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A guide to prostatitis: causes, symptoms and treatment

The prostate is a small gland that lies between the penis and bladder. It produces fluid that’s mixed with sperm to nourish it and create semen.

What is prostatitis?

Prostatitis is inflammation or swelling of the prostate gland. It can be very painful and distressing, but will often get better eventually. Prostatitis can come on at any age, but usually between 30 and 50.

There are 2 main types of prostatitis:

  • Acute prostatitis. This is where the symptoms are severe and come on suddenly. Acute prostatitis is rare, but potentially life-threatening, so requires immediate treatment.
  • Chronic prostatitis. The most common type. Symptoms will come and go over several months.

What causes prostatitis?

Acute prostatitis is usually caused when bacteria from the bowel or the urinary system enter the prostate.

The exact cause of chronic prostatitis is unknown. It’s thought there are a number of things that might trigger it, including:

  • Urine getting into the prostate
  • Previous infections in or around the prostate
  • An infection that doesn’t show up in tests
  • Problems with nerves, so that they send pain signals to the brain even when there’s nothing physically wrong
  • Stress, anxiety or depression
  • Problems with the pelvic floor muscles (the muscles that support your bladder and bowel and help to control urination).
  • Researchers believe a microorganism, though not a bacterial infection, may cause the condition. This type of prostatitis may relate to chemicals in the urine, the immune system’s response to a previous urinary tract infection (UTI), or nerve damage in the pelvic area.
  • Some studies have shown there’s a link between chronic prostatitis and stress though more research is needed.

You’re also more likely to get chronic prostatitis if you:

  • Are older: men aged between 50 and 59 are 3 times more likely to get it than men between 20 and 39
  • Have had prostatitis before
  • Have other painful abdominal conditions, such as irritable bowel syndrome (IBS)
  • Have been sexually abused

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Good to know: Prostatitis is not prostate cancer and there’s no clear evidence that it increases your chances of getting it.

Symptoms of acute prostatitis

The symptoms of prostatitis vary depending on whether it’s acute or chronic

Symptoms of acute prostatitis usually come on suddenly and include:

  • Pain, which may be severe, in or around your penis, testicles, anus, lower abdomen or lower back. Pooing can be painful.
  • Pain when peeing, needing to pee frequently (particularly at night), problems starting or “stop-start” peeing, an urgent need to pee and, sometimes blood in your urine.
  • Not being able to pee, which leads to a build-up of urine in the bladder known as acute urinary retention – this needs urgent medical attention.
  • Generally feeling unwell, with aches, pains and possibly a high temperature.
  • Lower back pain and pain on ejaculation.

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See a GP straight away if you have these symptoms so that the cause can be investigated.

Symptoms of chronic prostatitis

You may have chronic prostatitis if you have had some of the following symptoms for at least 3 months. These symptoms might come and go.

  • Pain in and around your penis, testicles, anus, lower abdomen or lower back
  • Pain when peeing, a frequent or urgent need to pee, particularly at night, or “stop-start” peeing
  • An enlarged or tender prostate on rectal examination
  • Sexual problems, such as erectile dysfunction, pain when ejaculating or pelvic pain after sex

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See your GP if you have these symptoms.

These symptoms can have a significant impact on your quality of life. But in most cases, they’ll gradually improve over time and with treatment.

Seeing the GP

If you do experience any of the symptoms described above, it’s important to go and see your GP. They’ll ask about the problems you’re having and examine your tummy. You may also have a rectal examination sometimes called a DRE (digital rectal examination). This is where a doctor inserts a gloved finger into your bottom to feel for anything unusual. This might feel uncomfortable and you might feel embarrassed or worried, but doctors are used to carrying these out. You can read more about them and hear from people who’ve had them here.

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.

Treatment for prostatitis

Treatments for both forms of prostatitis vary.

Acute prostatitis treatment

Symptoms are usually sudden and severe, so painkillers are usually prescribed along with a 2 to 4 week course of antibiotics. In order to treat the infection effectively, in some cases, you might need to be admitted to hospital.

Chronic prostatitis treatment

Treatments for chronic prostatitis usually aim to control the symptoms so they interfere less with your daily life. Your doctor might prescribe:

  • Painkillers, such as paracetamol or ibuprofen
  • Alphablockers. These are medicines that can help relax the muscles in the prostate gland and the base of the bladder. They can help you urinate more easily.
  • Antibiotics are sometimes prescribed.
  • Laxatives may be recommended if pooing is painful.

When it comes to treatment, you may have to try a few things until you find something that works well for you and that might take several months or even years. Symptoms can also return at a later date so you might need more treatment.

The Prostate Check questionnaire within the Evergreen Life app can also help you better understand your current prostate health and how best to protect it.

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Not got the app yet? Download the Evergreen Life app by tapping the button below and look out for a notification about your Prostate Check questionnaire*.

*Must be 18 or over and male to receive the Prostate Health Check. If you haven’t told us your age and sex, please first take the GP Check in your Records section.

Reviewed by:

Dr James Harmsworth King MBBS MPhil PhD Biotechnology & Medical Expert

Dr Brian Fisher MBBCh MBE MSc FRSA Medical Expert

Matthew Simms MBChB, DM, FRCS(Urol)

Matthew Simms MBChB, DM, FRCS(Urol)

Matthew Simms is a Consultant Urologist and our Men’s Health Expert at Evergreen Life. Matthew qualified in Sheffield in 1993 and after house positions, completed basic surgical training in Nottingham and Derby. He carried out research in bladder cancer before specialist training in urology in the East Midlands.