A prostate infection (prostatitis) occurs when your prostate and the surrounding area become inflamed. The prostate is about the size of a walnut. It’s located between the bladder and the base of the penis. The tube that moves urine from the bladder to the penis (urethra) runs through the center of your prostate. The urethra also moves semen from the sex glands to the penis.
Several types of infections can affect the prostate. Some men with prostatitis experience no symptoms at all, while others report many, including intense pain.
There are four types of prostatitis:
Acute bacterial prostatitis: This type is the least common and lasts a short time. It can also be life-threatening if left untreated. This is the easiest type of prostatitis to diagnose.
Chronic prostatitis, or chronic pelvic pain syndrome: This condition causes pain and discomfort around the groin and pelvic area. It can affect men of all ages.
Asymptomatic inflammatory prostatitis: The prostate is inflamed but there are no symptoms. It’s usually discovered when a doctor is diagnosing another problem.
The cause of prostate infection isn’t always clear. For chronic prostatitis, the exact cause is unknown. Researchers believe:
- a microorganism can cause chronic prostatitis
- your immune system is responding to a previous UTI
- your immune system is reacting to nerve damage in the area
For acute and chronic bacterial prostatitis, bacterial infections are the cause. Sometimes, bacteria can get into the prostate through the urethra.
You are at increased risk of prostate infection if you use a catheter or have a medical procedure involving the urethra. Other risk factors include:
Symptoms of a prostate infection vary depending on the type.
Acute bacterial prostatitis
Symptoms of an acute bacterial prostatitis are serious and happen suddenly. Seek immediate medical attention if you experience:
- burning or pain during urination
- nausea and vomiting
- body aches
- inability to empty your bladder
- fever and chills
- pain in your abdomen or lower back
You should notify your doctor if any of the following symptoms last longer than a few days:
- experience trouble urinating, whether starting or having a weak stream
- think you have a UTI
- have the need to urinate frequently
- experience nocturia, or the need to urinate two or three times during the night
Chronic bacterial prostatitis
Symptoms of a chronic infection, which may come and go, aren’t as severe as an acute infection. These symptoms develop slowly or remain mild. Symptoms can last more than three months, and include:
- burning while urinating
- frequent or urgent urination
- pain around the groin, lower abdomen, or lower back
- bladder pain
- testicle or penis pain
- trouble starting a stream of urine or having a weak stream
- painful ejaculation
The symptoms of chronic prostatitis are similar to the symptoms experienced with chronic bacterial prostatitis. You may also experience feelings of discomfort or pain for three or more months:
- between your scrotum and anus
- central lower abdomen
- around your penis, scrotum, or lower back
- during or after ejaculation
See a doctor if you have pelvic pain, painful urination, or painful ejaculation.
A prostate infection diagnosis is based on your medical history, a physical exam, and medical tests. Your doctor can also rule out other serious conditions such as prostate cancer during the exam. During a physical exam, your doctor will conduct a digital rectal exam to test your prostate and will look for:
- enlarged or tender lymph nodes in the groin
- swollen or tender scrotum
Your doctor may also ask about your symptoms, recent UTIs, and medications or supplements you’re taking. Other medical tests that can help your diagnosis and treatment plan include:
- urinalysis or semen analysis, to look for infections
- a prostate biopsy or a blood test for prostate-specific antigen (PSA)
- urodynamic tests, to see how your bladder and urethra store urine
- cystoscopy, to look inside the urethra and bladder for blockage
Your doctor may also order an ultrasound to get a closer look. The cause will help determine the correct course of treatment.
During treatment, your doctor may recommend you increase your liquid intake to help flush out bacteria. You may find it beneficial to avoid alcohol, caffeine, and acidic or spicy foods.
For bacterial prostatitis, you will take antibiotics or antimicrobials for six to eight weeks. If you have a severe acute infection, you may need hospitalization. During this time, you’ll receive fluids and antibiotics intravenously.
A chronic bacterial infection requires at least six months of antibiotics. This is to prevent recurring infections. Your doctor may also prescribe alpha-blockers to help your bladder muscles relax and lessen symptoms.
You may need surgery if there’s a blockage in the bladder or some other anatomic problem. Surgery can help improve urine flow and urinary retention by removing scar tissue.
Treatment for chronic prostatitis depends on your symptoms. Your doctor will provide antibiotics in the beginning to rule out a bacterial infection. Other medications to help ease discomfort and pain include:
- silodosin (Rapaflo)
- nonsteroidal anti-inflammatory drugs (NSAIDS) like ibuprofen and aspirin
- glycosaminoglycan (chondroitin sulfate)
- muscle relaxants such as cyclobenzaprine and clonazepam
Some people may find benefits from:
- warm baths or prostatic massage
- heat therapy from hot water bottles or heating pads
- Kegel exercises, to help train the bladder
- myofascial release, to help relax soft tissues in the lower back
- relaxation exercises
Always talk to your doctor before trying complementary or alternative medicine. Treatments like supplements and herbs may interact with medications you’re already taking.
It’s important to take all the medication your doctor prescribes to eliminate the bacteria. But bacterial prostatitis may recur, even with antibiotics. This may be because the antibiotics aren’t effective or don’t destroy all the bacteria.
You may need to take medications for a longer period or try different ones. Ask your doctor to refer you to a specialist, like a urologist, if you have recurring prostatitis. They can test to determine the specific bacteria causing the infection. To gather this information, your doctor will remove fluid from your prostate. After identifying the bacteria, your doctor may prescribe different medications.
In the case of an infection, bacterial prostatitis will clear up with proper treatment. Chronic prostatitis may require several different treatments.
Complications of acute prostatitis include:
- bacteria in the bloodstream
- formation of abscess
- inability to urinate
- death, in extreme cases
Complications of chronic prostatitis may include:
- difficulty urinating
- sexual dysfunction
- chronic pelvic pain
- chronic pain with urination
It’s possible to have elevated PSA levels with a prostate infection. Levels typically return to a normal range within one to three months. Follow up with your doctor after completing treatment. If your levels don't decrease, your doctor may recommend a longer course of antibiotics or a prostate biopsy to look for prostate cancer.
Prostate infections, even chronic ones, have nothing to do with prostate cancer. Nor do they increase your risk for prostate cancer. A prostate infection is also not contagious or caused by your partner. You can continue to have sexual relations as long as you’re not experiencing discomfort.
Talk to your doctor if you're experiencing symptoms of a prostate infection. These may include discomfort when urinating or pain around the groin or lower back. It’s best to get an early diagnosis so you can start treatment. In some cases, such as an acute bacterial prostatitis, early treatment is important for your outlook.
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