Prostatitis is inflammation of the prostate, which can be acute or chronic. Chronic prostatitis can be triggered by a bacterial infection, but in many cases, the cause is unknown.
Prostatitis is considered chronic if the prostate inflammation lasts at least
The prostate is a small gland located below the male bladder. It surrounds the urethra, produces a small amount of seminal fluid, and is important for the pH balance of semen.
Prostatitis may be caused by a bacterial infection, but there isn’t always an identifiable cause. It can produce uncomfortable symptoms such as burning during urination, a frequent need to urinate, and pain in the lower back. It can also trigger inflammation in the pelvis.
When a bacterial infection is a cause, it can be treated with antibiotics. When the cause is unknown, treating the symptoms may be the best course of action.
Even when the condition can’t be cured, males who receive treatment for chronic prostatitis can usually find relief from their symptoms.
[the terms “male” and “female”]
In this article, we use “male and female” to refer to someone’s sex as determined by their chromosomes and “men and women” when referring to their gender (unless quoting from sources using nonspecific language).
Sex is determined by chromosomes, and gender is a social construct that can vary between periods and cultures. Both of these aspects are acknowledged to exist on a spectrum both historically and by modern scientific consensus.
There are three types of chronic prostatitis:
Chronic bacterial prostatitis
A bacterial bladder or prostate infection can lead to chronic prostatitis. This prostatitis can affect males of any age but is seen more often in younger and older adult males. About
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)
With chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), inflammation develops in the pelvic area, causing chronic pain.
CP/CPPS is the more common type of chronic prostatitis. Research shows CP/CPPS cases make up at least
Asymptomatic inflammatory prostatitis
This is a type of chronic prostatitis that has no symptoms. It’s usually discovered while undergoing other tests. It usually
Both types of chronic prostatitis have multiple possible causes.
Chronic bacterial prostatitis
Chronic bacterial prostatitis is
A bacterial infection can also be caused by an infection originating in the bladder or a urinary catheter containing bacteria that is inserted into the bladder. A urinary catheter is a small, flexible tube placed in the body to collect and drain urine from the bladder.
Some bacterial infections contribute to the formation of prostate stones that aren’t expelled during urination.
Prostate stones are about the size of a poppy seed and aren’t always detectable in a physical examination. Infected prostate stones are a common cause of recurring urinary tract infections (UTIs) and make curing chronic bacterial prostatitis very difficult.
The direct cause of CP/CPPS is likely abnormal functioning of the nerves and muscles in the pelvic area or an immune system attack on the prostate.
Research suggests different potential triggers, one of which can be an infection in the bladder or prostate.
However, CP/CPPS was previously called chronic nonbacterial prostatitis because markers of an infection are not always present. The pain becomes chronic and continues after the infection is treated and resolved.
Asymptomatic inflammatory prostatitis
Since asymptomatic inflammatory prostatitis doesn’t cause symptoms and is only evident in the results of laboratory tests, it is difficult to determine a cause.
If CP/CPPS is triggered by a bacterial infection, the symptoms can begin
- a constant urge to urinate
- burning pain when urinating
- difficulty starting urination, followed by an uneven flow
- blood in the urine
- feeling as if the bladder isn’t fully emptied after urination
- painful ejaculation
In addition, in CP/CPPS you can then develop chronic pain in the following areas:
- lower back
- lower abdomen
- above the pubic area
- between the testicles and anus
Bacterial prostatitis may also be accompanied by fever or chills.
Conditions with similar symptoms
Conditions that can cause some of the same symptoms as chronic prostatitis include:
- prostate cancer, which can lead to urinary symptoms or sexual dysfunction
- urinary retention
- bladder stones, which can lead to urinary symptoms or pain in the lower abdomen
- benign prostatic hyperplasia (BPH), or enlarged prostate
Musculoskeletal pain and constipation are also possible.
Seek medical attention if you have any of these symptoms. Your doctor can rule out serious conditions or help you get started on appropriate therapy if necessary.
To diagnose your condition, your doctor will begin by surveying your symptoms and medical history. They
Depending on the results of your initial workup, your doctor may perform the following:
Digital rectal exam (DRE)
During a DRE, or prostate exam, the doctor inserts a gloved and lubricated finger into the rectum to feel the prostate. This can help them determine if the prostate is tender or enlarged.
A DRE may cause temporary pain or discomfort in men with prostatitis.
In some cases, a pelvic MRI may be used. An MRI can help your doctor:
- view your pelvic anatomy in great detail
- rule out prostate cancer as the cause of your symptoms
- detect areas of prostate inflammation
Once a diagnosis of chronic prostatitis is confirmed, your doctor will want to do further tests to determine the type and the cause, if possible.
A test of your urine can help your doctor diagnose chronic bacterial prostatitis.
The presence of bacteria is considered conclusive. However, if no bacteria are present in your urine, you may still have CP/CPPS.
Your doctor may then wish to perform further tests to look for a cause, or they may refer you to a doctor who specializes in diseases of the urinary tract.
Further tests may include:
- the examination of fluid excreted by the prostate
- a blood test
- cystoscopy, or the insertion of a small camera into the urethra for examination of the bladder, prostate, and urethra
Treatment for chronic bacterial prostatitis will depend on the type of infection you’re diagnosed with.
A long-term course of fluoroquinolones, a class of antibiotics, is usually the first treatment.
You may be required to take antibiotics for 4 to 12 weeks. About 75% of chronic bacterial prostatitis cases clear up with antibiotic treatment.
In most cases of CP/CPPS, the cause of the condition is unknown. This means that treatment typically involves using medications to reduce or eliminate symptoms, reduce inflammation, or relieve certain urinary symptoms.
- alpha-blockers such as tamsulosin (Flomax)
- muscle relaxers such as nonsteroidal anti-inflammatory drugs (NSAIDs)
- pain relievers
- anti-anxiety medications
Alternative and natural remedies that
- warm baths
- relaxation exercises
- kegel exercises
- using a cushion or pillow when sitting for long periods
- massage therapy
- avoiding spicy foods, caffeine, and alcohol that can irritate the bladder
- biofeedback, a relaxation technique
In some cases, prostatic massage can help drain fluid causing inflammation.
Bacterial forms of chronic prostatitis can be prevented with good hygiene. When the penis is kept clean, the risk of bacteria entering the urethra is lower. Learn more about penis health.
You can also prevent chronic bacterial prostatitis by drinking plenty of fluids to encourage regular urination and treating urinary tract or bladder infections as soon as they arise.
Chronic prostatitis can be an ongoing, painful condition. Depending on the cause, it may not be curable, but there are ways to manage the symptoms. Unless you experience discomfort, you can also continue having sexual intercourse.
In addition, according to the American Urological Association, having prostatitis does not increase your risk of prostate cancer.
While you’re in the process of getting a diagnosis or during treatment, you may experience anxiety or depression triggered by your symptoms. Talk with your doctor about treatments to improve your mental health. You can consider trying anxiety medication and antidepressants.
Joining a support group, getting private counseling, or participating in behavioral therapy can help you cope with the condition.