Mayo Clinic: What causes prostatitis, and how is it diagnosed?
Is it treatable?
Prostatitis ó a general term that encompasses a group of
conditions characterized by swelling or inflammation of the
prostate gland ó generally isnít life threatening.
Although itís less well-known than other prostate health
concerns, such as prostate enlargement or prostate cancer,
about 2 million American men visit their doctors for it each
year. Some forms of prostatitis can be challenging to diagnose
prostate is a walnut-sized gland located directly below the
bladder in men. One of its main jobs is to produce fluid
(semen) that nourishes and transports sperm. Irritation or
inflammation of the prostate gland can occur for a number of
reasons. Sometimes, bacteria-laden urine leaks from the
urethra into the prostate, causing an infection. Use of a
catheter or other instrument also can introduce infectious
agents. In many cases of prostatitis, however, no clear cause
can be found. Itís possible, though not proven, that other
factors, such as trauma, increased pressure on the prostate,
an overactive immune system or even excessive stress, can
contribute to prostate irritation.
can cause a variety of symptoms, including a frequent and
urgent need to urinate and painful or burning sensations while
urinating. This often is accompanied by pelvic, groin or low
back pain. If you experience any of these symptoms, see your
doctor promptly to avoid complications, such as spread of the
are four types of prostatitis ó two of which are caused by
bacteria. Acute bacterial prostatitis usually comes on
suddenly and can cause fever and chills in addition to pain
and urinary symptoms. Chronic bacterial prostatitis also is
caused by bacteria, but signs and symptoms typically develop
more slowly and are less severe. Sometimes, it occurs as a
complication of acute bacterial prostatitis that hasnít been
pelvic pain syndrome (chronic prostatitis) symptoms are a lot
like chronic bacterial prostatitis, but without the fever. In
addition, tests show no sign of bacteria in the urine or in
fluid from the prostate gland. In some cases, white blood
cells found in a urine sample may signal the presence of
inflammation. Although this is the most common form of
prostatitis, itís also the most challenging to diagnose and
treat, because the cause is so uncertain.
asymptomatic inflammatory prostatitis doesnít cause any
symptoms and usually is found during an examination done for
another reason. For example, prostatitis may increase the
level of prostate-specific antigen (PSA) in your blood, which
may be detected during a PSA screening test for prostate
cancer. Asymptomatic prostatitis often doesnít require
treatment. But, if you need a repeat PSA test, your doctor may
recommend a course of antibiotics first to clear the
diagnose prostatitis, a urine sample may be collected to check
for an infection. Unless the cause is clearly bacterial,
prostatitis generally is diagnosed by feeling the prostate
gland. To do this, your doctor inserts a gloved finger into
your rectum and feels the outside wall of the gland. An
inflamed prostate usually feels enlarged and tender. In some
cases, a second urine sample may be collected after massaging
the prostate, which forces fluid into the urethra. This fluid
then can be examined for bacteria.
neither bacteria nor white blood cells are found, your doctor
may recommend further testing to rule out other conditions
that may be causing your symptoms.
caused by bacteria can be treated with antibiotics. The length
of treatment varies, depending on the type of prostatitis.
While acute bacterial prostatitis usually can be treated with
a four- to six-week course of antibiotics, chronic bacterial
prostatitis is often more resistant to antibiotics and can
take six to 12 weeks before the infection is cured. In some
cases, a daily low-dose antibiotic may be needed indefinitely.
having difficulty urinating, your doctor may prescribe an
alpha blocker to help relax the muscles connected to the
bladder and prostate. Nonprescription pain relievers can help
relieve pain and discomfort. Other therapies might include
sitting and soaking in a warm bath (sitz bath), biofeedback
(which can teach you how to control your bodily responses to
certain stimuli), and physical therapy exercises. Acupuncture
also may help prostatitis symptoms.