Common symptoms
- Pain between the scrotum and back passage (the perineum), in the lower abdomen or the lower back
- Burning or pain while passing urine
- Frequent or urgent urination and a weak or interrupted stream
- Pain during or after ejaculation
- Pain in the testicles or the tip of the penis
- Fever, chills and body ache in acute bacterial prostatitis
- Difficulty passing urine, or not being able to pass it at all
When not to wait: Go to an emergency department at once if you have fever and chills with pain on passing urine, or if you cannot pass urine. Acute bacterial prostatitis can spread to the blood and needs prompt antibiotics.
Types of prostatitis
Doctors divide prostatitis into four types, because each is treated differently. Some people describe it as prostate mein sujan.
| Type | What happens | Main clues |
|---|---|---|
| Acute bacterial prostatitis | A sudden bacterial infection of the prostate | High fever, chills, pelvic pain, burning, difficulty passing urine |
| Chronic bacterial prostatitis | Bacteria stay in the prostate and cause repeated urine infections | The same germ in repeated infections, with milder symptoms between attacks |
| Chronic pelvic pain syndrome (CPPS) | Pelvic pain for three months or more with no infection found; the most common type | Pain in the perineum, testicles, penis or lower abdomen, urine symptoms, pain on ejaculation, normal cultures |
| Inflammation without symptoms | Inflammation found by chance, for example in a biopsy or semen test | No symptoms; usually needs no treatment, but can raise PSA |
Acute bacterial prostatitis: why it is an emergency
This form starts suddenly with fever, shivering, body ache, pain low in the pelvis and burning urination. The swollen prostate can block the flow so that you cannot pass urine at all. In men with diabetes, after a prostate biopsy or with a catheter, it can become serious quickly.
Treatment starts with antibiotics, given through a drip in hospital if you are very unwell, after urine and blood samples are taken for culture. The course then continues as tablets, usually for two to four weeks, because antibiotics reach the prostate less easily than the bladder. If urine is blocked, a catheter is placed, sometimes through the lower abdomen; see urinary retention. If the fever does not settle within a few days, a scan looks for a prostate abscess (a pocket of pus), which may need draining.
Chronic prostatitis and chronic pelvic pain syndrome
Chronic bacterial prostatitis shows up as urine infections with the same germ that keep returning. Once the germ is identified, a longer antibiotic course, often four to six weeks, is chosen from the culture report.
Chronic pelvic pain syndrome is different. No infection is found, and the pain probably comes from a mix of tight, tender pelvic floor muscles, irritated nerves, inflammation and stress, each feeding the others. Repeated antibiotic courses do not help when tests show no infection, and they can cause side effects and resistance. A combination of treatments chosen for your main symptoms is usually more helpful than any single medicine. Our article on chronic prostatitis and pelvic pain covers this in more depth.
How prostatitis is diagnosed
The doctor asks where the pain is, how long it has lasted, and about fever, urine symptoms, sexual symptoms, past infections and stress. A short symptom questionnaire may be used to track progress over time.
The examination includes the abdomen, the genitals and a gentle rectal examination of the prostate. In acute prostatitis this is done very gently and the prostate is not massaged, because that could spread the infection. In suspected chronic bacterial prostatitis, urine samples taken before and after a gentle prostate massage show whether the germ comes from the prostate, and a semen culture may be added where appropriate. Younger, sexually active men may be tested for sexually transmitted infections.
Much of the testing is to rule out other causes of similar pain, such as a stone, a urethral stricture or a bladder problem, before chronic pelvic pain syndrome is diagnosed.
Treatment of prostatitis
- Antibiotics for the right duration: for acute and chronic bacterial prostatitis, chosen from the culture and taken for the full course, even after you feel better.
- Alpha-blockers: medicines that relax the prostate and bladder neck, which can ease urine symptoms and sometimes pain.
- Pain relief: anti-inflammatory painkillers for flare-ups and, for some men, medicines that calm irritated nerves.
- Pelvic floor physiotherapy: a physiotherapist teaches you to relax tight pelvic floor muscles, with stretching and release of tender spots. Strengthening exercises such as Kegels are usually not advised for this pain, as they can tighten the muscles further.
- Lifestyle: warm sitz baths, a cushion for long sitting, breaks during long drives, avoiding long hours of cycling, regular exercise, enough water, and cutting down alcohol, caffeine and very spicy food if they trigger symptoms.
- Stress and sleep: stress makes pelvic pain worse; relaxation, counselling and good sleep are part of treatment, not a sign that the pain is imaginary.
Symptoms often improve over weeks to months and may flare from time to time. Persistent urine symptoms in older men are checked for BPH; see enlarged prostate treatment. Pain with sex, erection problems or fertility worries are covered under men’s sexual health care in Jaipur.
Prostatitis is not prostate cancer, and it is not BPH
Prostatitis is not cancer and is not known to turn into cancer. It can raise the PSA blood test for some weeks, so PSA is usually not checked during an acute infection and is repeated after treatment if needed. See the guide to the PSA test.
BPH is a slow, non-cancerous growth of the prostate that becomes common after 50 and mainly causes a weak stream and night-time urination. Prostatitis is inflammation, often affects younger men and mainly causes pain and burning. The two can exist together in older men, and treatment then takes both into account. The enlarged prostate page explains BPH, and the burning urination page covers other causes of burning.
Tests that may be needed
- Urine routine and culture, which look for infection
- Urine samples before and after prostate massage, which show whether bacteria come from the prostate
- Semen culture in selected men
- Ultrasound with the urine left after passing, and uroflowmetry for the stream
- PSA blood test, only once any infection has settled
- Transrectal ultrasound or CT scan when an abscess is suspected
Cost, insurance and government schemes
Cost depends on the procedure and your hospital stay. See how estimates, insurance and schemes work.
Frequently asked questions
Is prostatitis a sexually transmitted infection?
Usually not. Most bacterial prostatitis is caused by the same gut bacteria that cause urine infections. In younger men an STI can cause similar symptoms, so STI tests may be advised.
Can prostatitis affect erections or fertility?
Pain and stress can affect sexual function, and infection can affect semen quality for a while. These often improve as the prostatitis is treated. If you are trying for a child, say so, so that semen tests can be planned.
Can I have sex if I have prostatitis?
In chronic prostatitis, regular ejaculation is not harmful and eases symptoms for some men. In acute bacterial prostatitis, rest until the fever and pain settle, and use condoms if an STI has not been ruled out.
Will chronic prostatitis ever go away?
For many men symptoms improve a great deal over months with a combined approach, though flare-ups can happen. The aim is to reduce pain and urine symptoms so that they no longer control daily life.
Why did my doctor stop giving me antibiotics?
When repeated cultures show no bacteria, the problem is not an infection, and more antibiotics bring side effects without benefit. Treatment then focuses on the muscles, nerves and lifestyle factors behind the pain.
Does cycling cause prostatitis?
Long hours on a hard, narrow seat can press on the perineum and worsen pelvic pain in some men. A padded or split seat and regular breaks help; you do not usually need to stop exercising.
This page is general information, not a diagnosis. Please read our medical disclaimer.