Prostatitis: Causes,
Symptoms and Treatments

Published 2021/10/20

What is prostatitis?

Prostatitis is the swelling and inflammation of the prostate, which presents with various symptoms and has various causes.


The symptom of prostatitis can be tricky and not all are definitively diagnosable. 


One of the common symptoms is perineal pain—pain in the perineum. The perineum is located behind the scrotum and before the rectum. Another common symptom is pain during urination or ejaculation. Other symptoms include urgency such as the sudden urge to urinate. Finally, the so-called urinary retention—the inability to empty the bladder or empty completely. 

The National Institutes
of Health (NIH)
Has Classified Prostatitis into
Four categories:

1. Acute bacterial prostatitis

2. Chronic bacterial prostatitis

3. Chronic nonbacterial prostatitis/chronic pelvic pain syndrome 

4. Asymptomatic inflammatory prostatitis

How Prostatitis is Diagnosed?

Your healthcare provider will assess your symptoms and perform a physical exam.

  • Digital rectal exam: Your provider inserts a gloved, lubricated finger into the rectum to check the prostate gland for pain and swelling. In addition to digital rectal examination, this exam may include a prostate massage to collect a sample of seminal fluid.
  • Urinalysis: A urinalysis and urine culture check for bacteria and UTIs.
  • Blood test: A blood test measures PSA, a protein made by the prostate gland. High levels may indicate prostatitis, BPH or prostate cancer.

More invasive tests for prostatitis may include:

  • Cystoscopy: A cystoscopy can look for other urinary tract problems but does not diagnose prostatitis. Your provider uses a cystoscope (a pencil-sized lighted tube with a camera or viewing lens on the end) to view inside the bladder and urethra.
  • Transrectal ultrasound: Men with acute bacterial prostatitis or chronic bacterial prostatitis that doesn’t improve with antibiotics may get a transrectal ultrasound. To be more specific, a slender ultrasound will probe inserted into the rectum uses sound waves to produce images of the prostate gland. This test can show prostate gland abnormalities, abscesses or stones.

1. Acute Bacterial Prostatitis Cause, Symptoms, and Treatment

Cause: The cause of the first kind of prostatitis is a mainly acute bacterial infection, often diagnosed by the increased presence of bacteria and white blood cells in the urine, semen, and prostatic secretion.  



  • Fever
  • Chills
  • Fatigue
  • Joint and/or muscle aches 
  • Pain in the area of the perineum, pelvis, and genitals.  
  • Pain/burning with urination and ejaculation
  • Symptoms of urinary tract obstruction: frequent urination (especially at night), urgency (sudden strong urge to urinate), hesitancy (unable to start stream), weak stream, and incomplete voiding
  • Lower back and/or lower abdominal pain
  • Spontaneous urethral discharge—a fluid that is not urine or sperm, but the product of an infected or irritated urethra.  
  • Erectile dysfunction

Please note that the above symptoms can also occur in patients who don’t experience prostatitis, but instead have active urethritis, urinary or genital cancer, urinary tract disease, urethral strictures, or neurogenic bladder. Therefore it is important to consult your doctor and get a professional diagnosis. 


Treatment: Normally healthcare providers or physicians use antibiotics to treat acute bacterial prostatitis. If the pain is unmanageable, your healthcare provider or physicians may prescribe pain medication.


In cases where the prostate has enlarged and obstructed the urethra, an intermittent catheter can be prescribed to help void the bladder. An intermittent catheter is a thin tube that is inserted into the obstructed urethra, creating a clear passage for urine to come out. The intermittent catheter is inserted every time one needs to urinate and is disposed of afterward. 

2. Chronic Bacterial Prostatitis: Cause, Symptoms, and Treatment

Cause: The main cause of chronic bacterial prostatitis is the recurring bacterial infection of the prostate. It is diagnosed in the same way as acute bacterial prostatitis by the elevated presence of white blood cells and bacteria, but different from acute bacterial prostatitis, the infection does not respond immediately to antibiotics and needs further treatment. 


Symptoms: Symptoms are the same as acute bacterial prostatitis but present recurrently and often less intensely. 


Treatment: The treatment often includes several courses of antibiotics instead of one. In the case of the blocked urethra, a catheter can be prescribed to manage symptoms of urinary retention. 

3. Chronic Nonbacterial Prostatitis

The third kind, chronic nonbacterial prostatitis (a.k.a. Chronic Pelvic Pain Syndrome), is diagnosed when patients exhibit the same symptoms as chronic bacterial prostatitis but no bacteria presence is detected in urine, semen, or prostate secretion. 


This condition is subdivided into two types: inflammatory and noninflammatory.

  1. Inflammatory: Means there is a high level of white blood cells in semen and prostate secretions without a detectable presence of an infectious agent. 
  2. Noninflammatory: no presence of either white blood cells or infectious agents.

Chronic nonbacterial prostatitis is the most common type of prostatitis but very little is understood about it. There is no specific cause and treatment for chronic nonbacterial prostatitis at this point.

4. Asymptomatic Inflammatory Prostatitis

Asymptomatic inflammatory prostatitis is when the prostate is inflamed but the patient feels no symptoms at all. Because of the lack of symptoms, this kind of prostatitis is often diagnosed during tests for infertility or elevated prostate-specific antigen (PSA) level when a large amount of white blood cells is found in ejaculation. 


This type of prostatitis does not cause complications and does not need treatment unless causing infertility in males who are planning for conceiving a child with their partner.

A Common Effect
of Prostatitis: Urinary Retention

One major effect of prostatitis is urinary retention, which is the inability of urine to leave the body completely or partially. As the prostate becomes inflamed and enlarged, it obstructs the urethra, which travels through the middle of the prostate to connect the bladder and the penis. The obstruction of the urethra causes urinary retention, causing the urine cannot leave the body or have trouble being emptied completely. 


What’s more, urinary retention can increase risks for getting a bladder infection, bladder damage, UTI, kidney infection, and kidney failure. 


Doctors may prescribe catheters to manage urinary retention. Here is a comprehensive guide for how the choose the right catheter for you, covering important topics like size, tip, infection risks, types of lubrication, discretion, and portability. 

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