​​What is prostatitis?

Prostatitis is an inflammation of the prostate, a gland located under the male urinary bladder that helps produce semen. It is not a common disorder of the male genitourinary system, but can be distressing and cause severe illness.

What symptoms does it present?

Symptoms vary depending on whether or not the inflammation is caused by bacterial infection. The most frequent symptoms that may suggest a diagnosis of acute prostatitis are as follows:

• Dysuria: feeling a burning pain, stinging or itching when passing urine
• Urinary frequency and urgency
• Pain in the perineum (the region between the anus and the scrotum)
• Also, bacterial prostatitis may cause fever and, if severe, uncontrollable shaking

If you have any of the symptoms above, it is important to seek medical attention immediately. Your GP or urologist will perform a digital rectal examination and may find the diagnostic sign of tenderness in the prostate. Dipping and culturing the urine will confirm the presence of pus in the urine and/or a UTI.

In cases of chronic non-bacterial prostatitis, other symptoms may occur such as:

• discomfort in the testicles, groins, base of the penis and lower central abdomen
• painful ejaculation
• erectile dysfunction
• loss of libido

Causes of prostatitis or why it occurs

In most cases, acute prostatitis is caused by a bacterial infection, typically associated with a more general urinary tract infection (UTI). You are more likely to develop acute prostatitis if: 

• you suffer from recurrent UTIs (typically aged over 50) 
• you are diabetic
• you have recently undergone a needle biopsy of the prostate to check for cancer
• you have a sexually transmitted infection, particularly chlamydia, or HIV (typically age below 30)

With chronic prostatitis, it is not clear what the cause is and why it comes and goes over time. Chronic prostatitis is more common among men between the ages of 30 and 50, and you are more likely to have prostatitis if it has occurred before.

Can it be prevented?

Not all types of prostatitis can be prevented. Even a single UTI in an adult male should be investigated with an ultrasound scan to look for a cause like kidney stones or incomplete bladder emptying. Good personal hygiene and practising safe sex is essential to prevent bacteria from spreading to the prostate and causing it to swell.

How is it treated?

When the cause is bacterial, prostatitis is initially treated with oral antibiotics for four to six weeks. Occasionally, a patient may need to be hospitalised and receive intravenous antibiotics. Emergency surgery is very rarely necessary to drain a prostate abscess (a walled-off collection of pus). Chronic prostatitis is more difficult to treat, although generally less severe. Anti-inflammatory painkillers, antioxidents like quercetin, prostate massage, acupuncture and even strenuous daily walking exercises may help.

How is it diagnosed?

There are numerous tests that specialists use to diagnose prostatitis. These include: 

• digital rectal examination
• urine test
• blood test
• prostatic specimen test
• urodynamic tests
• imaging tests

Which specialist treats prostatitis?

Urologists are the specialists that can accurately and effectively diagnose and treat prostatitis.