Prostatitis

Overview

What is the prostate gland?

The prostate is a gland that lies just below a man’s urinary bladder. It surrounds the urethra and is in front of the rectum. The urethra is the tube that carries urine out of the bladder, through the penis and out of the body.

What is prostatitis?

Prostatitis is an inflammation of the prostate gland. Prostatitis may be easily confused with other infections in the urinary tract. If you think you have prostatitis, see your doctor.

Does prostatitis cause cancer?

Although prostatitis can cause you discomfort, it does not cause cancer. Some doctors use a blood test called the prostate-specific antigen (PSA) to test for prostate cancer.

If you have prostatitis, your PSA level might go up. This does not mean you have cancer. Your doctor will treat your prostatitis and may check your PSA level again.

The AAFP recommends against prostate-specific antigen (PSA)-based screening for prostate cancer.

Symptoms

Prostatitis can cause many symptoms, including the following:

  • Difficult or painful urination

  • Frequent urination

  • Fever

  • Low-back pain

  • Pain in the penis, testicles or perineum (the area between the testicles and the anus)

  • Inability to get an erection

  • Decreased interest in sex

Causes & Risk Factors

What causes prostatitis?

There are 2 kinds of prostatitis: acute prostatitis and chronic bacterial prostatitis. Both are caused by an infection of the prostate. Some kinds of prostatitis may be a result of the muscles of the pelvis or the bladder not working correctly.

Can prostatitis be passed on during sex?

Sometimes prostatitis is caused by a sexually transmitted organism, such as chlamydia. However, most cases of prostatitis are caused by infections that are not sexually transmitted. These infections can’t be passed on to sexual partners.

Diagnosis & Tests

How will my doctor know that I have prostatitis?

Your doctor may do a rectal exam and test urine samples to find out the cause. During a rectal exam, your doctor may check your prostate by putting a gloved, lubricated finger into your rectum to feel the back of your prostate gland.

Treatment

How is prostatitis treated?

The treatment is based on the cause. Antibiotics are used to treat prostatitis that is caused by an infection. You might have to take antibiotics for several weeks or a few months. If prostatitis is severe, you might have to go to a hospital for treatment with fluids and antibiotics.

What if my prostatitis is not caused by infection?

Because doctors do not yet understand what causes prostatitis without infection, it can be hard to treat. Your doctor might try an antibiotic to treat a hidden infection. Other treatments are aimed at making you feel better.

Nonsteroidal anti-inflammatory medicines, such as ibuprofen (two brand names: Advil, Motrin) or naproxen (one brand name: Aleve), and hot soaking baths may help you feel better. Some men get better by taking medicines that help the way the bladder or prostate gland work.

Can prostatitis come back?

Men who have had prostatitis once are more likely to get it again. Antibiotics may not get into the prostate gland well. Small amounts of bacteria might "hide" in the prostate and not be killed by antibiotics. Once you stop taking the antibiotic, the infection can get bad again. If this happens, you might have to take antibiotics for a longer period of time to prevent another infection. Prostatitis that is not caused by infection is often chronic. If you have this kind of prostatitis, you might have to take medicine for a long time.

Should I have my prostate gland taken out if I have prostatitis?

Prostatitis can usually be treated with medicine. Most of the time, surgery is not needed.

Questions to Ask Your Doctor

  • What treatment is best for me?

  • How long will my treatment last?

  • Is there anything I can do to feel better until my treatment starts working?

  • Could my symptoms be caused by something other than prostatitis?

  • Do I have chronic bacterial prostatitis or acute prostatitis?

  • Are there any side effects from my treatment?

  • Will I get prostatitis again?

  • Is there anything I can do to avoid getting prostatitis again?

  • Will I be at higher risk of developing prostate cancer?

Citations

  • Treatment of Prostatitis by JJ Stevermer, M.D., M.S.P.H. and SK Easley, M.D.( 05/15/00, http://www.aafp.org/afp/20000515/3015.html)