Men age 50 or older who have an enlarged prostate (benign prostatic hyperplasia) are at increased risk for prostatitis. The prostate gland may become blocked, making it easier for bacteria to grow. Symptoms of chronic prostatitis can be very similar to symptoms of an enlarged prostate gland.
Symptoms of acute prostatitis can start quickly, and can include:
Flushing of the skin
Symptoms of chronic prostatitis are similar, but not as severe. They usually begin more slowly. Some people have no symptoms between episodes of prostatitis.
If prostatitis occurs with an infection in or around the testicles (epididymitis or orchitis), you may also have symptoms of that condition.
Signs and tests
During a physical exam, your health care provider may find:
Enlarged or tender lymph nodes in your groin
Fluid released from your urethra
Swollen or tender scrotum
To examine your prostate, the health care provider will perform a digital rectal exam. During this exam, the provider will insert a lubricated, gloved finger into your rectum.
The prostate may feel:
Large and soft (with a chronic prostate infection)
Warm, soft, swollen, or tender (with an acute prostate infection)
Your doctor may do a prostatic massage to see whether you have an infection:
The health care provider will rub a gloved finger over the prostate gland a few times to release fluid from the urethra
The fluid will be examined for white blood cells and bacteria -- signs of an infection
Urine samples may be collected for urinalysis and urine culture.
Prostatitis may affect the results of the prostate-specific antigen (PSA), a blood test used to screen for prosate cancer.
Antibiotics are often used to treat prostate infections.
For acute prostatitis, you take antibiotics for 4 to 6 weeks.
For chronic prostatitis, you take antibiotics for at least 4 to 6 weeks. Because the infection can come back, you may need to take medicine for even longer -- up to 12 weeks -- to get rid of the infection.
Often, the infection will not go away, even if you've been taking antibiotics for a long time. After you stop taking antibiotics, your symptoms may return.
If your swollen prostate gland makes it hard to empty your bladder, you may need a tube to empty it through your abdomen (suprapubic catheter), or from inside your body (indwelling catheter).
To care for prostatitis at home:
Urinate often and completely.
Take warm baths to relieve pain.
Take stool softeners to make bowel movements more comfortable.
Avoid substances that irritate your bladder, such as alcohol, caffeinated foods and drinks, citrus juices, and hot or spicy foods.
Drink more fluid (64 - 128 ounces per day) to urinate often and help flush bacteria out of your bladder.
After you finish antibiotic treatment, get examined by your health care provider to make sure the infection is gone.
Acute prostatitis should clear up completely with medicine and minor changes to your diet and behavior.
Acute prostatitis may come back or turn into chronic prostatitis.
Spread of bacteria from the prostate to the bloodstream (sepsis)
Calling your health care provider
Call your health care provider if you have symptoms of prostatitis.
Not all types of prostatitis are preventable.
You can prevent infections caused by STDs by practicing safe sex behaviors.
Nickel JC. Inflammatory conditions of the male genitourinary tract: prostatitis and related conditions, orchitis, and epididymitis. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 9.
Barry MJ, McNaughton-Collins M. Benign prostate disease and prostatitis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 130.
Louis S. Liou, MD, PhD, Chief of Urology, Cambridge Health Alliance, Visiting Assistant Professor of Surgery, Harvard Medical School. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.