered a sexually transmitted disease, though it can result from several different sexually transmitted diseases.

Who's at risk for prostatitis?

Although any man can develop prostatitis at any age, there are some conditions that put you at greater risk for developing this condition:

  • recent bladder infection, urinary tract infection or other infection elsewhere in the body
  • injury or trauma to the perineum (the area between the scrotum and the anus)
  • abnormal urinary tract anatomy
  • enlarged prostate
  • rectal intercourse
  • recent procedures involving the insertion of a urinary catheter or cystoscope

What Are the Signs and Symptoms of Prostatitis?

Prostatitis has a few unique signs and symptoms that differ slightly from prostate cancer and BPH. Prostatitis is sometimes accompanied by fever, chills, lower back pain or pelvic pain, as well as discharge through the urethra. Each individual's symptoms may vary, so you should see your doctor for a proper diagnosis.

The most common symptoms of prostatitis are:

  • frequent and urgent need to urinate
  • burning sensation during urination
  • weak urine flow
  • pain or throbbing sensations in the rectal or genital area
  • fever and chills (usually present with an acute infection only)
  • lower back and/or pelvic pain
  • discharge through the urethra during bowel movements
  • sexual dysfunction and/or loss of sex drive

The symptoms of prostatitis may resemble other medical conditions or problems. Always promptly consult your doctor for a diagnosis.

Learn more about signs and symptoms of prostate conditions.

How is prostatitis diagnosed?

Due to the different types of prostatitis, effective treatment depends heavily on an accurate diagnosis. In addition to a complete medical history and physical examination, diagnostic procedures for prostatitis may include the following:

  • Digital rectal examination (DRE): A procedure in your doctor inserts a gloved finger into the rectum to examine the prostate for lumps, soft spots, hard spots or other abnormalities that could be a sign of a prostate condition.
  • Prostate massage: Your doctor may also perform a prostate massage to drain fluid into the urethra for analysis. Prostate massage is most commonly performed when your doctor suspects inflammation or infection usually associated with prostatitis.
  • Urine or sperm culture: A urine or semen culture involves specimen collection for later lab analysis. A urine culture is often used in collaboration with prostate massage to collect urine and prostatic fluid to analyze for the presence of white blood cells and bacteria that may mean you have prostatitis.
  • Cystoscopy: A cystoscopy (also called cystourethroscopy) is similar to a colonoscopy but for the urinary tract rather than the digestive tract. A cystoscopy is an examination in which a flexible tube is inserted into the bladder through the urethra, giving your your doctor an inside view of your bladder and urinary tract. A cystoscopy can detect tumors, structural abnormalities, obstructions and stones and help diagnose certain prostate conditions.

Learn more about how prostate conditions can be diagnosed

Treatment for prostatitis

Treatment varies for different types of prostatitis:

  • Acute bacterial prostatitis: Treatment of acute bacterial prostatitis usually involves taking antibiotics for two to three weeks, depending on the extent of the condition. Treatment is usually effective for acute bacterial prostatitis, but it is critical to take the full course of medication to prevent the development of antibiotic-resistant bacteria even when symptoms are absent. Pain relievers may also be prescribed as needed and patients may be advised to increase fluid intake. Hospitalization may be necessary in the most severe cases.
  • Chronic bacterial prostatitis: Treatment of chronic bacterial prostatitis usually involves antibiotic medication for four to 12 weeks. This type of prostatitis is difficult to treat and recurrence is possible. If the infection doesn't respond to shorter term antibiotics, long-term, low dose antibiotics may be prescribed. Hospitalization and/or surgery may be necessary in the most severe cases.

Your doctor will also tailor your specific treatment for prostatitis based on:

  • your age, overall health and medical history
  • extent of the condition
  • your tolerance for specific medications, procedures, or therapies
  • expectations for the course of the condition
  • your opinion or preference

Always consult your doctor for more information regarding the treatment of prostatitis.