Prostatitis

The prostate is a small gland found in men. It's about the size of a walnut, lies just below your bladder and surrounds the tube (urethra) that drains urine (pee) from your bladder. Its job is to secrete a milky fluid, which becomes part of the semen and nourishes the sperm.

There are 2 types of prostatitis:

• Chronic prostatitis – this is the most common type of prostatitis and symptoms come and go and last more than 3 months. 
• Acute prostatitis – this is less common, but symptoms can be more serious, come on suddenly and last for a shorter time.  

Chronic prostatitis

The cause of chronic prostatitis is usually not known. However, it can be caused by a previous or current infection that has spread from your urinary tract or other parts of your body. Or it can become inflamed without any infection. Sometimes, the infection can be caused by a bladder obstruction such as bladder stones, prostate stones or prostate enlargement, which can be the focus for bacteria in the urinary tract.  

Acute prostatitis

Acute prostatitis is usually caused by a bacteria from your urinary tract. Your urinary tract is made up of your bladder, kidneys, ureters (the tubes that connect your kidneys and your bladder) and urethra (a tube that runs through the centre of your prostate from your bladder to your penis, letting urine flow out of your body). You may or may not have an urinary tract infection at the same time.

Acute prostatitis can also be caused by less common causes, such as:

• after prostate surgery or biopsy – damage to your prostate can make it more likely to get an infection
• after a procedure that involves inserting a tube (catheter) into your urinary tract to drain urine or for investigations of nearby organs such as your bladder or prostate gland
• an infection that spreads from other parts of your body. 

Risk factors that can increase your risk of getting prostatitis include:

• a recent urinary tract infection (UTI), sexually transmitted infection (STI), HIV or AIDS
• a urinary catheter has been inserted to drain urine from your bladder
• a prostate biopsy or other procedures that involve your prostate
• a problem with your urinary tract, eg, bladder or prostate stones that cause bladder obstruction
• an injury to your pelvis
• anal sex
• older age – men aged above 50 are more likely to get chronic prostatitis than men aged below 40
• having had prostatitis before
• other gut conditions such as irritable bowel syndrome 
• having been sexually abused. 

Chronic prostatitis

Symptoms of chronic prostatitis usually develop slowly and last at least 3 months.

Common symptoms include:

• pain in and around your penis, testicles, anus, lower tummy and lower back
• painful urination (peeing)
• having to go toilet more frequently in the day and more than once at night
• having a sense of urgency to go to the toilet 
• difficulty starting and stopping urination (peeing)
• sexual problems such as erectile dysfunction, pain when ejaculating (coming) or pelvic pain after sex. 

See your GP or doctor if you have any symptoms of chronic prostatitis.  

Acute prostatitis

Symptoms of acute prostatitis come on suddenly and are more serious. However, the symptoms last for a shorter period of time. Symptoms can include:

• severe pain in or around your penis, testicles, anus, lower tummy or lower back
• painful urination (peeing)
• pus or discharge coming out from your urethra
• pain when you pass motions or stools (poos)
• having to go to the toilet more frequently in the day, and more than once at night
• difficulty starting or stopping urination
• blood in your urine (pee)
• having a sense of urgency to go to the toilet
• unable to urinate (pee), causing urinary retention (which needs urgent medical help)
• fever or a high temperature
• feeling unwell generally
• aches and pain all over your body
• lower back pain 
• pain when ejaculating (coming). 

It's not easy to diagnose prostatitis, because the symptoms can be vague. Your doctor will ask you questions about your symptoms and examine your prostate. They will usually perform an examination called a digital rectal examination (DRE) which involves inserting a finger with a glove into your anus to feel your prostate through the wall of your rectum. They will check if your prostate is hard or soft, as well as the size and shape of your prostate.

Your GP or doctor may also order some of the following tests to find out the cause of your prostatitis or rule out other conditions:

• Prostate specific antigen (PSA) blood test – PSA is a protein made by your prostate. Higher than normal levels can occur when there is a problem with your prostate, such as an infection, an enlarged prostate or prostate cancer.
• Blood culture – a blood test to check for presence of infection in your body. 
• A urine test – this is done to check for bacterial infection or sexually transmitted infection. 

Treatment of prostatitis depends on the cause, eg, acute prostatitis caused by a bacterial infection is treated with antibiotics. You may need hospital admission if you are very ill with acute prostatitis. 

If there isn't a clear underlying cause, eg, in chronic prostatitis, treatment aims to relieve your symptoms. Medicines that may be prescribed include:

• pain relief medicines such as paracetamol and NSAIDs
• alpha blockers such as doxazosin that can help relax muscles in your prostate and base of your bladder, which relieves pain. 

Talk to your healthcare provider to find out the best treatment options for you. 

There are things you can do to help relieve symptoms of prostatitis. These include:

• getting hot baths
• avoiding caffeine, alcohol and spicy food 
• avoiding hard bowel motions (poos) and constipation as it can put pressure on your prostate and cause more pain. Read more about how to prevent constipation.