Prostatitis is swelling or infection of the prostate gland. It often hurts. The prostate gland sits just below a man's bladder and makes part of the fluid for semen. In young men, the prostate is about the size of a walnut. It usually grows larger as you grow older.
There are several types of prostatitis. They vary based on how long a man has had the problem and what kind of symptoms he has.
Sometimes prostatitis is caused by bacteria, but often the cause is not known.
Symptoms of long-term (chronic) prostatitis are often mild and start slowly over weeks or months. They may include:
Symptoms of acute prostatitis are the same, but they start suddenly and are severe. They may also include a fever and chills.
Some men may have no symptoms.
A doctor can often tell if you have prostatitis by asking about your symptoms and past health. He or she will also do a physical exam, including a digital rectal exam. In this test, the doctor puts a gloved, lubricated finger in your rectum to feel your prostate. You may also need blood and urine tests to find out which type of prostatitis you have or to look for another cause of your problems.
Prostatitis caused by bacteria is treated with antibiotics and self-care.
Home treatment includes drinking plenty of fluids and getting lots of rest. Taking over-the-counter pain relievers can also help.
Your doctor may prescribe medicine to control pain and reduce swelling. He or she may also prescribe medicine to soften your stool and relax your bladder muscles.
Surgery is rarely used to treat prostatitis.
Learning about prostatitis:
Most men with prostatitis have chronic prostatitis/pelvic pain syndrome, inflammatory or noninflammatory. The cause of this type of prostatitis is not known.
About 1 out of 10 men have prostatitis caused by bacteria.
The specific cause of chronic prostatitis/pelvic pain syndrome, inflammatory, is usually not known. But doctors believe the possible causes include:
The causes of chronic prostatitis/pelvic pain syndrome, noninflammatory, may be the same as those for chronic prostatitis/pelvic pain syndrome, inflammatory. Some doctors think that a combination of things—including nervous system problems and strained pelvic floor muscles—causes the pain. Emotional problems and anxiety can make the pain worse.
The symptoms are similar for all forms of prostatitis, with the exception of acute prostatitis.
With acute prostatitis, symptoms are severe, come on suddenly, and include fever and chills. Signs of chronic bacterial prostatitis may be milder and come on suddenly or gradually over weeks or months, and the symptoms may come and go. Symptoms alone cannot be used to determine the type of prostatitis you have.
Prostatitis, especially if it continues for a long time, can cause stress, anxiety, and depression.
Men with acute prostatitis have severe pain and fever. Most men recover fully when treated with antibiotics. Delaying treatment increases the risk of complications, such as sepsis or an abscess in the prostate.
Chronic bacterial prostatitis can be difficult to treat, because some medicines have a hard time reaching the prostate.
Men with chronic bacterial prostatitis commonly have repeated urinary tract infections. The infection may spread to the epididymis.
The presence of infected prostate stones (prostatic calculi) can make treatment of chronic bacterial prostatitis more difficult.
Things that can increase your risk for prostatitis include:
If you have had chronic bacterial prostatitis, you have an increased chance of developing it again.
Contact your doctor immediately if you have sudden fever, chills, and urinary symptoms, such as pain or burning with urination or blood or pus in the urine. These symptoms may point to acute prostatitis.
Call your doctor if you have:
Most men will have some discomfort in their prostate (prostatitis) at some time during their lives. If you do not have a fever and chills or extreme pain, you may try home treatment for a few weeks. Take nonprescription pain medicines, such as aspirin, ibuprofen, or acetaminophen, to relieve pain. But if your urinary symptoms and pain continue, be sure to see a doctor.
Health professionals who can evaluate and treat your prostatitis include:
To prepare for your appointment, see the topic Making the Most of Your Appointment.
If your doctor suspects that you have prostatitis, he or she will begin with a complete medical history and physical exam. The type of prostatitis that you have cannot be determined solely from your history and symptoms. Your doctor will do tests to find out the cause of your prostatitis.
If your history and physical exam show that you do not have acute prostatitis, a pre- and post-massage test (PPMT) or expressed prostatic secretions test may be done to find out which type of prostatitis you have. An expressed prostatic secretions test is not done if acute prostatitis is suspected, because when the prostate is inflamed or infected, massaging it to obtain a sample for tests is very painful and possibly dangerous. Some doctors believe that massaging an infected prostate increases the risk of developing a bacterial infection of the blood (septicemia).
More tests may be needed if:
Tests that may be done include:
Treatment for prostatitis usually begins with taking an antibiotic for several weeks. If you begin to feel better, you may have to take the medicine for 2 to 3 months. If you do not get better while taking antibiotics, more tests may be done.
Treatment for acute prostatitis is aimed at curing the infection and preventing complications. Acute bacterial prostatitis is treated with antibiotics, pain and fever medicine, stool softeners, fluids, and rest.
Treatment for chronic bacterial prostatitis is aimed at curing the infection and preventing complications. Antibiotics are given for 6 to 12 weeks. Long-term antibiotic treatment may be needed if the infection returns.
Treatment of chronic prostatitis/pelvic pain syndrome, inflammatory, may be difficult.
Chronic prostatitis/pelvic pain syndrome, noninflammatory, is difficult to treat because it is not clear what causes this form of prostatitis. The primary goal of treatment is to relieve symptoms. Many treatments are tried, including:
You may be able to prevent prostatitis.
Prostatitis is usually treated with antibiotics and other medicines prescribed by your doctor. But there are some things you can do at home that may help you be more comfortable:
Treatment of prostatitis usually begins with antibiotics and possibly other medicines to relieve symptoms. If you begin to get better, you may have to continue taking antibiotics for 2 to 3 months. During this time, be sure to take the antibiotics as prescribed. If you do not begin to get better while taking medicines, your doctor may want you to have more tests.
Antibiotics are central to treating acute or chronic bacterial prostatitis. Your doctor may prescribe certain antibiotics based on your medical history, symptoms, and other factors such as your age. Other medicines may also be used to help control symptoms, including:
Chronic bacterial prostatitis may require long-term antibiotics, especially if the symptoms return. Some men need treatment with low doses of antibiotics over a long period to control infection and prevent repeated urinary tract infections (UTIs).
Chronic prostatitis/pelvic pain syndrome, inflammatory and noninflammatory, are usually treated first with antibiotics based on the possibility that an infection was missed during testing. But experts advise against long-term treatment with antibiotics unless an unusual bacterial infection is suspected.
Medicines that may be used to treat chronic prostatitis/pelvic pain syndrome, inflammatory or noninflammatory, include:
Prostate stones (prostatic calculi) can make chronic bacterial prostatitis more difficult to cure. If you have prostate stones, they may need to be surgically removed.
Surgery for prostatitis may be needed to treat chronic bacterial prostatitis that does not respond to long-term antibiotic treatment and that causes repeated urinary tract infections. Surgery may be done to remove part of the prostate or to remove infected prostate stones (prostatic calculi). But this does not always cure the infection, and it may make the symptoms worse. Surgery is typically done only if all other treatments have failed.
Surgical removal of part of the prostate to remove prostate stones or to treat an infection that does not respond to antibiotic treatment is called transurethral prostatectomy.
This surgery may not cure prostatitis, because the surgery may not remove the portion of the prostate causing the problem.
Prostatic massage for prostatitis ("milking" of the prostate by a doctor) is an old treatment that many doctors are beginning to use again because medicines do not always successfully cure prostatitis.
To massage your prostate gland, the doctor inserts a lubricated, gloved finger into your rectum and presses several times on your prostate. This may need to be done 2 or 3 times a week. Why this works is not certain, but it is believed that the massage helps open blocked ducts in the prostate, improving circulation and antibiotic penetration into the prostate.
Prostatic massage is not done for acute prostatitis, because it could cause the bacteria to spread from the prostate and cause a wider infection (sepsis).
Other treatments that may be helpful for chronic prostatitis/pelvic pain syndrome, inflammatory or noninflammatory, include:
|National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)|
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The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) is part of the U.S. National Institutes of Health. It conducts and supports research on many of the most serious diseases affecting public health, particularly the diseases of internal medicine. NIDDK sponsors the National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC). It has information about diseases of the kidneys and urologic system for people with these diseases and their families, health professionals, and the public.
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Publications and links to medical journal articles about prostatitis are available at this site. The Prostatitis Foundation also sponsors a moderated e-mail discussion group.
|Urology Care Foundation: The Official Foundation of the American Urological Association|
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UrologyHealth.org is a website written by urologists for patients. Visitors can find specific topics by using the "search" option.
The website provides information about adult and pediatric urologic topics, including kidney, bladder, and prostate conditions. You can find a urologist, sign up for a free quarterly newsletter, or click on the Urology A–Z page to find information about urologic problems.
- Anothaisintawee T, et al. (2011). Management of chronic prostatitis/chronic pelvic pain syndrome. JAMA, 305(1): 78–86.
Other Works Consulted
- Nickel JC (2001). Consensus development of a histopathological classification system for chronic prostatic inflammation. BJU International, 87(9): 797–805.
- Nickel JC, et al. (2003). Leukocytes and bacteria in men with chronic prostatitis/chronic pelvic pain syndrome compared to asymptomatic controls. Journal of Urology, 170(3): 818–822.
- Shoskes DA, et al. (2003). Long-term results of multimodal therapy for chronic prostatitis/chronic pelvic pain syndrome. Journal of Urology, 169(4): 1406–1410.
|Primary Medical Reviewer||E. Gregory Thompson, MD - Internal Medicine|
|Specialist Medical Reviewer||J. Curtis Nickel, MD, FRCSC - Urology|
|Last Revised||December 2, 2011|
Last Revised: December 2, 2011
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