The term prostatitis is used to describe conditions that cause inflammation or infection in the prostate, a small gland located directly below the bladder in men.
Prostatitis may have either a bacterial or nonbacterial cause. The types of prostatitis are:
- chronic bacterial prostatitis
- acute bacterial prostatitis
- chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) with inflammatory CPPS
- chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) with noninflammatory CPPS
- asymptomatic inflammatory prostatitis
Asymptomatic inflammatory prostatitis doesn’t cause any symptoms, but the inflammation is revealed during exams such as a biopsy.
However, the other types of prostatitis may result in swelling and frequent urinary tract infections (UTIs).
Before a doctor diagnoses someone with chronic bacterial prostatitis, they will first have to rule out the other types of prostatitis.
Even if chronic bacterial prostatitis is treated, bacteria may still survive in the prostate, and symptoms often return. Prolonged use of antibiotics is often necessary to effectively treat this condition.
Bacterial infections in the prostate can be very painful.
The symptoms begin slowly and last 3 months or longer. Seek medical attention if you have any of the following symptoms:
- blood in the urine or semen
- foul-smelling urine
- pain or burning with urination
- pain with ejaculation
- pain with bowel movements
- pain in the following locations:
Serious complications can arise if an infection isn’t properly treated. Complications include:
A bacterial infection causes chronic bacterial prostatitis. Even when the primary symptoms of infection have been treated, bacteria may continue to thrive in the prostate.
Causes of infection include:
- any bacteria that causes a UTI
- sexually transmitted infections (STIs), such as chlamydia and gonorrhea
- E. coli after having an infection of the testicles, urethritis (inflammation of the urethra), or a UTI
Certain factors put people at risk for developing this condition, such as:
Your doctor will also perform a digital rectal exam (DRE) to examine the prostate. During this test, they will insert a lubricated and gloved finger into your rectum to look for signs of infection, such as a soft or enlarged prostate.
Your doctor may also use the following tests and techniques:
Antibiotics are the main course of treatment for this condition. They’re usually taken for 4 to 12 weeks. For many people, treatment will last for 6 weeks.
First-line treatment is typically a fluoroquinolone antibiotic, such as ciprofloxacin (Cipro), ofloxacin, or levofloxacin.
However, fluoroquinolones can increase your risk for a ruptured Achilles tendon, which is why they are no longer considered a preferred treatment.
Other commonly prescribed antibiotics include:
- sulfamethoxazole/trimethoprim (Bactrim), another first-line treatment
- tetracycline antibiotics, such as doxycycline or azithromycin (Zithromax)
Tetracyclines are commonly used in cases where a doctor identifies or suspects chlamydia or mycoplasma genitalium. Like chlamydia, mycoplasma genitalium is an STI.
The antibiotic that you’re prescribed will ultimately depend on which bacterium is causing your prostatitis.
Your doctor will schedule a follow-up exam once you’ve finished treatment to ensure that the infection is completely gone. It may take 6 months to 1 year for symptoms to go away completely.
Treatments for symptom relief
The preferred treatment regimen for chronic bacterial prostatitis is a combination of antibiotics and anti-inflammatory medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs).
Although NSAIDs can provide relief from the pain of prostatitis, they’re primarily used to reduce inflammation.
Other medications you may receive are:
- stool softeners to avoid constipation
- alpha-blocker medications, such as tamsulosin (Flomax), to help treat urinary retention
Certain home remedies may be able to ease your symptoms too. Home remedies include:
- warm baths
- drinking 64 to 128 ounces of water per day
- avoiding alcohol, caffeine, citrus juices, and hot and spicy food
You may need additional treatment in the following rare cases:
- If you’re unable to urinate, a healthcare professional will insert a Foley catheter into your bladder to help empty it.
- If you have an abscess, your doctor will drain it.
- If you develop sepsis, you’ll get intensive antibiotic therapy, and you’ll need to stay in the hospital for treatment.
- If you have stones, or mineral deposits, in your prostate, your doctor may need to remove your prostate. This is very rare.
This condition is very treatable. However, it’s very common for the infection to come back.
Make sure to schedule follow-up appointments with your doctor, so that they can make sure your treatments are effective.