Prostate Infections: A Treatable Urinary Problem

What is a prostate infection?

A prostate infection (also called prostatitis) is an inflammation of the prostate. The prostate produces fluid (semen) that nourishes and protects sperm. Infection occurs when bacteria lining the urethra goes into the prostate gland. The urethra is a tube that runs through the prostate and releases urine from your bladder.

There are two main types of prostate inflammation:

• Acute bacterial prostatitis is an infection of the prostate caused by bacteria that travel from the urethra to the prostate.
• Chronic bacterial prostatitis. This is a low-grade bacterial infection of the prostate that can continue for weeks or even months. It is more common in older men who have an enlarged prostate. It can follow a bout of acute bacterial prostatitis.

Prostate infections are usually not something to worry about. It can happen in men of all ages. But you should see your doctor right away if you have symptoms so you can be treated with antibiotics.

Most common symptoms

Symptoms of acute prostatitis are dramatic and develop suddenly. It typically causes high fever, chills, joint and muscle aches, and extreme fatigue.

You may have pain around the base of your penis and behind your scrotum, pain in your lower back, or the feeling of a full rectum. As the prostate becomes more swollen, you may find it difficult to urinate, and the urine stream may become weak.

Signs of chronic prostatitis, on the other hand, develop gradually. They may be so subtle that you don’t realize you have a problem. You may have urinary symptoms that come and go. Some men have low back pain, pain in the rectum, or a feeling of heaviness behind the scrotum. Others have pain after ejaculation. Because the symptoms are subtle, many men do not know they have it.

Main symptoms

Acute prostatitis

• Difficulty urinating, with a weak urine stream
• Pain while urinating
• Pain behind your scrotum
• Pain in your lower back
• Feeling of a full rectum
• Fever
• Chills
• Joint and muscle aches
• Fatigue

Chronic prostatitis

• Urinary symptoms that come and go, including urgency, frequent urination, and painful urination
• You may have low back pain, pain in the rectum, or heaviness behind the scrotum
• You may have pain after ejaculation
• You may have semen tinged with blood
• You may have a low-grade fever

Next steps

If you think you have a prostate infection, see your doctor. They will examine your prostate and take urine samples to test for bacteria. If you develop fevers or chills or your symptoms become unbearable, see your doctor immediately, or go to urgent care.

Treatment

Acute prostatitis

Acute prostatitis is treated with antibiotics. You may be prescribed a combination of trimethoprim and sulfamethoxazole (Bactrim), or a fluoroquinolone (Ciprofloxacin or Levofloxacin).

Antibiotics should be taken for at least 4 to 6 weeks. It may take some time after starting treatment for symptoms to subside. Be sure to finish the entire course of antibiotics.

Chronic prostatitis

The same antibiotics used to treat acute prostatitis are also used to treat chronic prostatitis. But you need to take them for a longer period of time (up to 3 months). There is a chance that the infection may return. But it can usually be controlled with another course of antibiotics.

Your doctor may also recommend taking over-the-counter pain medications, such as ibuprofen (Advil), and warm baths to help with pain while the antibiotics do their job.

Causes

Prostate infections occur when bacteria lining the urethra finds its way to the prostate gland. Prostatitis frequently develops in men who have difficulty urinating or emptying their bladder completely. Urine that hasn’t been released can back up in the prostate ducts, which leads to infection.

A prostate infection may also be triggered by a sexually transmitted infection, such as gonorrhea or chlamydia.

Risk factors

• Difficulty urinating or emptying your bladder completely
• A weakened immune system
• Previous prostate biopsy or urologic surgery
• Age (acute prostatitis usually occurs in younger men, while chronic prostatitis is more common in older men)

Follow up

Your doctor may want to see you once you’ve completed the antibiotics. If you continue to have symptoms or infections, your doctor may refer you to a specialist, such as a urologist.

Preventative tips

• Drink plenty of fluids
• Urinate regularly
• Address issues that are causing difficulty urinating with your doctor
• Get treated promptly if you suspect you have a urinary tract infection (UTI) or sexually transmitted infection