The prostate is a gland located at the base of a man's bladder. It surrounds the tube that drains urine and semen to outside of the body. Prostatitis occurs when the prostate gland is inflamed. This inflammation can often lead to swelling, pain and other symptoms. The inflammation can be acute (short-term) or chronic (long-term). Sometimes it causes no symptoms at all. There are four types of prostatitis:
- Chronic nonbacterial prostatitis (also called chronic pelvic pain syndrome)
- Acute bacterial prostatitis
- Chronic bacterial prostatitis
- Asymptomatic inflammatory prostatitis
There are many causes of prostatitis, but the cause may not always be determined.
- The most common type of prostatitis is chronic nonbacterial prostatitis. This type is not caused by a bacterial infection, but may be caused by irritating urine backing up into the prostate. It can also be caused by activities that can irritate the prostate (such as jogging and biking) or an infection somewhere else in the body. Symptoms include pain in the pelvis and groin, difficulty urinating and painful ejaculation. Often the cause of this form of prostatitis is not clear.
- Acute and chronic bacterial prostatitis may be caused by medical procedures that involve the urinary system. They can also be caused by the same bacteria that cause urinary tract infections or sexually transmitted diseases. Symptoms of acute prostatitis usually come on suddenly and can include fever and chills, pain in the pelvis or lower back, painful ejaculation, blood-tinged semen, and pain and difficulty with urination. Symptoms of chronic bacterial prostatitis are similar but typically come on slower, are less severe and may come and go.
- The cause of asymptomatic inflammatory prostatitis is not well understood. It has no symptoms and is often diagnosed when a man is being evaluated for the cause of other conditions (such as infertility or a biopsy to evaluate an enlarged prostate or diagnose prostate cancer).
You should contact your healthcare provider if you have symptoms of prostatitis. He or she will ask questions about your medical history and do a physical examination, which will include a prostate examination (digital rectal examination). During a digital rectal examination (DRE), a gloved, lubricated finger will be inserted into your rectum to feel your prostate gland.
- Your healthcare provider may also massage the prostate to get a sample of prostatic fluid for examination.
- A urine sample may be taken to check for bacteria and white blood cells.
- To help determine the severity of your symptoms, you may be asked to fill out a questionnaire called the Chronic Prostatitis Symptom Index from the National Institutes of Health. The index may be used to determine treatment effectiveness.
If you have prostatitis, treatment usually starts with antibiotics. Your healthcare provider may also prescribe a medication to decrease pain with urination and an over-the-counter medication for fever or discomfort. The following may also help ease your symptoms:
- Drink an adequate amount of fluids; the amount may vary depending on your health status, size, activity level, environment and dietary patterns. Ask your healthcare provider how much is right for you.
- Empty your bladder at regular intervals.
- Avoid foods and beverages that irritate your bladder (such as spicy foods, chocolate, coffee, tea, cola and alcohol).
- Avoid bicycling.
- Sit on a pillow or an inflatable cushion.
- Sit in a warm bath.
Asymptomatic inflammatory prostatitis does not usually require treatment.
Make an appointment with your healthcare provider if you have symptoms of prostatitis.
- Bring a copy of your medical history (past illnesses, surgeries, and hospitalizations).
- Make a list of your medications (including over-the-counter).
- Write down any questions, symptoms or concerns you want to talk about.
Here are some questions to ask your healthcare provider.
- What type of prostatitis do I have? What treatment are you recommending? Are there any alternatives?
- Is there anything I can do to help my symptoms?
- If medication is recommended, what are the possible side effects? How long will I need to take medication?
- When might I start to see improvement in my symptoms?
- What tests do I need? What is the reason for those tests? Will the test results change my treatment plan?
- What are my follow-up plans and what symptoms should I report before my next appointment?
Make sure you understand your treatment plan, any possible alternatives and what medications are recommended (including possible side effects).