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What is prostatitis?
Prostatitis is a common cause of pelvic pain in men, and affects about 15% of Australian men at some point in their lives.
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
You can also sometimes have whole-body symptoms like fever, muscle pain and generally feeling unwell.
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.
CP/CPPS is also associated with long-term pelvic pain, although the cause of this is unknown.
As the name indicates, asymptomatic inflammatory prostatitis (type IV) does not cause any symptoms. Prostatitis symptoms can vary depending on the type, so it’s worth seeing your doctor if pelvic pain, urinary symptoms or sexual symptoms persist.
Over 2.4 million Australian men and boys live with incontinence.
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 gland.
The cause of CP/CPPS is not known. Other possible prostatitis causes can include sexually transmitted infections, problems with the urinary tract or factors that affect pelvic floor muscles and nerves.
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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 wellbeing.
Treatment of prostatitis
Acute and chronic bacterial prostatitis are treated with antibiotics.
In some patients, medication to relax the muscles around the prostate might also be prescribed.
CP/CPPS can be treated with anti-inflammatory drugs and medications that affect nerve function of the muscles around the prostate. Pelvic floor therapy may provide relief in some cases.
If CP/CPPS affects your mental health, psychological therapy or medications may help.
Rarely, surgery may be needed to treat CP/CPPS. The right prostatitis treatment depends on the type of prostatitis, what’s causing it and how much the symptoms are affecting your life.
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 returning.
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 men.
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 cancer.
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. In Australia, prostatitis treatment usually starts with a GP, who can help rule out other causes and guide the next steps. 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.
