2. Prostatitis is a disorder of the prostate gland
usually associated with inflammation.
Prostatitis often causes painful or difficult
urination, as well as pain in the groin, pelvic
area or genitals. Bacterial infections cause
some but not all cases of prostatitis.
The prostate gland, about the size of a
walnut, is located just below the bladder in
men. It surrounds the top portion of the
tube that drains urine from the bladder
(urethra). The prostate and other sex glands
produce the fluid that transports sperm
OVERVIEW
3. TYPES
Types of prostatitis include:
• Acute bacterial prostatitis (category 1): A UTI causes an infection in the prostate gland.
Symptoms include fever and chills. You may experience painful and frequent urination or have
trouble urinating. Acute bacterial prostatitis requires immediate medical treatment.
• Chronic bacterial prostatitis (category 2): Bacteria become trapped in the prostate gland,
causing recurrent UTIs that are difficult to treat.
• Chronic pelvic pain syndrome, or CPPS (category 3): CPPS is the most common
prostatitis type. Prostate gland inflammation occurs in approximately 1 out of 3 men. As the
name implies, this type causes chronic pain in the pelvis, perineum (the area between the
scrotum and rectum) and genitals.
4. • Asymptomatic inflammatory prostatitis (category 4): This condition causes
prostate gland inflammation but no symptoms. You may learn you have this condition
after getting tests to find the cause of other problems. For example, a semen analysis
for infertility may detect asymptomatic inflammatory prostatitis. This type doesn’t
need treatment.
5. CAUSE
Different types of prostatitis have different
causes. Risk factors for chronic pelvic pain
syndrome (CPPS), the most common type, aren’t
clear. Potential contributors to CPPS include:
• Autoimmune diseases.
• Pelvic floor muscle spasms.
• Stress.
Potential causes of bacterial forms of prostatitis
include:
• Bladder infections or bladder stones.
• Surgery or biopsy requiring use of a urinary
catheter.
• Prostate stones.
• Urinary retention (not emptying the bladder
6. RISK FACTORS
Risk factors for prostatitis include:
Young or middle-aged adulthood
Previous prostatitis
Infection of the urinary or reproductive system
HIV infection or AIDS
Use of a tube inserted into the urethra to drain the bladder (urinary
catheter)
Diagnostic sampling of prostate tissue (biopsy)
Additional risk factors for chronic prostatitis/chronic pelvic pain
syndrome may include:
Psychological stress
Nerve damage in the pelvic region due to surgery or trauma
7. SYMPTOMS
Signs and symptoms of prostatitis can vary depending on
the type of disorder. They may include:
Pain or burning sensation when urinating (dysuria)
Difficulty urinating, such as dribbling or hesitant urination
Frequent urination, particularly at night (nocturia)
Urgent need to urinate
Cloudy urine
Blood in the urine
Pain in the abdomen, groin or lower back
Pain in the area between the scrotum and rectum (perineum)
Pain or discomfort of the penis or testicles
Painful ejaculation
Fever, chills, muscle aches and other flu-like symptoms (with
acute bacterial prostatitis)
8. DIAGNOSIS
Less invasive tests for prostatitis may include:
Digital rectal exam: Your provider inserts a gloved, lubricated finger into the
rectum to check the prostate gland for pain and swelling. This exam may include
prostate massage to collect a sample of seminal fluid.
Urinalysis: A urinalysis and urine culture check for bacteria and UTIs.
Blood test: A blood test measures PSA, a protein made by the prostate gland.
High levels may indicate prostatitis, BPH or prostate cancer.
9. More invasive tests for prostatitis include:
Cystoscopy: A cystoscopy can look for other urinary tract problems but does not
diagnose prostatitis. Your provider uses a cystoscope (a pencil-sized lighted tube
with a camera or viewing lens on the end) to view inside the bladder and urethra.
Transrectal ultrasound: Men with acute bacterial prostatitis or chronic bacterial
prostatitis that doesn’t improve with antibiotics may get a transrectal ultrasound. A
slender ultrasound probe inserted into the rectum uses sound waves to produce
images of the prostate gland. This test can show prostate gland abnormalities,
abscesses or stones.
10. COMPLICATIONS
Complications of acute or chronic prostatitis can include:
Bacterial infection of the blood (bacteremia)
Inflammation of the coiled tube attached to the back of the testicle (epididymitis)
Pus-filled cavity in the prostate (prostatic abscess)
Infection that spreads to the upper pelvic bone or lower spine
Complications of chronic prostatitis/chronic pelvic pain syndrome may include:
Anxiety or depression
Sexual dysfunction, such as the inability to get and maintain an erection (erectile dysfunction)
Changes in sperm and semen that may cause infertility
11. TREATMENT
• Urinary: Medications, such as tamsulosin (Flomax®) and alfuzosin (Uroxatral®), relax
muscles around the prostate and bladder to improve urine flow.
• Psychosocial: Stress management can help. Some men benefit from counseling or
medications for anxiety, depression and catastrophizing (over-reaction to minor stresses
common in people with chronic pain).
• Organ: Quercetin and bee pollen supplements may relieve a swollen, inflamed prostate
gland.
• Infection: Antibiotics kill infection-causing bacteria.
• Neurologic: Prescription pain medicines, such as amitriptyline (Elavil®) and gabapentin
(Gralise®), relieve neurogenic pain. This pain can include fibromyalgia or pain that
extends into the legs, arms or back.
• Tenderness: Pelvic floor physical therapy may include myofascial release (gentle
