Prostatitis: Symptoms, Causes & Treatment

Prostatitis is a common condition in men consisting of inflammation or irritation of the prostate gland, a small walnut-sized gland located below the bladder and surrounding the urethra, with a role in producing part of the semen. Unlike benign prostate enlargement that affects the elderly, prostatitis can affect men of various ages, including young and middle-aged men. It is important to emphasize that prostatitis is not cancer and does not increase the risk of prostate cancer.

Prostatitis has several types differing in their causes, symptoms, and treatment: acute bacterial prostatitis, a sudden infection that may be severe and cause fever, chills, pain, and severe difficulty urinating, considered a condition requiring urgent treatment; chronic bacterial prostatitis, a recurrent or persistent infection with milder symptoms; and chronic pelvic pain syndrome, the most common, which may have no clear bacterial cause. General symptoms include: pain or discomfort in the pelvis, lower back, or perineal area (between the scrotum and anus) or genitals, urinary symptoms such as burning, frequent urination, urgency, and difficulty urinating, and sometimes pain on ejaculation.

Diagnosis begins with clinical assessment and a urine test to determine whether there is a bacterial infection, and sometimes additional tests. Treatment depends mainly on the type of inflammation: in bacterial types antibiotics are the main treatment, and may need a relatively long treatment period especially in the chronic type, and it is important to complete the full course. Chronic pelvic pain syndrome's treatment is more complex and may combine medications to relax the bladder and prostate muscles, painkillers, and sometimes pelvic-floor physical therapy and lifestyle modifications. Drinking fluids, avoiding irritants (such as caffeine, alcohol, and spicy foods), and warm baths help relieve symptoms. Acute prostatitis with fever and severe difficulty urinating requires urgent medical review.

• Pain or discomfort in the pelvis, lower back, perineum, or genitals.
• Burning, frequent urination, urgency, and difficulty urinating.
• Pain on ejaculation sometimes.
• In the acute type: fever, chills, and severe difficulty urinating.

• Bacterial infection (in acute and chronic bacterial types).
• Chronic pelvic pain syndrome (the most common, may have no known bacterial cause).
• Predisposing factors such as urinary tract infections and some procedures.

• Clinical assessment and a urine test to determine a bacterial infection.
• Sometimes additional blood or semen tests.
• Evaluation to exclude other causes of urinary symptoms.

Bacterial types

• Antibiotics are the main treatment, and may need a long period (especially chronic) with completing the full course.

Chronic pelvic pain syndrome

• Medications to relax the bladder and prostate muscles, painkillers, and sometimes pelvic-floor physical therapy and lifestyle modifications.

Symptom relief

• Drinking fluids, avoiding caffeine, alcohol, and spicy foods, and warm baths.

This content is educational and does not replace consulting a urologist.

• Acute urinary retention or an abscess in the acute bacterial type.
• Recurrent urinary infections in the chronic type.
• Chronic pain affecting quality of life.

• Treating urinary tract infections early.
• Drinking fluids and avoiding irritants (caffeine, alcohol, spicy foods).
• Medical follow-up and not neglecting persistent urinary symptoms.