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Prostatitis - bacterial

Chronic prostatitis - bacterial; Acute prostatitis

Prostatitis is inflammation of the prostate gland. This problem can be caused by an infection with bacteria. However, this is not a common cause.

Acute prostatitis starts quickly. Long-term (chronic) prostatitis lasts for 3 months or more.

Ongoing irritation of the prostate that is not caused by bacteria is called chronic nonbacterial prostatitis.

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Causes

Any bacteria that can cause a urinary tract infection can cause acute bacterial prostatitis.

Infections spread through sexual contact can cause prostatitis. These include chlamydia and gonorrhea. Sexually transmitted infections (STIs) are more likely to occur from:

In men over age 35 years, E coli and other common bacteria most often cause prostatitis. This type of prostatitis may begin in the:

Acute prostatitis may also be caused by problems with the urethra or prostate, such as:

Men age 50 years or older who have an enlarged prostate have a higher risk for prostatitis. The prostate gland may become blocked. This makes it easier for bacteria to grow. Symptoms of chronic prostatitis can be similar to symptoms of an enlarged prostate gland.

Symptoms

Symptoms can start quickly, and can include:

Symptoms of chronic prostatitis are similar, but not as severe. They often begin more slowly. Some people have no symptoms between episodes of prostatitis.

Urinary symptoms include:

Other symptoms that may occur with this condition:

If prostatitis occurs with an infection in or around the testicles (epididymitis or orchitis), you may also have symptoms of that condition.

Exams and Tests

During a physical exam, your health care provider may find:

The provider may perform a digital rectal exam to examine your prostate. During this exam, the provider inserts a lubricated, gloved finger into your rectum. The exam should be done very gently to reduce the risk of spreading bacteria into the blood stream.

The exam may reveal that the prostate is:

Urine samples may be collected for urinalysis and urine culture.

Prostatitis may affect the results of the prostate-specific antigen (PSA), a blood test to screen for prostate cancer.

Treatment

Antibiotics are often used to treat prostate infections.

Often, the infection will not go away, even after taking antibiotics for a long time. Your symptoms may come back when you stop the medicine.

If your swollen prostate gland makes it hard to empty your bladder, you may need a tube to empty it. The tube may be inserted through your abdomen (suprapubic catheter) or through your penis (indwelling catheter).

To care for prostatitis at home:

Get checked by your provider after you finish taking your antibiotic treatment to make sure the infection is gone.

Outlook (Prognosis)

Acute prostatitis should go away with medicine and minor changes to your diet and behavior.

It may come back or turn into chronic prostatitis.

Possible Complications

Complications may include:

When to Contact a Medical Professional

Contact your provider if you have symptoms of prostatitis.

Prevention

Not all types of prostatitis can be prevented. Practice safe sex behaviors.

Related Information

Chlamydia
Urinary tract infection - adults
Urethritis
Epididymitis
Bladder outlet obstruction
Enlarged prostate

References

McGowan CC. Prostatitis, epididymitis, and orchitis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Disease. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 110.

Nicolle LE. Urinary tract infection. In: Lerma EV, Sparks MA, Topf JM, eds. Nephrology Secrets. 4th ed. Philadelphia, PA: Elsevier; 2019:chap 46.

Pontari M. Inflammatory and pain conditions of the male genitourinary tract: prostatitis and related pain conditions, orchitis, and epididymitis. In: Partin AW, Domochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 56.

US Department of Health and Human Services; National Institute of Diabetes and Digestive and Kidney Diseases. Prostatitis: inflammation of the prostate. www.niddk.nih.gov/health-information/urologic-diseases/prostate-problems/prostatitis-inflammation-prostate. Updated July 2014. Accessed September 14, 2021.

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Review Date: 7/26/2021  

Reviewed By: Kelly L. Stratton, MD, FACS, Associate Professor, Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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