Prostatitis

Symptoms of prostatitis

There are two main types of prostatitis:

• acute prostatitis – symptoms are severe and develop suddenly; it's rare but it can be serious and requires immediate treatment; it's always caused by an infection 
• chronic prostatitis – symptoms come and go over a period of several months; it's the most common type; it's not usually caused by an infection

Acute prostatitis

Symptoms of acute prostatitis include:

• pain, which may be severe, in or around your penis, testicles, anus, lower abdomen or lower back – passing stools (faeces) can be painful
• urinary symptoms, such as pain when peeing, needing to pee often (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 (AUR) – this needs urgent medical attention
• generally feeling unwell, with aches, pains and possibly a fever
• a small amount of thick fluid (discharge) may come out of your penis

See your GP if you have any of these symptoms. If you can’t see your GP and your symptoms are too severe to wait, contact your GP out of hours service.

Chronic prostatitis

You may have chronic prostatitis if you've had the following symptoms for at least three months:

• 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, although in some cases it may be normal 
• sexual problems, such as erectile dysfunction, pain when ejaculating, or pelvic pain after sex

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

When to see your GP

See your GP if you have symptoms of prostatitis, such as:

• pelvic pain
• difficulty or pain when peeing
• painful ejaculation

Your GP will ask about the problems you're having and examine your tummy. You may also have a digital rectal examination (DRE). This is where a doctor inserts a gloved finger into your bottom to feel for abnormalities in your prostate gland. You may experience some discomfort if your prostate is swollen or tender.

Your urine will usually be tested for signs of infection, and you may be referred to a specialist for further tests.

See your GP immediately if you develop sudden and severe symptoms of prostatitis. You may have acute prostatitis. It needs to be assessed and treated quickly to prevent serious problems, such as being unable to pass urine.

If you have persistent symptoms (chronic prostatitis), you may be referred to a urologist (a doctor who specialises in urinary problems). 

Treating prostatitis

Treatment for prostatitis will depend on whether you have acute or chronic prostatitis. The main treatment used is usually pain relieving medication and may include antibiotic treatment.

Treatment for chronic prostatitis aims to control the symptoms and reduce them so that they interfere less with day-to-day activities. Your GP will discuss your treatment with you.

A referral to your local pain clinic may also be considered if the symptoms are severe and not responding to treatment.

Risk factors for prostatitis

Risk factors for acute prostatitis include:

• having a urinary tract infection (UTI) in the recent past
• having an indwelling urinary catheter
• having a prostate biopsy
• having a sexually transmitted infection (STI)
• having HIV or AIDS
• having a problem with your urinary tract
• anal sex
• injuring your pelvis

Risk factors for chronic prostatitis include:

• being middle-aged (30-50 years of age)
• having prostatitis in the past
• frequent urine infections
• If you have HIV or a problem with your immune system
• rarely it can occur as a result of a sexually transmitted infection

Outlook

Acute prostatitis

Acute prostatitis usually clears with a course of antibiotics. It's important to take the full course to make sure that the infection clears completely.

Rarely, other complications of acute prostatitis can occur. These include:

• acute urinary retention
• prostate abscess 

Chronic prostatitis

Chronic prostatitis can be challenging to treat because little is known about what causes it. Most men will gradually recover with treatment. This can take months or years.

Some men with prostatitis find their symptoms return, which will require further treatment.

Prostatitis isn't prostate cancer and there's currently no clear evidence that it increases your chances of developing cancer of the prostate.