Sexual Health > Prostate Health > Prostate Health - Conditions

The Facts About Prostatitis

Prostatitis causes discomfort during urination and sex but it can be treated.

An blue pelvic area shows the prostate, testicles, and penis in red.

The prostate, a walnut-sized gland located below a man's bladder, produces some of the fluid contained in semen and is partially responsible for moving semen through the urethra during ejaculation. One common dysfunction of the prostate is prostatitis, or the inflammation and swelling of the prostate gland.

While prostatitis affects men in all age groups, it's more common in males age 50 and younger. Men with prostatitis may experience pain while urinating or ejaculating, along with flu-like symptoms and extreme tenderness in the groin area.

Prostatitis manifests in one of four types:

  • Acute bacterial prostatitis is a relatively rare form with rapid development. It may occur in conjunction with a urinary tract infection and sometimes leads to more frequent, urgent and/or painful urination. Antibiotics typically eliminate the problem in two to four weeks.
  • Asymptomatic inflammatory prostatitis may go unnoticed unless a doctor discovers it while testing for prostate health. Since this form presents no symptoms, treatment typically isn't needed.
  • Chronic bacterial prostatitis occurs repeatedly and more gradually than acute bacterial prostatitis. Antibiotics are effective in 60 to 80 percent of men with this form of prostatitis.
  • Chronic nonbacterial prostatitis is also referred to as chronic pelvic pain syndrome. This is the most common yet least understood form of prostatitis. Antibiotics, anti-inflammatory drugs, and alpha blockers are most often used for treatment.

Untreated prostatitis can lead to serious complications such as prostatic abscess (collections of pus that need to be drained), epididymitis (inflammation of a sperm-carrying coiled tube in the testicles), bacterium (bacterial infection of the blood), semen abnormalities and infertility.

Causes and risk factors of prostatitis

Prostatitis is often caused by an infection. (In some cases, the cause of the condition is unclear.) When caused by a bacterial infection, a full round of antibiotics usually solves the problem. If the root bacteria causing prostatitis is not treated, the infection can become difficult to treat, resulting in chronic bacterial prostatitis.

The root of the infection is commonly the leakage of infected urine into the prostate gland. Nerve damage inside the lower urinary tract, as a result of trauma or surgery, may trigger prostatitis.

Depending on its origin, prostatitis can develop rapidly or slowly. Improvement happens much the same way: The condition may clear up by itself, or may last for months and even return after subsiding.

Certain factors put men at higher risk of recurrent prostate infections, such as having unprotected sex or already having contracted a sexually transmitted infection (STI) or disease (STD). Nonbacterial prostatitis is more common among older men.

Once a man has contracted prostatitis, his chances of getting it again are higher. Pelvic trauma (sometimes caused by a bicycle or horseback riding accident) and bladder or urethral infections also increase the chances of getting prostatitis.

Symptoms

Symptoms of the condition vary by type of prostatitis, and men with asymptomatic inflammatory prostatitis do not show any symptoms.

The signs of prostatitis include pain or a burning sensation while ejaculating or urinating, as well as issues with the urination stream, such as hesitation, frequency and dribbling. Note the condition of urine, which might appear bloody or have traces of blood. Nocturia, which is excessive urination during the night, may also occur.

Prostatitis may cause men to experience pain in the groin, pelvic or genital area, and potentially the lower back and abdomen. With bacterial prostatitis, men may experience flu-like symptoms such as nausea, vomiting, chills and fever.

Diagnosing prostatitis

If you experience pelvic pain, difficulty urinating, painful urination or any of the other previously mentioned symptoms, you should see your doctor immediately.

Diagnosing prostatitis usually involves ruling out other conditions. Your doctor will start by going over your symptoms and conducting a physical exam. After that, you might be given a urine test to determine if there are any bacteria in your urine. The sample is sent to a lab for analysis, and those results typically take a few days to be completed. Additionally, you may have your blood tested for signs of infection.

Your doctor might also conduct a CT scan or sonogram of your prostate and urinary tract to provide detailed information about the infection.

Lastly, in rare cases in which the usual diagnostic tools are not enough, your doctor might give you a prostate massage to examine the secretions for signs of infection.

Treatment

Treatment for the condition depends on the type of prostatitis you have. The most common treatment used for prostatitis is antibiotics targeting a specific bacteria causing the infection. Usually, this means taking oral antibiotics for four to six weeks, but more severe cases can necessitate intravenous medicine. Further treatment might be needed if the condition is chronic or recurring.

If your condition is causing significant pain or discomfort, you might also be prescribed anti-inflammatory medication or alpha blockers to relieve painful urination. Some men take herbs and supplements to ease pain, but there is no significant evidence proving their effectiveness.

While medication is usually necessary to clear the bacteria, you can relieve some symptoms naturally by limiting alcohol and caffeine (both of which can irritate the bladder), avoid bicycling, soak in a warm bath, utilize a heating pad and drink plenty of water to flush bacteria.

Alternative therapies such as biofeedback and acupuncture show promise, but it's important to talk to your doctor before starting any treatment.

Preventing prostatitis

There is no way to completely prevent prostatitis, but there are ways to minimize risk. Good hygiene is a must. Keep your penis clean in order to prevent infection or bacterial growth. Drink a lot of water—many cases of prostatitis are caused by bacteria going from the urinary tract to the bladder and causing infection. Staying hydrated causes frequent urination, which can flush out the urethra, and hopefully the bacteria before it causes any unpleasant infections.

Regular exercise keeps your body healthy and ready to fight infection. Sitting for long periods of time can put pressure on your prostate gland, causing inflammation. If you are prone to prostatitis, choose activities such as walking or running rather than bicycling as frequent bike rides can lead to pelvic trauma.

Living with prostatitis

Men often believe they need to avoid sexual activity if they have prostatitis, but this isn't necessarily true. Prostatitis might make ejaculation painful and sex difficult to enjoy, but the act itself isn't likely to worsen the condition. It's also unlikely the bacterial infection will pass to a partner during sex.

Worth noting, studies have found any condition that affects the lower urinary tract, including prostatitis, can lead to sexual dysfunction.

Because prostatitis is so common, men should be aware of its symptoms and potential complications, along with their potential risk factors. If you feel pain during urination or ejaculation, it's time to see a doctor. Timely treatment prevents the infection from getting worse and improves successful outcomes.