What is prostatitis?
Prostatitis is inflammation of the prostate gland, which can be classified into four types1:
- Acute bacterial prostatitis (type I), which is short term and caused by bacterial infection
- Chronic bacterial prostatitis (type II), which is long term and caused by bacterial infection
- Chronic prostatitis/chronic pelvic pain syndrome (type III), which is long term and not associated with infection
- Asymptomatic inflammatory prostatitis (type IV), which does not cause pain.
Prostatitis is a common cause of pelvic pain in men2, and affects about 15% of Australian men at some point in their lives3.
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS; type III) is the most common type of prostatitis, accounting for 80-90% of cases. Bacterial prostatitis is responsible for 5-10% of cases, and most of these are chronic (type II). Around 10% of prostatitis cases are asymptomatic (type IV).
Symptoms of prostatitis
Symptoms of acute bacterial prostatitis (type I) include:
- Urinary tract infection
- A frequent feeling of needing to urinate
- Pain when urinating.
You can also sometimes have whole-body symptoms like fever, muscle pain and generally feeling unwell1.
The symptoms of chronic bacterial prostatitis (type II) are the same as for type I, but these symptoms reoccur with periods in between when there are no symptoms and bacteria remain present.
Symptoms of CP/CPPS (type III) include:
- Genital and/or abdominal pain
- Ejaculatory pain
- Lower urinary tract symptoms (LUTS)
- Erectile dysfunction.
CP/CPPS is also associated with long-term pelvic pain, although the cause of this is unknown1.
As the name indicates, asymptomatic inflammatory prostatitis (type IV) does not cause any symptoms.
Causes of prostatitis
Acute and chronic bacterial prostatitis are usually caused by bacteria responsible for urinary tract infections and occur when the bacteria move into the prostate gland2.
The cause of CP/CPPS is not known4.
Diagnosis of prostatitis
If you have symptoms of prostatitis, your doctor will ask you some questions, perform an examination and may ask for a urine sample (to test for bacteria). During the examination, your doctor may perform a digital rectal examination to gently feel your prostate.
Your doctor may use a questionnaire to assess the severity of your symptoms and their impact on your wellbeing4.
Treatment of prostatitis
Acute and chronic bacterial prostatitis are treated with antibiotics2.
In some patients, medication to relax the muscles around the prostate might also be prescribed2.
CP/CPPS can be treated with anti-inflammatory drugs and medications that affect nerve function of the muscles around the prostate4. Pelvic floor therapy may provide relief in some cases4.
If CP/CPPS affects your mental health, psychological therapy or medications may help4.
Rarely, surgery may be needed to treat CP/CPPS.
Health effects of prostatitis
Acute and chronic bacterial prostatitis can be successfully treated by antibiotics, but it may be necessary to continue taking antibiotics for some time after your symptoms go away to avoid the infection returning5.
CP/CPPS can be difficult to treat because the cause is not always known. By classifying CP/CPPS according to the symptoms it causes, treatment can be targeted to provide relief for most men4.
Prostatitis can be a painful and frustrating condition but it is not life-threatening. Chronic prostatitis is uncommonly associated with reduced fertility for some men, but there is no evidence that it leads to prostate cancer6.
Prostatitis is not a sexually transmitted infection (STI) and it's not contagious. However, it can be caused by an STI, which you can pass on to others.
What to do about prostatitis
If you have symptoms of prostatitis, make an appointment to see your doctor. If you have a bacterial infection, a course of antibiotics may be enough to clear it.
By understanding your symptoms, your doctor will be able to guide treatment so you can get some relief. The frustration and long-term pain of CP/CSSP can affect your mental health, so be sure to seek help if your symptoms are affecting how you feel.
What questions should I ask my doctor about prostatitis?
- How do we rule out other causes of my pain?
- Can you explain what’s involved in the tests I might need to diagnose prostatitis?
- Is there someone I can talk to about managing my pain caused by prostatitis?
 Krieger et al., 1999. NIH Consensus Definition and Classification of Prostatitis. JAMA
 Lipsky et al., 2010. Treatment of Bacterial Prostatitis. Clinical Infectious Diseases
 Dickson, 2013. Prostatitis – diagnosis and treatment. Australian Family Physician
 Polackwich & Shoskes, 2016. Chronic prostatitis/chronic pelvic pain syndrome: a review of evaluation and therapy. Prostate Cancer and Prostatic Diseases
 Stevermeyer & Easley, 2000. Treatment of prostatitis. American Family Physician
 Verze et al., 2016. The role of the prostate in male fertility, health and disease. Nature Reviews Urology
What is the prostate?