Prostatitis is an inflammation of the prostate gland that can affect men of all ages. The condition can cause pain and affect both the urinary tract and sexual function. Symptoms vary depending on the type of prostatitis; some forms are short-term and heal quickly with treatment, while others can become chronic and require longer-term management.
The four types of prostatitis
- Acute bacterial prostatitis: Caused by a bacterial infection that occurs suddenly. It is a serious form that requires rapid treatment with antibiotics.
- Chronic bacterial prostatitis: A long-term or recurring bacterial infection of the prostate. Symptoms are often less intense than in the acute form, but the infection can be difficult to completely get rid of.
- Chronic prostatitis / Chronic pelvic pain syndrome: By far the most common form of prostatitis. Bacteria are rarely found here. The exact cause is often unknown, but factors such as stress, muscle tension in the pelvic floor or previous infections may contribute.
- Asymptomatic inflammatory prostatitis: Does not cause any noticeable symptoms and is usually discovered by chance during an investigation for other conditions or through tests.
Symptoms
Symptoms vary depending on the cause and type of inflammation, but common signs include:
- Pain or discomfort in the lower abdomen, groin, scrotum or lower back.
- Burning pain when urinating, frequent urination or difficulty emptying the bladder.
- Pain during ejaculation or other sexual problems.
- High fever, chills and feeling unwell (especially in acute bacterial prostatitis).
Diagnosis and investigation
To make a diagnosis, the doctor will review your medical history and your symptoms.
The examination usually includes:
- Digital rectal examination (DRE): The doctor feels the prostate through the rectum to assess whether it is swollen or tender.
- Urine test and urine culture: Taken to look for bacteria or signs of inflammation.
- Blood test: Can be taken to check for inflammation markers such as CRP. In some cases, PSA is also measured, as the value can rise when the prostate is inflamed. However, PSA tests are mainly taken to rule out prostate cancer and are not routinely included in a pure prostatitis investigation.
Treatment options
Treatment is adapted to the type of prostatitis you have:
- Antibiotics: Used for bacterial infections.
- Alpha-inhibitors: Drugs that relax the muscles around the prostate and bladder neck, which makes urination easier.
- Painkillers and anti-inflammatory drugs: Reduces pain, swelling and discomfort.
- Physiotherapy: Can help with muscle relaxation in the pelvic floor in chronic conditions.
- Lifestyle changes: Regular exercise, stress management and heat (e.g. hot baths) can relieve symptoms.
When should you seek medical attention?
If you experience symptoms of prostatitis – especially if you also have a fever or difficulty urinating – you should contact your healthcare provider for a correct diagnosis and treatment.
