What is Prostatitis?

The prostate is a walnut-sized gland that all men have. It’s found below your bladder and in front of your rectum. The job of the prostate is to make fluid that contains sperm (semen). This fluid protects the sperm when they travel toward a woman’s egg.

If your prostate becomes swollen, tender, and inflamed, you have a condition called “prostatitis.” This isn’t cancer, and it’s different from having an “enlarged prostate.”

Symptoms of Prostatitis

There are four types of prostatitis. Each has its own set of symptoms and causes. These include:

Acute bacterial prostatitis. Your urinary tract is made up of your kidneys, bladder, and the tubes that pass between them. If bacteria from here finds its way into your prostate, you can get an infection.

This type of prostatitis comes on quickly. You might suddenly have:

• Urgent need to pee but only a little comes out, or you have to get to the toilet quickly to prevent an accident
• High fever
• Chills
• Trouble peeing
• Pain around the base of your penis or behind your scrotum
• Cloudy urine

Acute bacterial prostatitis is a severe condition. If you notice these symptoms, seek medical care right away.

Chronic bacterial prostatitis. This is more common in older men. It’s a milder bacterial infection that can linger for several months. Some men get it after they’ve had a urinary tract infection (UTI) or acute bacterial prostatitis.

The symptoms of chronic bacterial prostatitis often come and go. This makes them easy to miss. With this condition, you might sometimes have:

• An urgent need to pee, often in the middle of the night
• Painful urination
• Pain after you ejaculate (release semen at orgasm)
• Lower back pain
• Rectum pain
• A “heavy” feeling behind your scrotum
• Blood in your semen
• Urinary blockage (difficulty peeing or a weak urine stream)

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). This is the most common type of prostatitis. It shares many of the same signs as bacterial prostatitis. The difference is that when tests are run, no bacteria are present with this type.

Doctors aren’t sure what causes CP/CPPS. Triggers include stress, nearby nerve damage, and physical injury. Chemicals in your urine or a UTI you had in the past may play a role. CP/CPPS has also been linked to immune disorders like chronic fatigue syndrome and irritable bowel syndrome (IBS).

The main symptom of CP/CPPS is pain that lasts more than 3 months in at least one of these body parts:

• Penis (often at the tip)
• Scrotum
• Between your scrotum and rectum (the perineum)
• Lower abdomen

You may also have pain when you pee or ejaculate. You might not be able to hold your urine, or you may have to pee more than 8 times a day. A weak urine stream is another common symptom of CP/CPPS.

Asymptomatic prostatitis. Men who have this type of prostatitis have an inflamed prostate but no symptoms. You may only learn you have it if your doctor does a blood test that checks your prostate health. Asymptomatic prostatitis doesn’t need any treatment, but it can lead to infertility.

Prostatitis Risk Factors

You’re more likely to have problems with your prostate if:

• You’ve had a UTI
• You’ve had a groin injury
• You use a urinary catheter
• You’ve had a prostate biopsy
• You have HIV/AIDS
• You have an enlarged prostate or voiding symptoms
• You’ve had prostatitis before

An inflamed or infected prostate gland is common in men of all ages.

Treatment for Prostatitis

If you have prostatitis, your doctor can help you find ways to manage your symptoms and control your pain. Treatments can include these medications:

• Antibiotics. If a bacterial infection is causing serious symptoms, your doctor may want you to go to the hospital and get antibiotics through an IV at first. Then, you may need to take them by mouth for up to a month. If your symptoms keep coming back, your doctor might suggest you stay on a low dose of antibiotics for the long term.
• Alpha-blockers. These drugs help relax parts of your urinary tract. They help reduce obstruction from an enlarged prostate, which can lead to UTIs and prostatitis.
• Nonsteroidal anti- inflammatory drugs. Over-the-counter pain relief can help ease any soreness and swelling.
• Pain medicine. Antidepressants or anti-seizure medications are just two types of medicine that can be used to treat long-term prostate pain.
• Supplements. Quercetin, a natural compound found in plants, has been shown to ease inflammation in some men who have prostatitis. A pollen extract called cernilton may also help. Talk to your doctor before trying any supplements or herbal remedies. They could make other medicines you’re taking not work as well.
• Medications that improve sexual function. It’s common for prostatitis to lead to problems with your sex life. If you have trouble getting or keeping an erection, your doctor can prescribe a medicine like sildenafil (Viagra) to help.

At some point, you may also need a different kind of treatment:

• Urinary catheter. If you can’t pee, a nurse can insert a flexible tube into your urethra (the tube that removes urine from your body) to drain your bladder.
• Prostate massage. This helps empty fluid from your prostate ducts (tubes). Having it done two to three times a week could help. Frequent ejaculation may help just as much.
• Physical therapy. Sometimes prostatitis is caused by a problem with your pelvic floor muscles. These support your bladder and bowel and help with sexual function. Your doctor may refer you to a physical therapist who can help you improve your strength and posture. They can also help you learn about habits you have that could be causing damage to your pelvic floor.
• Mental health therapy. Stress, depression, and feeling helpless may play a part in some types of prostatitis. Talk to a mental health counselor. They can help you learn to control your negative thoughts so you can feel better.

Lifestyle changes can make a difference, too. These options may help you start to feel better right away:

• Watch your diet. Spicy food, caffeine, and alcohol can all make your symptoms worse.
• Take “sitz baths.” Sitting in 2 to 3 inches of warm water can provide some relief from your symptoms.
• Protect yourself. If you must sit at a desk or in a chair for a long time, sit on a cushion.
• Be active when you can. Regular exercise may not only reduce your pain but also improve your outlook.

Researchers are also trying to better understand what causes prostatitis. This may lead to new treatments.

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