Prostatitis

Overview

Prostatitis is a condition of the prostate gland most often linked with swelling and irritation, called inflammation. Prostatitis can make it painful or hard to urinate. It also may cause pain in the groin, pelvic area or genitals. Bacterial infections cause some but not all prostatitis.

The prostate gland, about the size of a walnut, sits just below the bladder in people assigned male at birth. It surrounds the top part of the tube that drains urine from the bladder, called the urethra. The prostate and other sex glands make the fluid that carries sperm during ejaculation. This fluid is called semen.

Types

There are four main types of prostatitis:

• Acute bacterial prostatitis. Bacteria causes this infection of the prostate. It most often has sudden, serious symptoms.
• Chronic bacterial prostatitis. This is a bacterial infection that lasts or comes back. The symptoms often are less serious than are those of acute bacterial prostatitis.
• Chronic prostatitis, also called chronic pelvic pain syndrome. This causes pelvic pain and urinary tract symptoms that last or come back. But there's no sign of infection.
• Asymptomatic inflammatory prostatitis. This has signs of an inflamed prostate with no urinary symptoms.

Symptoms

Symptoms of prostatitis depend on the type of condition. They may include:

• Pain or burning feeling when urinating, called dysuria.
• Trouble urinating, such as dribbling or trouble starting a stream of urine or keeping it going.
• Urinating often, mostly at night, called nocturia.
• Urgent need to urinate.
• Cloudy urine.
• Blood in the urine.
• Pain in the belly, groin or lower back.
• Pain in the area between the scrotum and rectum, called the perineum.
• Pain or discomfort of the penis or testicles.
• Painful ejaculation.
• Fever, chills, muscle aches and other flu-like symptoms with acute bacterial prostatitis.

When to see a doctor

Several conditions can cause symptoms like those of prostatitis. Get a diagnosis and treatment as soon as possible.

Get care right away if you:

• Are not able to pass urine.
• Have a fever and trouble urinating or pain while urinating.
• Have blood in your urine.
• Have a lot of discomfort or pain in the pelvic area or genitals.

Causes

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Prostate gland

Prostate gland

The prostate gland sits just below the bladder. It surrounds the top part of the tube that drains urine from the bladder, called the urethra. The prostate's main job is to make the fluid that feeds and carries sperm, called seminal fluid. The prostate is part of the male reproductive system.

Causes depend on the type of prostatitis.

• Acute bacterial prostatitis. Common strains of bacteria are most often the cause. The infection may have spread from other parts of the urinary or reproductive systems.
• Chronic bacterial prostatitis. This most often has the same cause as acute bacterial infection. It may happen when treatment for an acute infection isn't long enough or fails to kill all the bacteria.
• Chronic prostatitis, also called chronic pelvic pain syndrome. Research suggests that the cause may involve several factors. These include an earlier infection, a condition of the nervous system or immune system, psychological stress, or issues with hormones.
• Asymptomatic inflammatory prostatitis. This has no known cause. It may show up during an exam for other medical conditions.

Risk factors

Risk factors for prostatitis include:

• Young or middle adulthood.
• Earlier prostatitis.
• Infection of the urinary or reproductive system.
• HIV infection or AIDS.
• Use of a tube put into the urethra to drain the bladder, called a urinary catheter.
• Having a sample of prostate tissue taken for study in a lab, called a biopsy.

Other risk factors for chronic prostatitis, also called chronic pelvic pain syndrome, may include:

• Mental stress.
• Nerve damage in the pelvic region due to surgery or injury.

Complications

Complications of acute or chronic prostatitis can include:

• Bacterial infection of the blood, called bacteremia.
• Irritation of the coiled tube attached to the back of the testicle, called epididymitis.
• Pus-filled cavity in the prostate, called a prostatic abscess.
• Infection that spreads to the upper pelvic bone or lower spine.

Complications of chronic prostatitis/chronic pelvic pain syndrome may include:

• Worry or depression.
• Sexual dysfunction, such as not being able get and keep an erection, called erectile dysfunction.
• Changes in sperm and semen that may affect having children, called infertility.

There's no proof that prostatitis can lead to prostate cancer. Researchers are looking into whether long-term irritation of the prostate is a risk factor for cancer.