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Prostatitis

Last Updated August 2022 | This article was created by familydoctor.org editorial staff and reviewed by Beth Oller, MD

What is prostatitis?

The prostate is a gland that is part of the male reproductive system. It’s about the size of a walnut and helps in sperm production and ejaculation. The prostate lies below a man’s bladder and in front of the rectum. It surrounds the urethra, which is the tube that carries urine.

Prostatitis is inflammation of the prostate gland. This occurs when the gland’s tissue becomes swollen and irritated. This can hurt. There are 2 main types: bacterial prostatitis (chronic or acute) or nonbacterial prostatitis.

Symptoms of prostatitis

You can have a range of prostatitis symptoms. They may be similar to other problems with your prostate or urinary tract. If you have any of these symptoms, contact your doctor:

  • Difficult or painful urination
  • Frequent urination
  • Fever
  • Lower back pain
  • Pain in your penis, testicles, or perineum (the area between your testicles and rectum)
  • Blood in your urine or semen
  • Failure to get an erection
  • Tenderness in your lower stomach

What causes prostatitis?

An infection causes bacterial prostatitis. It is chronic if it starts slowly and lasts for several months. It is acute if it begins and goes away quickly. Infection can occur from:

  • A biopsy or surgery
  • A sexually transmitted infection (STI)
  • Urine blockage
  • An injury to your genitals

Nonbacterial prostatitis is more common, but its cause is unknown. This type usually is chronic. It may be related to a previous urinary tract infection (UTI) or chemicals in your urine. Pelvic nerve damage also is a possible cause.

How is prostatitis diagnosed?

Your doctor will ask about your family’s medical history. They will also do physical and rectal exams. For the physical test, the doctor looks for a swollen, tender scrotum and enlarged lymph nodes in your groin area. For the rectal test, your doctor will insert a gloved, lubricated finger into your rectum. They feel the back of your prostate gland for swelling, warmth, and tenderness. Your doctor also may test your urine, blood, or semen samples. This helps rule out other problems.

Can prostatitis be prevented or avoided?

You can’t prevent most cases of prostatitis. However, you should get checked for STIs. To best protect yourself, use a condom during all sexual encounters. This helps prevent getting or spreading the infection.

Men who have frequent UTIs are more likely to have prostatitis. Men who are 50 years of age or older and have an enlarged prostate also have an increased risk.

Prostatitis treatment

It’s common for your doctor to prescribe medicine to get rid of the infection, even for nonbacterial cases. This medicine helps get rid of infection. You may have to take the medicine for several weeks or a few months. For severe cases, you may need to go to a hospital. There you can get fluids to rehydrate or a catheter to help you urinate.

You can treat symptoms of prostatitis by doing these things:

  • Drinking extra fluids to urinate more often. This helps get rid of the bacteria faster.
  • Avoid food and drinks that dehydrate you. This includes caffeine, alcohol, and anything spicy or acidic.
  • Take nonsteroidal anti-inflammatory medicines, such as ibuprofen or naproxen. These can reduce pain and swelling.
  • Take warm baths to relieve pain in your lower back and other areas.

Living with prostatitis

Treatment should get rid of prostatitis. Take your medicine according to your doctor’s instructions. Finish the prescription and don’t skip any doses. Your doctor likely will recommend follow-up tests. These will confirm if the infection is gone and help prevent it from reoccurring. If it does come back, you’ll need to take more medicine for a longer time.

It is rare for people who have prostatitis to need surgery. Talk to your doctor if your condition is chronic and medicine isn’t helping.

Although prostatitis is painful, it does not cause cancer. However, it can cause your prostate-specific antigen (PSA) level to increase. This is a problem if your doctor does a PSA blood test to check for prostate cancer. A positive result does not mean you have cancer. The American Academy of Family Physicians (AAFP) does not recommend routine prostate-specific antigen screening for prostate cancer. For men aged 55 through 69 who are considering periodic prostate cancer screening, clinicians should discuss the risks and benefits and engage in shared decision making that enables an informed choice.

Questions to ask your doctor

  • Could my symptoms be caused by something other than prostatitis?
  • How do I know if an STI caused my prostatitis?
  • How long do I need to take medicine?
  • Are there any side effects from treatment?
  • Should I avoid having sex while I have prostatitis?
  • Is there anything I can do to avoid getting prostatitis again?

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