What is acute prostatitis?

Acute prostatitis happens when your prostate gland becomes suddenly inflamed. The prostate gland is a small, walnut-shaped organ located at the base of the bladder in men. It secretes fluid that nourishes your sperm. When you ejaculate, your prostate gland squeezes this fluid into your urethra. It makes up a large portion of your semen.

Acute prostatitis is usually caused by the same bacteria that cause urinary tract infections (UTIs) or sexually transmitted diseases (STDs). Bacteria can travel to your prostate from your blood. It can enter your prostate during or after a medical procedure, such as a biopsy. It can also be caused by infections in other parts of your genitourinary tract.

If you have acute prostatitis, you may develop:

  • chills
  • a fever
  • pelvic pain
  • painful urination
  • blood in your urine
  • foul-smelling urine
  • a decreased urinary stream
  • difficulty emptying your bladder
  • difficulty starting to urinate
  • increased frequency of urination
  • painful ejaculation
  • blood in your semen
  • discomfort during bowel movements
  • pain above your pubic bone
  • pain in your genitals, testicles, or rectum

Any bacteria that causes UTIs can cause prostatitis. Bacteria that commonly cause UTIs and prostatitis include:

  • Proteus species
  • Klebsiella species
  • Escherichia coli

Some bacteria that cause STDs, such as chlamydia and gonorrhea, can also cause acute bacterial prostatitis. Other conditions that can lead to acute bacterial prostatitis include:

  • urethritis, or inflammation of your urethra
  • epididymitis, or inflammation of your epididymis, which is the tube that connects your testicles and vas deferens
  • phimosis, which is the inability to pull back the foreskin of your penis
  • injury to your perineum, which is the area between your scrotum and rectum
  • bladder outlet obstruction, which can occur due to an enlarged prostate or stones in your bladder
  • urinary catheters or cystoscopy

Factors that increase your risk of UTIs, STDs, and urethritis also increase your risk of acute prostatitis. For example, these risk factors include:

  • not drinking enough fluids
  • using a urinary catheter
  • having multiple sexual partners
  • having unprotected vaginal or anal intercourse

Other risk factors include:

  • being over the age of 50
  • having a UTI
  • having a history of prostatitis
  • having certain genes that can make you more susceptible to prostatitis
  • having pelvic injuries from bike riding or horseback riding
  • having orchitis, or inflammation of your testicles
  • having HIV
  • having AIDS
  • being under psychological stress

Your doctor will likely start by asking questions about your medical history. They’ll also conduct a physical examination.

They’ll probably conduct a digital rectal examination (DRE). During this procedure, they’ll gently insert a gloved and lubricated finger into your rectum. Your prostate is located in front of your rectum, where your doctor can easily feel it. If you have acute bacterial prostatitis, it will likely be swollen and tender.

During a DRE, your doctor may also massage your prostate to squeeze a small amount of fluid into your urethra. They can collect a sample of this fluid for testing. Laboratory technicians can check it for signs of infection

Your doctor may also feel the lymph nodes in your groin, which may be enlarged and tender.

They may also conduct or order additional tests, such as:

  • a blood culture to rule out bacteria in your blood
  • a urinalysis or a urine culture to test your urine for blood, white cells, or bacteria
  • a urethral swab to test for gonorrhea or chlamydia
  • urodynamic tests to learn if you have problems emptying your bladder
  • a cystoscopy to examine the inside of your urethra and bladder for signs of infection

Your doctor will likely prescribe antibiotics for four to six weeks to treat acute bacterial prostatitis. Your treatment may last longer if you have recurrent episodes. The specific type of antibiotic will depend on the bacteria causing your condition.

Your doctor may also prescribe alpha-blockers to help relieve symptoms. These drugs relax your bladder muscles. They can help decrease urinary discomfort. Examples include doxazosin, terazosin, and tamsulosin. Your doctor may also recommend over-the-counter pain relievers, such as acetaminophen and ibuprofen.

Your doctor may advise you to adjust your daily habits to help relieve symptoms. For example, they may encourage you to:

  • avoid bicycling or wear padded shorts to decrease pressure on your prostate
  • avoid alcohol, caffeine, and foods that are spicy and acidic
  • sit on a pillow or donut cushion
  • take warm baths

Acute prostatitis usually goes away with antibiotics and lifestyle adjustments. In some cases, it may recur and become chronic prostatitis. Ask your doctor for more information about your specific condition, treatment options, and outlook. They may advise you to take certain steps to lower your risk of recurring infections.