Prostatitis: is there a link to infertility or prostate cancer?

There are four main types of prostatitis but the most common is chronic bacterial prostatitis, or chronic pelvic pain syndrome, which occurs in about 90% of cases. The good news is that the infection can be treated with a course of antibiotics, however, if it does recur there are other treatment options available to manage the condition.

We’ve asked leading urologist Mr Andrew Ballaro to answer those burning questions on prostatitis, from whether it affects male fertility, if there is a link with prostate cancer, to how it can be treated.
 

How can I tell if I have prostatitis or prostate cancer?

The conditions are not the same and prostatitis is not a form of prostate cancer. The age groups of both conditions differ as prostate cancer occurs in those who are middle-aged and older but prostatitis tends to occur in younger patients.

Symptoms are sometimes nonspecific but the main issue with early prostate cancer is that there are no symptoms. Whereas symptoms of chronic bacterial prostatitis may include blood in the urine or semen, pain when passing urine, ejaculating and/or in the lower back or perineal area.
 

Can prostatitis lead to male infertility?

No, there isn’t any evidence to suggest that there is a link between prostatitis and infertility.
 

Can prostatitis be caused by a sexually transmitted infection (STI)?

Rarely, it can do. But very rarely the vast majority are not related to STIs although the symptoms can be similar. If you have symptoms of an STI then you should visit a sexual health clinic. Ongoing symptoms of an STI can then be related to prostatitis.
 

How can I get tested for chronic bacterial prostatitis?

There aren’t any definitive tests but we usually make a diagnosis based on the patient’s symptoms and we often use a urine flow rate test and urine analysis. Sometimes there is an examination of the prostate but it is not always necessary. The characteristics of the symptoms make it reasonable to diagnose prostatitis. In some cases, we may advise a prostatic massage with a culture of the urine afterwards, which both may lead to diagnosis and help treatment.
 

How long does it take to receive the test results?

During the first consultation, we can give a fairly accurate diagnosis. We receive the urine tests results then and there.
 

How is prostatitis treated?

Treatment depends on which type of prostatitis that the patient has. The most common type, chronic bacterial prostatitis, is usually treated with a four to six-week course of antibiotics to treat the bacteria in the prostate.

There are tablets that relax the prostate or shrink down its size, which can help urinary symptoms and also give anti-inflammatories and painkillers to treat the associated discomfort.

Some patients do well with shock wave therapy to the prostate and, in some cases, a cystoscopy is required to check that there is nothing else underlying. Most patients notice an improvement within two weeks but treatment may take up to six months.
 

Can it recur following treatment?

Yes, it can because sometimes we don’t find what causes it. Symptoms can relapse and remit on their own. Usually, if you’re given a good course of antibiotics it doesn’t come back but in some cases, it can. We focus our treatment on symptoms and excluding a structural cause. If something like a urethra or prostate stone causes a problem then we treat that.
 

What happens if prostatitis is left untreated? Is it dangerous?

There are some studies that relate chronic inflammation in the prostate to cancer formation, but there is no definitive link. Just because you have prostatitis, it doesn’t mean you will get cancer.

Read more: when is prostatitis an emergency?

Do not hesitate to book an appointment with Mr Ballaro if you’re concerned about prostatitis.