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Prostatitis(Prostadynia)
Definition

Prostatitis is swelling of the prostate gland. The prostate is a walnut-sized gland in men that surrounds the urethra. It produces a fluid that is part of semen.

Anatomy of the Prostate Gland


Copyright © Nucleus Medical Media, Inc.

There are four types of prostatitis:

  • Acute bacterial prostatitis
  • Chronic bacterial prostatitis
  • Chronic pelvic pain syndrome
  • Asymptomatic inflammatory prostatitis
Causes

Acute and chronic bacterial prostatitis are caused by an infection. A bacteria enters the prostate—usually from the urinary tract or rectum.

The causes of chronic pelvic pain syndrome and asymptomatic inflammatory prostatitis are not clearly understood. In some people, it is possible that a cause may not be found.

Risk Factors

Prostatitis is most common in men who use catheters. Other factors that may increase your risk of prostatitis include:

  • Unprotected sex
  • Phimosis—inability of the foreskin to fully retract over the head of the penis
  • Narrowing of the urethra, the tube that carries urine from the bladder to the outside of the body
  • Enlarged prostate
  • History of urinary tract infections
Symptoms

Symptoms depend on the category of prostatitis syndrome. In many people, symptoms may not appear. In others, they may appear as another condition.

Symptoms may include:

  • Needing to urinate frequently and/or urgently
  • Pain or burning while urinating
  • Difficulty urinating
  • Lower abdominal pain or pressure
  • Penile, rectal, or perineal discomfort
  • Lower back pain
  • Fever or chills
  • Difficulty getting an erection
Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. A digital rectal exam may be done as part of the physical exam.

Your bodily fluids and tissues may be tested. This can be done with:

  • Urine tests
  • Prostate massage
  • Prostate biopsy
Treatment

Treatment depends on the type of prostatitis:

Infectious Prostatitis

Acute and chronic bacterial prostatitis are treated with oral antibiotics. Antibiotics may be given over 4-12 weeks. The antibiotics may be given through an IV for severe infections.

Other medications to help manage symptoms include:

  • Stool softeners
  • Anti-inflammatory medications
  • Pain medication
  • Alpha-blockers or 5-alpha reductase inhibitors to help with urine flow

Your doctor may recommend that you avoid alcohol and caffeinated beverages.

Noninfectious Prostatitis

Antibiotics may be recommended if an infection is possible. Other treatments to manage symptoms include:

  • Alpha-blockers or 5-alpha reductase inhibitors
  • Anti-inflammatory medications such as ibuprofen
  • Pain medication
  • Warm sitz baths
  • Repeated prostate massages
Prevention

You may be able to prevent prostatitis if you:

  • Practice safe sex. Protect yourself from sexually transmitted diseases (STDs) by using condoms.
  • Emptying your bladder regularly and as soon as you feel the urge

RESOURCES:

Prostatitis Foundation
http://www.prostatitis.org

Urology Care Foundation
http://www.urologyhealth.org

CANADIAN RESOURCES:

Canadian Urological Association
http://www.cua.org

Men's Health Centre
http://www.menshealthcentre.net

References:

Acute prostatitis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated May 17, 2013. Accessed March 3, 2014.

Propert KJ, McNaughton-Collins M, et al. A prospective study of symptoms and quality of life in men with chronic prostatitis/chronic pelvic pain syndrome: The National Institutes of Health Chronic Prostatitis Cohort Study. J Urol. 2006;175:619-623.

Prostatitis. National Kidney and Urologic Diseases Information Clearinghouse website. Available at: http://kidney.niddk.nih.gov/KUDiseases/pubs/prostatitis/index.aspx. Updated June 29, 2012. Accessed March 3, 2014.

Prostatitis (prostate infection). Urology Care Foundation website. Available at: http://www.urologyhealth.org/urology/index.cfm?article=15. Updated 2013. Accessed March 3, 2014.

Sharp VJ, Takacs EB, et al. Prostatitis: diagnosis and treatment. Am Fam Physician. 2010 Aug 15;82(4):397-406.



Last reviewed March 2014 by Adrienne Carmack, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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