Introduction 

Prostatitis is the inflammation (swelling) of the prostate gland. It can be very painful and distressing, but will usually get better eventually.

The prostate is a small gland found in men that lies between the penis and the bladder. It produces a thick white fluid that's mixed with sperm to create semen.

Unlike other prostate conditions such as prostate enlargement or prostate cancer, which usually affect older men, prostatitis can develop in men of all ages.

Signs and symptoms

Symptoms of prostatitis can include:

  • pain in the pelvis, genitals, lower back and buttocks
  • pain when urinating
  • a frequent need to pee
  • difficulty urinating, such as problems starting or "stop-start" peeing
  • pain when ejaculating, which may contribute to erectile dysfunction or loss of libido (sex drive)

Sometimes you may also experience tiredness, aching joints and muscles, chills, and a high temperature (fever) of 38C (100.4F) or above.

These symptoms usually develop gradually and come and go over several months, but they can sometimes start suddenly.

When to seek medical advice

See your GP if you have symptoms of prostatitis. Your GP will ask about the problems you're having and may examine your tummy. It's likely you'll also need a rectal examination, where they insert a finger into your bottom to feel if the prostate is swollen.

Your urine will usually be tested for signs of infection, and you may be referred to a specialist for further tests to rule out other conditions.

See your GP immediately if you develop sudden and severe symptoms of prostatitis. You may have acute prostatitis, which needs to be assessed and treated promptly because it can cause serious problems, such as suddenly not being able to pass urine (acute urinary retention).

What causes prostatitis?

There are two main types of prostatitis:

  • chronic prostatitis – the symptoms come and go over a period of several months; this is the most common type
  • acute prostatitis – the symptoms are severe and develop suddenly; this is rare, but can be serious and requires immediate treatment 

Acute prostatitis is usually caused by bacteria in the urinary tract (the kidneys, bladder, and the tubes that connect them) entering the prostate.

In chronic prostatitis, doctors can't usually find any infection in the prostate gland. The cause of symptoms in these cases is not clear.

Treating prostatitis

Treatment for chronic prostatitis usually aims to control the symptoms. Painkillers such as paracetamol or ibuprofen may help relieve your pain.

A medication called an alpha-blocker (such as tamsulosin) may also be prescribed if you have problems with urination, as these can help relax the muscles in the prostate gland and the base of the bladder.

Occasionally, a four- to six-week course of antibiotics (such as ciprofloxacin) may be prescribed even if no infection is found. This is to see if your condition improves.

For severe symptoms, the use of other painkillers, such as amitriptyline and gabapentin, may need to be considered. The aim is to reduce symptoms to a level where they interfere less with day-to-day activities, rather than getting rid of the pain completely. A referral to the local pain clinic may also be considered.

Acute prostatitis is usually treated with painkillers and a two- to four-week course of antibiotics. In some cases, you may need to be treated in hospital if you are very ill or are unable to pass urine (acute urinary retention).

Outlook

Chronic prostatitis can be challenging to treat, as little is known about the cause of the condition. Most men will gradually recover with treatment, but this can take several months or years.

Most men with acute prostatitis will make a full recovery within a few weeks, although around 1 in every 10 will go on to develop chronic prostatitis at some point in the future.

Some men with prostatitis find their symptoms return (relapse) later on, which will require further treatment.

Prostatitis is not cancer and there's currently no clear evidence that it increases your chances of developing prostate cancer.

Page last reviewed: 24/02/2015

Next review due: 24/02/2017