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Chronic prostatitis

Medically reviewed by Drugs.com. Last updated on Dec 5, 2022.

What is chronic prostatitis?

Harvard Health Publishing

The prostate is a walnut-sized gland that sits below the bladder in men. This gland makes fluid that mixes with sperm to form semen.

Chronic prostatitis

Prostatitis is inflammation or swelling of the prostate gland. When symptoms start gradually and linger for more than a couple of weeks, the condition is called chronic prostatitis.

Three major types of chronic prostatitis are:

Chronic prostatitis is common and affects adult men of all ages and from all backgrounds. About five percent of men experience symptoms of chronic prostatitis at some point in their lives. Chronic prostatitis is the reason for up to 25% of office visits to urologists. Urologists are doctors who specialize in diseases of the urinary tract.

Some men develop a chronic infection in the prostate that does not cause any symptoms. Men with this problem may be diagnosed during an evaluation for other urological conditions, such as enlarged prostate or infertility. Doctors often treat the infection with the same antibiotics used for chronic bacterial prostatitis.

Bacterial infection of the prostate gland also can cause acute prostatitis, which starts suddenly and usually causes fever and more serious symptoms. Acute prostatitis is less common than chronic prostatitis.

Symptoms of chronic prostatitis

Prostatitis usually causes swelling of the prostate gland. The prostate surrounds the urethra (the tube that carries urine out of the body from the bladder). The swollen prostate presses on the urethra causing pain or other problems with urination.

Typical symptoms of chronic prostatitis include:

In some men, symptoms may be hardly noticed or only slightly annoying. Other men are quite bothered by chronic prostatitis and find that the symptoms interfere with work, leisure activities and sexual enjoyment.

Diagnosing chronic prostatitis

If your doctor suspects prostatitis, he or she will ask you to describe your symptoms in detail. Your doctor will also want to know:

Your doctor will examine your prostate gland by inserting a gloved and lubricated finger into your rectum. In chronic prostatitis, the gland may be swollen, firm and tender, or it may feel normal. You may experience pain or an urgent need to urinate when pressure is applied to the prostate. Your doctor will examine you to look for other problems that may be causing your symptoms.

The next step will be to examine a urine specimen to look for white blood cells and bacteria. Often your doctor will ask you to produce separate urine specimens before and after your prostate gland is examined. Typical findings depend on the specific type of chronic prostatitis:

In most cases of chronic prostatitis, this simple evaluation is all that is needed to make a diagnosis and begin treatment. Occasionally, a person may have vague or unusual symptoms. Then your doctor will consider other diagnoses, such as interstitial cystitis, urethritis, benign enlargement of the prostate, or even prostate cancer. In such a situation, your doctor may recommend additional blood or urine tests, an ultrasound of the prostate, an examination of the bladder with a lighted telescope (cystoscopy) or a needle biopsy of the prostate.

Treatment options

The following list of medications are in some way related to or used in the treatment of this condition.

View more treatment options

Expected duration of chronic prostatitis

Chronic prostatitis may last for weeks or months before it is diagnosed. Some cases of chronic prostatitis respond promptly to treatment, and symptoms disappear over several days. In other cases, symptoms may linger for weeks or months or may come and go over a period of years.

Preventing chronic prostatitis

Chronic prostatitis cannot be prevented.

Treating chronic prostatitis

For many years, antibiotics have been the mainstay of treatment for chronic prostatitis. Antibiotics such as trimethoprim-sulfa (Bactrim, Septra), ciprofloxacin (Cipro) and levofloxacin (Levaquin) are used most often to treat chronic bacterial prostatitis. Because it is difficult for antibiotics to get into the prostate gland, they must be given at high doses for an extended period, often four or more weeks.

Even if no bacteria are seen in the urine, your doctor may still be concerned that you have a chronic bacterial prostatitis. In that situation, he or she may prescribe a course of antibiotics. Some men may get relief from this treatment. However, in many cases, antibiotics alone will not eliminate the problem.

Other treatments that men may consider include:

Often the exact reason why a man with chronic prostatitis has symptoms is not clear. And there may be more than one contributing factor. A treatment for one man may not work in another man with similar symptoms.

Some men will improve on their own or with the first treatment that is tried. Others will continue to experience symptoms despite a variety of treatments.

When to call a professional

Contact a health care professional if you develop:

Prognosis

Chronic prostatitis can be very difficult to cure. Many men do not respond to one or more prolonged courses of antibiotics. Because little is understood about prostatitis that is not caused by infection, finding the right treatment may be difficult. Nonetheless, several potentially effective treatments are available.

Don't be discouraged if your symptoms have not responded to the first or even second treatment. Keep working with your doctor to help you get relief. If you have unusual or particularly troubling symptoms, your doctor may refer you to a urologist or other specialist.

There is no evidence that chronic prostatitis increases the risk of developing prostate cancer.

Additional info

National Institute of Diabetes and Digestive and Kidney Disorders
https://www.niddk.nih.gov/

American Urological Association
https://www.auanet.org/


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