Patient information from BMJ

Prostatitis

Last published:Aug 06, 2021

Prostatitis causes pain and fever in the pelvic area, and can affect men of any age. This information is about acute prostatitis, which comes on quickly. It is usually caused by an infection and is treated with antibiotics.

What is prostatitis?

Prostatitis means your prostate gland is inflamed (swollen), usually because of an infection. The prostate gland is between your bladder and your penis, just in front of your rectum. The prostate helps to make semen, the fluid that sperm swim in.

There are two types of prostatitis. Acute prostatitis comes on quickly and usually doesn't come back after treatment. Chronic prostatitis is harder to treat. Symptoms may come and go, and their severity may vary over time.

The most common cause of acute prostatitis is infection with bacteria. You are more likely to get prostatitis if you’ve had a urine infection (also called a urinary tract infection or UTI) or if you have an enlarged prostate.

What are the symptoms?

The symptoms of prostatitis include:

• Pain around your penis, testicles, anus, pelvis, or lower back

• A fever

• Feeling generally unwell, and

• Finding it difficult or painful to pass urine.

Your doctor might examine you by gently placing a gloved finger inside your anus to feel the prostate. You will probably need to give a urine sample to be checked for bacteria.

What treatments work?

Drug treatments

You will need to take antibiotic tablets to treat the infection, usually for several weeks. It is very important to finish the course of antibiotics, even if you start feeling better before you have taken them all.

Men with signs of very serious infection (sepsis) may need to have antibiotics through an intravenous (IV) drip directly into the bloodstream. If you need IV antibiotics you will need to have this treatment in hospital, and you may need to stay in hospital for a day or so. You will still need to take a course of antibiotic tablets after the IV treatment.

Non-steroidal anti-inflammatory drugs (NSAIDs for short) such as ibuprofen can help with pain while the antibiotics are getting to work.

If you are having problems with urination your doctor might prescribe an additional medication called an alpha-blocker. This should help relax the muscles around the bladder.

Other treatments

If you are unable to pass urine because of swelling caused by the infection, you may need to have a tube (called a catheter) inserted for a short while, to drain the urine from your bladder. This is usually only needed for a short time, until the swelling goes.

What will happen to me?

Most men with prostatitis get better after taking antibiotics. The infection is treated and the symptoms go away. But some men go on to get chronic prostatitis. This means that they continue to get pain and problems with passing urine. This is treated with a longer course of antibiotics and other medicines.