Symptoms may include:
Symptoms that are common with acute bacterial prostatitis include:
Symptoms that are common with chronic bacterial prostatitis include:
Symptoms that are common with chronic nonbacterial prostatitis are similar to those of chronic bacterial prostatitis, but without fever.
Asymptomatic inflammatory prostatitis has no symptoms and is usually discovered when undergoing tests for other problems.
As its name suggests, bacterial prostatitis is caused by bacteria. Researchers are not sure what causes chronic nonbacterial prostatitis or asymptomatic prostatitis. Injury to the prostate, or problems with the immune or nervous systems, may contribute to chronic nonbacterial prostatitis. Men with prostate cancer often have prostatitis, benign prostatic hyperplasia (BPH), or both. Prostatitis interacts with BPH-increasing the risk of prostate cancer.
Your doctor will take a medical history and ask you about your symptoms. Your doctor will do a digital rectal exam, examining your prostate by inserting a lubricated finger into your rectum. You may need to provide a urine sample, semen sample, or get a blood test. Your doctor may suggest you see a urologist, a specialist who treats urinary tract problems.
Bacterial prostatitis. Oral antibiotics, taken for several weeks. In severe cases, you may need intravenous (IV) antibiotics. Other medications may include stool softeners and pain relievers, such as ibuprofen (Advil).
Chronic nonbacterial prostatitis. In addition to pain relievers, alpha blockers, which help relax the bladder may help if you have trouble urinating. Alpha blockers include alfuzosin (Uroxatral) and doxazosin (Cardura). Side effects can include headaches and low blood pressure.
Severe cases of bacterial prostatitis may require surgery.
Be sure to tell your doctors about any herbs or supplements you take, or any alternative therapies you use. Some herbs, supplements, and alternative therapies (CAM) may interfere with conventional medicine. Work with a doctor who is experienced in complementary and alternative therapies to find the combination of treatments that is right for you.
Drink plenty of water (48 oz. a day). Avoid alcohol, caffeine, and spicy foods. These supplements may help:
Herbs are a way to strengthen and tone the body's systems. As with any therapy, you should work with your doctor to diagnose your problem before starting treatment. You may use herbs as dried extracts (capsules, powders, or teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, make teas with 1 tsp. of herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Drink 2 to 4 cups per day. You may use tinctures alone or in combination as noted.
Some of the most common remedies used for prostatitis are listed below. The usual dose is 3 to 5 pellets of a 12X - 30C remedy every 1 to 4 hours until your symptoms improve.
Kegel exercises improve pelvic muscle tone. They may help some men reduce urinary symptoms. These exercises involve tightening and relaxing the pelvic floor muscles. To identify the muscles, it may help to think of the muscles you use to stop and start a stream of urine, or to keep from passing gas. Tighten muscles for a count of 10, then relax for a count of 10. Repeat 10 times, and do 5 to 10 sets daily.
Contrast sitz baths. You will need two basins that you can sit in comfortably. Fill one basin with hot water, one with cold water. Sit in hot water for 3 minutes, then in cold water for 1 minute. Repeat this 3 times to complete 1 set. Do 1 to 2 sets a day, 3 to 4 days a week. Avoid sitz baths if you have acute bacterial prostatitis.
Acupuncture may improve urinary flow and decrease swelling and inflammation in some men with chronic nonbacterial prostatitis.
Be sure you follow your doctor's instructions for treatment, and keep using the treatment as directed even if you start to feel better.
Men should have a yearly prostate examination after age 40, even if they have no symptoms of prostate problems. In recurring cases, you may need ongoing treatment with periodic checkups.
Bergman J, Zeitlan SI. Prostatitis and chronic prostatitis/chronic pelvic pain syndrome. Expert Rev Neurother. 2007;7(3):301-307.
Budia A, Palmero J, Broseta E, Tejadillos S, Benedicto A, Queipo JA, et al. Value of semen culture in the diagnosis of chronic bacterial prostatitis: A simplified method. Scand J Urol Nephrol. 2006;40(4):326-331.
Capodice JL, Bemis DL, Buttyan R, Kaplan SA, Katz AE. Complementary and alternative medicine for chronic prostatitis/chronic pelvic pain syndrome. Evid Based Complement Alternat Med. 2005 Dec;2(4):495-501.
Elist J. Effects of pollen extract preparation Prostat/Poltit on lower urinary tract symptoms in patients with chronic nonbacterial prostatitis/chronic pelvic pain syndrome: A randomized, double-blind, placebo-controlled study. Urology. 2006;67:60-63.
Ferri. Ferri's Clinical Advisor 2014, 1st ed. St. Louis, MO: Mosby. 2013.
Giubilei G, Mondaini N, Minervini A, Saieva C, Lapini A, Serni S, et al. Physical activity of men with chronic prostatitis/chronic pelvic pain syndrome not satisfied with conventional treatments -- could it represent a valid option? The physical activity and male pelvic pain trial: A double-blind, randomized study. J Urol. 2007;177(1):159-165.
Gujadhur R, Anng J. Careful assessment key in managing prostatitis. Practitioner. 2015; 259(1781):15-9,2.
Hochreiter WW, Weidner W. Prostatitis -- a frequently unrecognized disease. Ther Umsch. 2006;63(2):117-121.
Hung SC, et al. Synergistic interaction of benign prostatic hyperplasia and prostatitis on cancer risk. Br J Cancer. 2013;108(9):1778-1783.
Ismail M, Mackenzie K, Hashim H. Contemporary treatment options for chronic prostatitis/chronic pelvic pain syndrome. Drugs Today. 2013;49(7):457-462.
Kaplan SA, Volpe MA, Te AE. A prospective, 1-year trial using saw palmetto versus finasteride in the treatment of category III prostatitis/chronic pelvic pain syndrome. J Urol. 2004;171:284-288.
Kim JW, Oh MM, Bae JH, Kang SH, Park HS, Moon du G. Clinical and microbiological characteristics of spontaneous acute prostatitis and transrectal prostate biopsy-related acute prostatitis: Is transrectal prostate biopsy-related acute prostatitis a distinct acute prostatitis category? J Infect Chemother. 2015; 21(6):434-7.
Kucuk EV, Suceken FY, Bindayi A, Boylu U, Onol FF, Gumus E. Effectiveness of acupuncture on chronic prostatitis-chronic pelvic pain syndrome category IIIB patients: a prospective, randomized, nonblinded, clinical trial. Urology. 2015; 85(3):636-40.
Larsen EH, Frimodt-Moller C. Prostatitis -- pelvic pain syndrome. Ugeskr Laeger. 2007;169(20):1921-1923.
Lee JH, Lee SW. Relationship between premature ejaculation and chronic prostatitis/chroni pelvic pain syndrome. J Sex Med. 2015; 12(3):697-704.
Marx S, Cimniak U, Rutz M, Resch KL. Long-term effects of osteopathic treatment of chronic prostatitis with chronic pelvic pain syndrome: a 5-year follow up of a randomized controlled trial and considerations on the pathophysiological context. Urologe A. 2013;52(3):384-390.
Murphy AB, Macejko A, Taylor A, Nadler RB. Chronic prostatitis: management strategies. Drugs. 2009;69(1):71-84.
Nickel JC. Treatment of chronic prostatitis/chronic pelvic pain syndrome. Int J Antimicrob Agents. 2008 Feb;31 Suppl 1:S112-6.
Sun H, Wang H, Zhang A, et al. Berberine ameliorates nonbacterial prostatitis via multi-target metabolic network regulation. OMICS. 2015; 19(3):186-95.
Vicari E, La Vignera S, Castiglione R, Condorelli RA, Vicari LO, Calogero AE. Chronic bacterial prostatitis and irritable bowel syndrom: effectiveness of treatment with rifaximin followed by the probiotic VSL#3. Asian J Androl. 2014; 16(5):735-9.
Wagenlehner FM, Schneider H, Ludwig M, Schnitker J, Brähler E, Weidner W. A pollen extract (Cernilton) in patients with inflammatory chronic prostatitis-chronic pelvic pain syndrome: a multicentre, randomised, prospective, double-blind, placebo-controlled phase 3 study. Eur Urol. 2009 Sep;56(3):544-551.
Zhang R, Sutcliffe S, Giovannucci E, et al. Lifestyle and risk of Chronic Prostatitis / Chronic Pelvic Pain Syndrome in a Cohort of United States Male Health Professionals. J Urol. 2015; 194(5):1295-300.