There are four types of prostatitis:
- Acute bacterial prostatitis
- Chronic bacterial prostatitis
- Chronic prostatitis or chronic pelvic pain syndrome
- Asymptomatic inflammatory prostatitis
Treatment to get rid of prostatitis depends on the type of prostatitis.
Treatment for bacterial prostatitis includes:
- Medications to make it easier to urinate
- Fluids and intravenous (IV) antibiotics, for severe cases of acute bacterial prostatitis
- Alpha blockers, for chronic bacterial prostatitis
- Surgery to treat urinary retention caused by chronic bacterial prostatitis
- Treatment for symptoms may include:
Treatment of chronic prostatitis/chronic pelvic pain syndrome is aimed at reducing pain, discomfort, and inflammation and may include:
- Silodosin (Rapaflo)
- 5-alpha reductase inhibitors such as finasteride (Proscar) and dutasteride (Avodart)
- Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve)
- Glycosaminoglycans such as chondroitin sulfate
- Muscle relaxants such as cyclobenzaprine (Amrix, Flexeril) and clonazepam (Klonopin)
- Neuromodulators such as amitriptyline, nortriptyline (Aventyl, Pamelor), and pregabalin (Lyrica)
- Antibiotics may be prescribed initially until a bacterial infection is ruled out
- Stress reduction or counseling for men whose symptoms are affected by psychological stress
- Alternative treatments may include:
- Warm baths (“sitz baths”)
- Hot water bottles or heating pads
- Physical therapy
- Kegel exercises (also called pelvic muscle exercises)
- Myofascial release (also called myofascial trigger point release)
- Relaxation exercises
- Phytotherapy with plant extracts such as quercetin, bee pollen, and saw palmetto
Asymptomatic inflammatory prostatitis usually does not cause symptoms and does not generally require treatment.
What Are Symptoms of Prostatitis?
Acute and chronic bacterial prostatitis can cause slightly different symptoms.
Symptoms of acute bacterial prostatitis come on suddenly, can be severe, and may include:
- Flu-like symptoms
- Muscle pain
- Body aches
- Pain or burning sensation during urination
- Urinary urgency
- Urinary frequency
- Nighttime urination (nocturia)
- Urinary retention
- Difficulty starting a urine stream
- Weak or interrupted urine stream
- Complete inability to urinate
- Urinary tract infection (UTI)
- Pain in or near the groin, genitals, lower abdomen, or lower back
- Cloudy urine
Seek medical care immediately for symptoms of acute bacterial prostatitis.
Chronic bacterial prostatitis may not cause any symptoms. When symptoms occur, they are similar to those of acute bacterial prostatitis but not as severe. Chronic bacterial prostatitis usually develops gradually and lasts three months or more.
Symptoms of chronic prostatitis/chronic pelvic pain syndrome include:
- Pain or discomfort lasting 3 or more months in one or more of the following areas:
- Between the scrotum and anus
- Central lower abdomen
- Lower back
- Pain during or after ejaculation
- Pain in the urethra or penis during or after urination
- Urinary frequency (eight or more times per day)
- Urinary urgency
- Weak or an interrupted urine stream
Asymptomatic inflammatory prostatitis does not cause symptoms and may be diagnosed when testing for other urinary tract or reproductive tract disorders.
What Causes Prostatitis?
- The causes of prostatitis depend on the type.
- Acute and chronic bacterial prostatitis are caused by a bacterial infection of the prostate that may happen when bacteria travel from the urethra into the prostate. Men who have urinary tract infections (UTIs) may be more likely to develop bacterial prostatitis.
- The cause of chronic prostatitis/chronic pelvic pain syndrome is not known but a microorganism is thought to cause the condition. It may also be due to chemicals in the urine, the immune system’s response to a previous UTI, or nerve damage in the pelvic area.
How Is Prostatitis Diagnosed?
Prostatitis is diagnosed with a patient history, and physical examination which may include a digital rectal exam that involves the doctor inserting a finger into the anus to feel the prostate.
Tests used to diagnose prostatitis or determine the cause of the inflammation may include: