Prostatitis

Prostatitis is an inflammation of the prostate gland. It's one of the most common urological conditions, accounting for around 25% of all urology consultations in the UK. Prostatitis occurs in three main forms:

  • Acute bacterial prostatitis. Often due to bacteria infecting the urinary tract.
  • Chronic bacterial prostatitis. This happens when bacteria persist in the prostate gland, causing recurring episodes of infection, often with symptomless periods in between.
  • Chronic abacterial prostatitis. Shows no sign of bacteria in the prostate and no recurring urinary tract infections. The cause of prostate inflammation in this case is unknown.

Please note: the information below doesn't constitute medical advice. If you have any concerns at all about prostatitis symptoms, speak to your GP.

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Prostatitis symptoms

Prostatitis can be a long-term condition or patients may experience symptoms for only a short time. Doctors will look for the following signs and symptoms:

  • Pain or discomfort between the scrotum and anus.
  • Pain in the lower back, penis, testicles, rectum or inner thighs.
  • Lower urinary tract symptoms, such as a burning sensation when passing urine or a frequent need to urinate.
  • Discomfort during or after ejaculation.
  • Fever if the prostatitis is due to an acute bacterial infection.

Prostatitis diagnosis

First, a doctor will discuss any possible symptoms with you. Following that, you may need an external check of the abdomen, perineum and genitals, as well as a digital rectal examination.

With acute prostatitis the prostate gland will be tender and have a spongy consistency. Your doctor may also carry out tests to exclude benign prostatic hyperplasia (BPH) and prostate cancer. With severe inflammation your prostate-specific antigen (PSA) level may be increased, and therefore may not indicate prostate cancer.

You may need to produce a urine sample. You will then have your prostate massaged so that secretions are released, a procedure similar to a digital rectal examination.

The secretions will be collected from the end of your penis.

There is no specific technique to diagnose chronic abacterial prostatitis. Often the diagnosis comes from the history and exclusion of the tests above. Occasionally other tests such as uroflowmetry, urodynamics or cystoscopy are used.

Prostatitis treatment

Bacterial prostatitis usually means taking a course of antibiotics for 4-6 weeks. It is important that you complete the course.

If bacteria are not present, an anti-inflammatory drug may help as well as a prostatic massage.

Occasionally an abscess forms. This is a 'walled off' area of pus that antibiotics have difficulty in penetrating. Therefore a small operation may be necessary to drain this collection.

Need more information?

Your local GP surgery is the best place to find information on prostatitis, especially if you are concerned about symptoms and treatment.

Another useful resource is the Your Prostate website (www.yourprostate.eu) from the European Men's Health Forum. You can send an email - anonymously if you prefer - and a urologist or prostate nurse will get back to you with free advice.

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