Prostate Inflammation: Symptoms & Treatment

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If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Medicade.co.uk are based on peer-reviewed research and information from medical societies and governmental agencies. However, they should not be used as a substitute for professional medical advice, diagnosis, or treatment.

What is prostate inflammation?

Men who suffer from prostate inflammation often experience pain when urinating and in the perineal area. In medical terms, prostate inflammation is referred to as prostatitis or prostatitis syndrome and is ultimately to be understood as inflammation of the male prostate gland.

Intestinal bacteria are often involved in prostate inflammation, which enter the prostate via the urinary tract or the blood and are responsible for inflammation there.

What is the difference between chronic and acute prostatitis?

When it comes to prostate inflammation, a distinction is made between chronic and acute prostatitis in men¹ . While chronic prostate inflammation occurs in an estimated 2 – 10%² of all men, it is only about 0.2%³ in acute cases.

In chronic prostatitis , the affected person suffers from persistent pain in the urinary tract and genitals. However, it is not entirely clear whether this in turn originates from the prostate. Chronic bacterial prostatitis is preceded by a three-month bacterial prostatitis. On the other hand, there is the so-called chronic pelvic pain syndrome (CPPS), which causes similar symptoms and pain, but in which there is no evidence of a bacterial infection.

Acute prostatitis , on the other hand, occurs suddenly and is caused by bacteria. It means severe pain and can usually only be treated with careful medication therapy. It’s not just the area between the penis and the anus that hurts, the stomach and back can also be affected. There is also occasional fever, chills and a general feeling of illness.

Causes prostate inflammation?

Inflammation of the prostate occurs due to various causes. While there is no proven cause for chronic nonbacterial prostatitis, it is known to be possible as a result of acute prostatitis. Scientists assume that a bacterial infection can be the cause of chronic prostate inflammation. However, bacteria can only rarely be detected. Further observations show that men who are often under stress often have chronic prostate inflammation. However, it is not known whether the stress is actually the cause or a side effect resulting from it.

Acute prostatitis is caused by a bacterial infection . This triggers an inflammation at the corresponding site. In some cases, acute prostatitis is the result of a urinary tract infection that has not been cured. In addition to the stress already mentioned, cold in the pelvic and genital areas can also lead to inflammation of the prostate. It is also possible that cycling or horseback riding can cause prostate inflammation. This is a result of the constant pressure of the saddle on the prostate.

Bacterial prostate inflammation

Chronic and acute prostatitis can have both bacterial and non-bacterial causes. Chronic bacterial prostate inflammation is the result of acute bacterial prostate inflammation if this lasts for at least three months. While the prostate’s job is to transport urine and semen to the outside, it can also transport bacteria into the body in the other direction, through the urethra, and trigger acute prostatitis there. Various types of bacteria, such as E. Coli, are the cause of this.

Bacterial prostate inflammation can be contagious and transmitted during sex.

Inflammation of the prostate from sexuality

Sexuality accompanies us almost our entire life – and as beautiful as it may be, it can still cause prostate inflammation, for example, and for different reasons. It is well known that acute prostatitis is often triggered by bacteria. These can be transmitted during sexual intercourse and thus lead to prostate inflammation in the partner.

So that sex is still fun and doesn’t mentally block anyone, condoms protect against transmission. If you like having sex outdoors, you should still keep your genital area warm – or at least pack it up again quickly after intercourse. Cold in the pelvic area can also lead to prostate inflammation.

Symptoms of prostate inflammation

Inflammation of the prostate is often easy to recognize: A list of symptoms can quickly provide information as to whether there is an inflammation of the prostate. In addition to flu-like symptoms such as fever, chills, tiredness or diarrhea , abdominal pain, back pain and testicular pain are also indicators of prostatitis. There is also blood in the urine or semen and general discharge.

The most striking feature of prostate inflammation is pain in the perineum and when urinating. If several of these symptoms occur, a visit to the doctor is recommended in order to be able to start therapy. A visit to the doctor is also advisable because the same symptoms can also indicate other diseases of the prostate.

While the protracted symptoms such as pain occur in chronic prostate inflammation, the usual flu symptoms such as fever, chills and fatigue also occur in chronic prostate inflammation.

Symptoms of prostate inflammation:

  • Fever
  • chills
  • fatigue
  • Diarrhea
  • blood in the urine
  • blood in the semen
  • pain when urinating
  • Pain on defecation
  • perineal pain
  • stomach pain
  • back pain
  • testicle pain
  • discharge

Is prostate inflammation contagious?

Unlike abacterial prostate inflammation, bacterial inflammation of the prostate is considered contagious. In some cases, prostatitis can be sexually transmitted via the bacteria. If there is an acute bacterial prostate inflammation, you should therefore avoid sexual intercourse in order not to infect your partner.

If it does happen, it is strongly recommended to use at least a condom to avoid contagion. As a rule, however, prostate inflammation is not caused by sexually transmitted bacteria. Nevertheless, caution is required.

Diagnosis of prostate inflammation

If you notice the symptoms listed above, a visit to the doctor is advisable. The right contact person for prostate inflammation is the urologist or alternatively, in the first step, the family doctor, who will then probably refer you to the urologist.

The course of the investigation

The examination by the doctor itself begins with a simple conversation in which possible previous illnesses are discussed and to what extent which symptoms have already occurred. This also includes questions about potency and libido⁶.

After the interview, the testicles, penis and abdomen are palpated to detect possible injuries to the internal organs. With a glove and some gel, the doctor inserts his finger into the patient’s rectum to feel the prostate just behind it. For example, possible hardening is detected.

Determine blood and PSA levels

A first possible indicator of prostate inflammation is an elevated PSA level. PSA levels are determined by examining the blood. The doctor takes that from the patient and uses the blood values ​​to determine whether the PSA value is elevated or within the normal range. However, based on this, it is not possible to determine exactly what the patient is suffering from.

An increased PSA value could not only be an indication of prostate inflammation, but also of prostate cancer or other diseases of the chestnut-sized organ. Either way, it is an important indicator for the doctor and patient that they need to carry out more detailed examinations in order to be able to make a definitive diagnosis.

PSA is a protein made exclusively by the prostate. When diseases of the prostate occur, it produces more protein than in a healthy state, which increases the PSA value⁷.

Treatment of prostate inflammation

In order to find the right method for treating prostatitis, it is first important to determine whether it is chronic or acute prostatitis. But what helps against which form of prostate inflammation?

What to do against acute prostatitis?

In the case of acute bacterial prostatitis, the person affected is treated with medication. In advance, the doctor creates a bacterial culture to determine which pathogen is responsible for the prostate inflammation. In this way, a decision can be made as to which antibiotic is to be used for therapy. Antibiotics commonly used in bacterial prostatitis are fluroquinolones such as ciproflaxin or ofloxacin. Taking the medication is usually recommended for a minimum of four weeks, as this is the only way to prevent chronic bacterial prostate inflammation. If the symptoms of the disease are particularly pronounced, the treatment is carried out as an inpatient in the hospital, since the antibiotic can be inserted directly into the vein here and thus takes effect more quickly⁸.

If it is no longer possible to urinate due to urinary retention, a urinary catheter must be surgically inserted through the abdomen. The treatment of prostate inflammation must be carefully coordinated with the doctor responsible.

What helps against chronic prostatitis?

In order to be able to treat chronic prostate inflammation ideally, it is important to distinguish between bacterial and non-bacterial chronic prostate inflammation.

In the case of bacterial prostatitis, drug treatment is also necessary to control the inflammation. Natural and herbal therapies and remedies also work against non-bacterial chronic prostate inflammation and alleviate the suffering. Which therapy is used always depends on the symptoms.

Abacterial chronic prostate inflammation is often caused by the psyche. In these cases, psychotherapy would be used to bring about a cure. Warmth, e.g. hot sitz baths, light exercise, e.g. jogging and drinking a lot, help to alleviate the symptoms. Tea made from stinging nettles, goldenrod, willowherb or birch is especially effective in addition to water⁹.

A prostate massage can relax the prostate and stimulate the flow of secretions so that the bacteria can be flushed out. Autogenic training, on the other hand, relaxes the pelvis.

In addition, alpha-1 receptor blockers help relax the muscles of the prostate and bladder. This makes it easier to urinate and is associated with less pain.

How long does prostate inflammation last?

The duration of prostate inflammation depends on its cause. If acute bacterial prostatitis lasts three months or more, it is called chronic prostatitis, which has a treatment period of about four to six weeks. If the acute bacterial prostatitis is treated with medication in good time, it usually takes between ten and 14 days to heal.

Chronic nonbacterial prostate inflammation, on the other hand, is difficult to treat and cure. Here, the therapy is aimed more at relieving the symptoms. Since this form of prostatitis often has its origins in the male psyche, psychotherapy is often recommended for healing.

Prostate Inflammation Won’t Go Away?

If prostatitis is not treated early, it can gradually become increasingly difficult to treat and manage the symptoms. Even after the prostate inflammation has healed, men should continue to take it easy and do nothing that could irritate the prostate – such as cycling, horseback riding or exposing the pelvis to cold weather. Otherwise the prostate inflammation keeps coming back and doesn’t go away.

What are the possible consequences of prostate inflammation?

With the constant enlargement of the prostate, prostate inflammation can eventually lead to erectile dysfunction. As the tissue inside the prostate expands, its ducts can become increasingly blocked. This in turn can lead to painful urination, sex and ejaculation and thus to erectile dysfunction.

Inflammation of the prostate can also limit the fertility of the person concerned and possibly even endanger the desire to have children. But the latter rarely happens. It is more common that the mobility of the sperm is reduced in the course of prostate inflammation, which makes it more difficult for the partner to become pregnant. This may even necessitate artificial insemination.

Especially chronic, correspondingly long-lasting prostate inflammation can affect the psyche and sometimes even cause depression. Due to the fact that simple activities such as urinating are no longer possible without symptoms, the mind is always busy with the inflammation. She may question one’s masculine abilities when it comes to sexual activity and induce a fear of failure as a lover or potential father.

How to prevent prostate inflammation?

If you want to prevent prostate inflammation, you can follow a few simple rules. The prostate is considered prone to inflammation when it is hypothermic. Good prevention is therefore characterized, among other things, by always keeping the pelvic region warm and not confronting it with cold for too long. An occasional bath or a visit to the sauna can help to create a pleasant feeling of warmth.

It is also recommended to drink water regularly. This flushes the bladder and urethra regularly and prevents bacteria from taking hold. If a urinary tract infection is already present, it should be treated immediately before it develops into prostatitis. Not only water flushes the body well: regular sexual intercourse also flushes the germs out of the prostate.

Passionate cyclists or riders are particularly at risk of developing prostate inflammation. The ideal prevention here is to make sure not to choose a saddle that is too hard. It would eventually press on the prostate permanently and irritate it.

Sport despite prostate inflammation?

Whether sport is possible with prostate inflammation depends on the type of inflammation. If you have acute prostatitis, which is usually accompanied by fever, chills and tiredness, you should urgently refrain from exercising. Due to the severity of the symptoms, the person concerned will probably not consider it anyway – and that’s a good thing, because sport would only intensify them and prolong the healing process. Even after healing, sporting activities should only be resumed very slowly and carefully. Cycling or horseback riding should be avoided at first. The contact of the pelvis with the saddle causes additional stress.

If you have classic nonbacterial chronic prostate inflammation, exercise is even advisable¹⁰. It is often related to the psyche – and sport would improve the state of mind of the person concerned. Pelvic floor exercises in particular are recommended because they train muscles and connective tissue and promote blood circulation. This in turn increases the immune system. But the same applies here: cycling and horseback riding are not ideal and irritate the prostate. Swimmers could potentially pick up bacteria from the water. In the case of prostate inflammation, on the other hand, going to the sauna can provide a pleasant feeling of warmth in the pelvic region.

The explanations and lists of possible treatment options are purely informative and do not replace consultation with your doctor or the explanations about the intake, mode of action and side effects from the product-specific leaflet.

Isabel D White

Isabel D White

Isabel led the Royal Marsden Hospital (London) psychosexual therapy service until 2019. She works in partnership with individuals & couples to explore physical, emotional & relationship factors that contribute to sexual difficulties after cancer. These include: low desire, erection, arousal or orgasmic difficulties, sexual pain & sexual avoidance. She adopts an integrative approach to personalized therapy using psychosexual therapy (sensate focus framework), biomedical management (erectile dysfunction medication & devices, menopause & vaginal health strategies, sexual aids) & psychoeducation.

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