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Prostatitis

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Prostatitis – an infection or inflammation of the prostate gland – is a non-cancerous condition.

Types of prostatitis

There are four main types of prostatitis:

  • chronic pelvic pain syndrome (CPPS)
  • acute bacterial prostatitis
  • chronic bacterial prostatitis
  • asymptomatic inflammatory prostatitis.

You can also read more about the signs and symptoms, tests and treatments for the different types of prostatitis.

Chronic pelvic pain syndrome (CPPS)

CPPS is the most common type of prostatitis – around 19 out of every 20 men (90 to 95 per cent) with prostatitis have it. You might also hear it called chronic non-bacterial prostatitis, chronic abacterial prostatitis or prostate pain syndrome. Chronic means long-lasting.

Men with CPPS usually have symptoms for three months or longer. Even after treatment, you may still have prostatitis for a long time. It might come and go, causing occasional episodes of severe pain, sometimes known as flare-ups.

What causes it?

Nobody knows for certain what causes CPPS. Unlike other types of prostatitis it isn’t usually caused by a bacterial infection. There could be a number of causes, which makes it difficult to diagnose and treat.

There are also a number of things that might trigger it, including:

  • urine getting into the prostate
  • previous infections in or around the prostate
  • an infection that doesn’t show up in tests
  • problems with nerves, so that they send pain signals to the brain even when there’s nothing physically wrong
  • stress, anxiety or depression
  • problems with the pelvic floor muscles (the muscles that support your bladder and bowel and help to control urination).

Some research shows a link between stress, anxiety and depression and CPPS. But this doesn’t mean that CPPS is all in your head. If you’re feeling stressed or depressed, this may cause physical symptoms that trigger CPPS, or make symptoms worse.

There’s some evidence that CPPS may be linked to other conditions such as chronic fatigue syndrome, which causes severe tiredness, and irritable bowel syndrome (IBS), which causes bowel problems.

Some men with CPPS have symptoms of these conditions too. There’s also some evidence that in a small number of men, CPPS may be caused by a sexually transmitted infection. But we need more research to know for sure.

 

Acute bacterial prostatitis

Acute bacterial prostatitis is an infection of the prostate that is caused by bacteria. Acute means that the symptoms develop very quickly. It isn’t common, but it can be serious and may need treating in hospital.

What causes it?

Acute bacterial prostatitis can develop when certain types of bacteria get into your prostate, causing it to become infected.

Bacteria that normally live in your bowel may spread to the tip of your penis and to the urethra (the tube you urinate through). From here, the bacteria might reach your prostate. Bacteria can also spread to your prostate from your bladder or bloodstream.

Acute bacterial prostatitis can happen if:

  • you have a urine infection
  • you’ve had difficulty emptying your bladder
  • you’ve had a prostate biopsy
  • you regularly use a thin tube called a catheter to drain urine from your bladder.

Chronic bacterial prostatitis

Chronic bacterial prostatitis is an infection of the prostate that can last for a long time – at least three months. Chronic means that it is long-lasting. It tends to come and go, causing episodes or flare-ups. It isn’t common.

What causes it?

Chronic bacterial prostatitis is caused by a bacterial infection. It tends to affect men who’ve had lots of urine infections or an inflamed urethra (urethritis) in the past, or who have a damaged or narrow urethra (a stricture). Each episode tends to be caused by the same bacteria, which also cause the urine infections.

It can develop from acute bacterial prostatitis if antibiotics don’t get rid of all the bacteria. This could be because the bacteria were resistant to the antibiotics or because the treatment was stopped too early.

Asymptomatic inflammatory prostatitis

This is prostatitis that doesn’t have any symptoms – the word asymptomatic means there are no symptoms. It is usually detected by chance when you’re having tests for other conditions, such as prostate cancer.

References

Last updated July 2019 | To be reviewed July 2022

  • List of references  

    • Almugbel SK, Alanezi FKB, Alhoshan FM, Alkhalifa RO, Alkhzaim AH, Almohideb MA. Classification and treatment of prostatitis: a review of literature. Int J Community Med Public Health. 2018 Oct 25;5(11):4941.
    • BMJ. Acute prostatitis - Symptoms, diagnosis and treatment | BMJ Best Practice [Internet]. 2018 [cited 2019 Jan 4]. Available from: https://bestpractice.bmj.com/topics/en-gb/172?q=Prostatitis&c=suggested
    • Bonkat G, Bartoletti RR, Bruyère F, Cai T, Geerlings SE, Koves B, et al. EAU Guidelines on Urological Infections. European Association of Urology; 2019.
    • Bowen DK, Dielubanza E, Schaeffer AJ. Chronic bacterial prostatitis and chronic pelvic pain syndrome. BMJ Clin Evid [Internet]. 2015 Aug 27 [cited 2019 Jan 14];2015. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4551133/
    • Coker TJ, Dierfeldt DM. Acute Bacterial Prostatitis: Diagnosis and Management. Am Fam Physician. 2016 Jan 15;93(2):114–20.
    • Davis SN, Morin M, Binik YM, Khalife S, Carrier S. Use of pelvic floor ultrasound to assess pelvic floor muscle function in Urological Chronic Pelvic Pain Syndrome in men. J Sex Med. 2011 Nov;8(11):3173–80.
    • Doggweiler R, Stewart AF. Pelvic Floor Therapies in Chronic Pelvic Pain Syndrome. Curr Urol Rep. 2011 May 6;12(4):304–11.
    • Engeler D, Baranowski AP, Berghmans B, Borovicka J, Cottrell AM, Dinis-Oliveira P, et al. EAU Guidelines on Chronic Pelvic Pain. European Association of Urology; 2019.
    • Gasperi M, Krieger JN, Forsberg C, Goldberg J, Buchwald D, Afari N. Chronic prostatitis and comorbid non-urological overlapping pain conditions: A co-twin control study. J Psychosom Res. 2017 Nov;102:29–33.
    • Habermacher GM, Chason JT, Schaeffer AJ. Prostatitis/chronic pelvic pain syndrome. Annu Rev Med. 2006;57:195–206.
    • Krieger JN, Lee SWH, Jeon J, Cheah PY, Liong ML, Riley DE. Epidemiology of prostatitis. Int J Antimicrob Agents. 2008 Feb;31:85–90.
    • Krieger JN, Nyberg L, Nickel JC. NIH consensus definition and classification of prostatitis. JAMA. 1999 Jul 21;282(3):236–7.
    • Liao C-H, Lin H-C, Huang C-Y. Chronic Prostatitis/Chronic Pelvic Pain Syndrome is associated with Irritable Bowel Syndrome: A Population-based Study. Sci Rep [Internet]. 2016 May 26 [cited 2019 Jan 8];6. Available from: www.ncbi.nlm.nih.gov/pmc/articles/PMC4880941/
    • Lipsky BA, Byren I, Hoey CT. Treatment of Bacterial Prostatitis. Clin Infect Dis. 2010 Jun 15;50(12):1641–52.
    • Ozden E, Bostanci Y, Yakupoglu KY, Akdeniz E, Yilmaz AF, Tulek N, et al. Incidence of acute prostatitis caused by extended-spectrum beta-lactamase-producing Escherichia coli after transrectal prostate biopsy. Urology. 2009 Jul;74(1):119–23.
    • Papeš D, Pasini M, Jerončić A, Vargović M, Kotarski V, Markotić A, et al. Detection of sexually transmitted pathogens in patients with chronic prostatitis/chronic pelvic pain: a prospective clinical study. Int J STD AIDS. 2017 May 1;28(6):613–5.
    • Perletti G, Marras E, Wagenlehner FM, Magri V. Antimicrobial therapy for chronic bacterial prostatitis. Cochrane Database Syst Rev [Internet]. 2013 [cited 2015 Feb 8];(8). Available from: onlinelibrary.wiley.com/doi/10.1002/14651858.CD009071.pub2/abstract
    • Riegel B, Bruenahl CA, Ahyai S, Bingel U, Fisch M, Löwe B. Assessing psychological factors, social aspects and psychiatric co-morbidity associated with Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) in men — A systematic review. J Psychosom Res. 2014 Nov;77(5):333–50.
    • Rodríguez MÁB, Afari N, Buchwald DS. Evidence for Overlap Between Urological and Nonurological Unexplained Clinical Conditions. J Urol. 2013 Jan;189(1):S66–74.
    • Sandhu J, TU HYV. Recent advances in managing chronic prostatitis/chronic pelvic pain syndrome. F1000Research [Internet]. 2017 Sep 25 [cited 2018 Dec 10];6. Available from: www.ncbi.nlm.nih.gov/pmc/articles/PMC5615772/
    • Schaeffer AJ. Epidemiology and evaluation of chronic pelvic pain syndrome in men. Int J Antimicrob Agents. 2008 Feb;31:108–11.
    • Smith CP. Male chronic pelvic pain: An update. Indian J Urol IJU J Urol Soc India. 2016;32(1):34–9.
    • Thakkinstian A, Attia J, Anothaisintawee T, Nickel JC. α-blockers, antibiotics and anti-inflammatories have a role in the management of chronic prostatitis/chronic pelvic pain syndrome. BJU Int. 2012 Oct;110(7):1014–22.

"I think it's important to keep talking about prostatitis"

Simon Smith

Simon's prostatitis story

Simon Smith was diagnosed with prostatitis in 2011 at the age of 24. By sharing his story, he hopes to raise awareness of this common condition and let other men know they are not alone.

Read more