Prostatitis

Overview

Prostatitis is a swelling and inflammation (redness and irritation) of the prostate gland. The prostate is a small, walnut-shaped gland in men that helps make semen. Prostatitis can cause pain in the lower belly, groin, or lower back, and it can make urinating difficult or painful. It is not the same as prostate cancer or an enlarged prostate, though some symptoms are similar.

Yes, prostatitis is fairly common. About 1 in 6 men will have symptoms of prostatitis at some point in their lives. It is the most common urinary tract problem for men under 50 and the third most common for men over 50.

Prostatitis can affect men of all ages, but it is most common in men between 30 and 50 years old. It is rare in children and teenagers. Men who have had a urinary tract infection, use a urinary catheter, or have had a recent bladder infection may have a higher risk.

Symptoms

Common symptoms

• Pain or burning when urinating
• Frequent urge to urinate, especially at night
• Difficulty starting to urinate or weak urine stream
• Pain in the lower belly, groin, lower back, or between the scrotum and anus (perineum)
• Painful ejaculation
• Flu-like symptoms (fever, chills, body aches) – more common in acute bacterial prostatitis

Symptoms in children

• Prostatitis is very rare in children. If it does occur, symptoms may include pain during urination, fever, and pain in the lower abdomen. Any such symptoms in a child should be checked by a doctor right away.

Symptoms in older adults

• Older adults may have similar symptoms to younger men, but they are more likely to have trouble urinating or be unable to empty the bladder completely.
• Sometimes the only symptom in older men is a sudden change in urinary habits or new-onset back pain.

Causes

Main causes

• Bacterial infection – bacteria from the urinary tract or the bowel enter the prostate gland. This is the cause of acute bacterial prostatitis and some cases of chronic bacterial prostatitis.
• Non-infectious inflammation – sometimes the prostate becomes inflamed without an infection. The exact cause is often unknown, but it may be linked to past infections, nerve problems, or an immune system reaction.
• Chronic pelvic pain syndrome – a long-lasting condition where pain and urinary symptoms occur without clear evidence of infection. This is the most common type of prostatitis.

Risk factors

• Having a urinary tract infection (UTI)
• Using a urinary catheter
• Having a recent procedure on the bladder or urethra (the tube that carries urine out of the body)
• Having a sexually transmitted infection (STI)
• Having an enlarged prostate (benign prostatic hyperplasia)
• Injury to the pelvic area (for example from a fall or exercise)
• Pelvic muscle tension or stress

When to see a doctor

See a doctor urgently if:

• You cannot urinate at all.
• You have a high fever (over 101°F / 38.3°C) and chills along with urinary pain.
• You have severe lower belly or back pain.

Book a routine appointment if:

• You have pain or burning when urinating that lasts more than a day or two.
• You have frequent urination or a weak stream.
• You have pain during ejaculation.
• You have groin, lower back, or perineum pain that does not go away.

Diagnosis

A doctor will ask about your symptoms, medical history, and do a physical exam. They may also perform a digital rectal exam (DRE) – a quick exam where they gently insert a gloved, lubricated finger into the rectum to feel the prostate. This can show if the prostate is swollen, tender, or has lumps. It is not painful for most men, just a little uncomfortable.

Tests that may be done

• Urine tests to check for infection or blood
• Blood tests (such as a PSA test) to rule out other problems like prostate cancer
• A swab from the urethra to test for sexually transmitted infections
• In some cases, imaging like an ultrasound or a CT scan

What to expect at your appointment

The doctor will explain what they find and whether the cause is likely an infection or not. You may be asked to collect a sample of urine or semen. Testing usually takes a few days. The doctor will discuss treatment options based on the results.

Treatment

Treatment depends on the type of prostatitis. Most cases of acute bacterial prostatitis are treated with antibiotics. Chronic prostatitis may need a combination of medicines, self-care, and sometimes physical therapy. Treatment aims to relieve pain, clear any infection, and help you urinate comfortably.

Self-care at home

• Drink plenty of water to help flush the urinary tract.
• Avoid caffeine, alcohol, spicy foods, and acidic drinks (like citrus juice) as they can irritate the bladder.
• Take warm baths or use a hot water bottle on your lower belly to ease pain.
• Rest and avoid heavy lifting or prolonged sitting.
• Try pelvic floor relaxation exercises – a physical therapist can teach you.

Medical treatments

Your doctor may prescribe antibiotics if an infection is found. These need to be taken exactly as directed, even if you feel better. For non-infectious prostatitis, medicines that relax the muscles around the prostate or help with nerve pain may be offered. Some men benefit from a medicine that helps urine flow. Always take medicines as prescribed and discuss any side effects. Do not use over-the-counter pain relievers without asking your doctor first, as some can affect the kidneys or interact with other medicines.

When is surgery considered?

Surgery is rarely needed for prostatitis. It may be considered if there is an abscess (a pocket of pus) in the prostate that does not drain on its own, or if the prostate is completely blocking the flow of urine. Your doctor will explain if this is necessary and what it involves.

Living with this condition

Living with prostatitis, especially the chronic type, can be frustrating. Symptoms may come and go. Be patient with yourself and follow your treatment plan. Keep a symptom diary to share with your doctor – it can help identify triggers like certain foods or activities.

Lifestyle tips

• Manage stress with relaxation techniques like deep breathing, meditation, or gentle yoga.
• Avoid sitting for long periods – if you have a desk job, get up and walk every hour.
• Urinate when you feel the urge, and try to empty your bladder completely.
• Avoid heavy exercise that puts pressure on the pelvic area until symptoms improve.

Diet and exercise

A balanced diet rich in fruits, vegetables, and whole grains can support your immune system. Some men find that cutting back on spicy foods, caffeine, and alcohol reduces flare-ups. Gentle exercise like walking, swimming, or stretching is good – but avoid high-impact activities until you feel better.

Mental health and emotional wellbeing

Chronic pain and urinary problems can affect your mood, sleep, and relationships. It is common to feel anxious or down. If you feel this way, talk to your doctor. They can offer support, recommend counselling, or suggest ways to manage stress. You do not have to cope alone.

Prevention

There is no sure way to prevent all types of prostatitis, but you can reduce your risk. Practicing safe sex and avoiding sexually transmitted infections can help prevent some types. Staying hydrated and urinating regularly can keep the urinary tract healthy. If you have a catheter, follow your doctor's instructions for care.

Vaccines

No vaccines are available to prevent prostatitis.

Screening programmes

There is no routine screening for prostatitis. However, if you have any urinary symptoms or pelvic pain, see your doctor for evaluation.

Complications

If left untreated

• If acute bacterial prostatitis is not treated, it can lead to a prostate abscess (a collection of pus) or a urinary tract infection that spreads to the kidneys (pyelonephritis).
• Chronic prostatitis can cause ongoing pain, sexual problems, and emotional distress.
• In rare cases, an untreated severe infection can lead to sepsis (blood poisoning), which is life-threatening.

Long-term outlook

The outlook for prostatitis is generally good. Most men with acute bacterial prostatitis recover fully with treatment. Chronic prostatitis can be more challenging, but many men find relief with a combination of treatments and lifestyle changes. With your doctor's help, most symptoms can be managed, and you can return to your normal activities.

Find support

International organisations

• World Health Organization

Local organisations

• Your local healthcare provider or clinic · All regions
• NHS (National Health Service) – UK ↗ · United Kingdom

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