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Medically Approved by Dr Aqua Asif (May 1st 2025)

Written by FTC Medical team, 

At a Glance

Prostatitis — inflammation of the prostate gland — affects up to 15% of men at some point in their lives and is one of the commonest urological diagnoses in men under 50. It can cause pelvic pain, urinary difficulties and sexual symptoms, but with accurate diagnosis most men respond well to targeted treatment including antibiotics, pelvic-floor physiotherapy or lifestyle changes.

Key takeaways:

  • Four recognised types — acute bacterial, chronic bacterial, chronic pelvic pain syndrome (CP/CPPS) and asymptomatic inflammatory prostatitis
  • CP/CPPS is the most common — accounting for around 90% of cases, often with no detectable bacterial cause
  • Not the same as prostate cancer — prostatitis is inflammatory, not malignant, though both can raise PSA levels
  • Treatable condition — antibiotics clear bacterial forms; chronic cases benefit from a tailored multi-approach plan
  • Seek urgent help — if you develop fever, rigours or inability to pass urine alongside pelvic symptoms

Prostatitis is an umbrella term for inflammation of the prostate gland. It may be triggered by a bacterial infection or arise without detectable bacteria — a form known as chronic prostatitis / chronic pelvic pain syndrome (CP/CPPS). Men can experience troublesome urinary symptoms, pelvic pain and, at times, sexual dysfunction that can seriously disrupt day-to-day life.

Prostatitis is one of the commonest prostate-related diagnoses in men under 50, accounting for roughly a quarter of male urology consultations (EAU Guidelines on Urological Infections, 2024). In this guide, reviewed by Dr Aqua Asif (MRCS), we outline what prostatitis is, why it occurs, and the tests and treatments available.

What is the prostate?

The prostate is a walnut-sized gland located directly beneath the bladder, surrounding the first segment of the urethra (the tube that drains urine). Its main role is to add nutrient-rich fluid to semen during ejaculation. Because the urethra passes through the gland, any process that makes the prostate swollen, tender or larger than usual can disturb urinary flow or ejaculatory function.

From mid-life onwards the prostate often enlarges as part of a benign process called benign prostatic hyperplasia (BPH). Both BPH and prostatitis can cause urinary symptoms. Prostate cancer also becomes more common with age, although it typically develops silently at first. Doctors will usually investigate persistent pelvic or urinary problems thoroughly to distinguish between benign and malignant causes.

What causes prostatitis?

Prostatitis has two broad causes: bacterial infection and non-bacterial inflammation. Bacterial prostatitis accounts for a minority of cases, while chronic prostatitis / chronic pelvic pain syndrome (CP/CPPS) — which has no single identifiable cause — is by far the most common form.

  • Bacterial prostatitis (acute or chronic) develops when bacteria reach the prostate, usually via the urethra or following a bladder infection. It can also follow procedures such as prostate biopsy, catheterisation or pelvic surgery, or result from a sexually transmitted infection.
  • Non-bacterial prostatitis / CP/CPPS is multifactorial. Current evidence suggests a combination of pelvic-floor muscle over-activity, nerve hypersensitivity, prior pelvic injury or infection, autonomic dysregulation linked to stress, and — in some men — persistent low-grade inflammation (EAU Guidelines on Urological Infections, 2024).

Features that appear to raise risk include:

  • Previous prostatitis — recurrent episodes or urinary-tract infections
  • Prostate procedures — recent instrumentation, biopsy or pelvic trauma
  • Perineal pressure — prolonged cycling, horse-riding or sitting on hard surfaces
  • Psychological stress — chronic stress, anxiety or depression
  • Weakened immunity — poorly controlled diabetes or immunosuppression
  • Unprotected sex — chiefly due to infection risk

Because triggers vary, an accurate diagnosis is important so treatment — whether antibiotics, pelvic-floor physiotherapy, pain modulation or other measures — targets the dominant likely driver.

How common is prostatitis?

Prostatitis is one of the most common urological conditions in younger men. Around 2-10% of adult men experience symptoms of chronic prostatitis at any one time, and up to 15% report at least one episode during their lives. It accounts for roughly a quarter of all male urology consultations, particularly in men under 50 (EAU Guidelines on Urological Infections, 2024).

Men may experience a single acute episode, recurrent bouts, or persistent symptoms that wax and wane over months or years.

What are the symptoms of prostatitis?

Prostatitis symptoms vary by subtype but commonly include pelvic or perineal pain, urinary difficulties (burning, frequency, urgency) and sometimes painful ejaculation or sexual dysfunction. Symptoms may overlap with benign prostatic hyperplasia (BPH) or, less commonly, prostate cancer — making accurate diagnosis important.

Feature Acute Bacterial Chronic Bacterial CP/CPPS Asymptomatic
Onset Sudden Gradual / intermittent Fluctuating None
Fever Common Rare No No
Pain Severe pelvic / perineal Dull, recurrent Variable pelvic discomfort None
Urinary symptoms Burning, difficulty, retention Irritative, recurrent UTIs Frequency / urgency None
Sexual symptoms Possible Cloudy semen Painful ejaculation, dysfunction None
Bacterial cause Yes Yes Usually no No

Source: NICE NG110, EAU Guidelines on Urological Infections (2024)

 

How does it differ from prostate cancer?

Prostatitis and prostate cancer are fundamentally different conditions — prostatitis is inflammation, not malignancy — but they can share overlapping symptoms such as urinary difficulties and a raised PSA level. Understanding the key differences helps reduce unnecessary anxiety.

  • Speed and pain: Prostatitis, especially the acute bacterial type, often presents abruptly with pain and systemic upset. Early prostate cancer typically does not cause pain and develops more slowly, although advanced disease can cause bone pain or obstructive urinary symptoms.
  • Fever: High temperature, rigours or feeling acutely unwell suggests infection or inflammation rather than cancer.
  • PSA overlap: Both conditions can raise PSA. A transient PSA rise linked to prostatitis typically falls after treatment, whereas a persistently or progressively elevated PSA warrants further investigation.

Multiparametric MRI (mpMRI) has reshaped early prostate-cancer diagnosis — it detects many clinically significant tumours and helps avoid unnecessary biopsy. A negative MRI greatly lowers, but does not eliminate, the chance of cancer, so biopsy may still be advised if PSA remains suspicious or clinical concern persists (NICE NG131).

When to seek medical care

Seek urgent assessment if you experience:

  • Fever, shivering (rigours) or feeling acutely unwell alongside urinary symptoms
  • Inability to pass urine

If you have persistent pelvic pain / discomfort, or painful ejaculation / new sexual dysfunction, arrange a prompt review also. Early evaluation ensures targeted treatment and helps to investigate other prostate or bladder conditions. Getting a consultation or second opinion can also provide clarity, especially if symptoms are persistent or unclear.

How is prostatitis diagnosed?

  1. Symptom review and examination – your doctor will ask about pain, waterworks, sexual health and general wellbeing, then examine your abdomen and perform a digital‑rectal examination (DRE) to feel the prostate.
  2. Urine tests – a mid‑stream (MSU) sample checks for infection and inflammation. If a sexually‑transmitted infection is a possibility, a first‑pass urine or swab is sent for chlamydia/gonorrhoea.
  3. Blood tests – a full blood count and markers of infection if you are unwell; PSA may be measured but can rise transiently during prostatitis, so it is often repeated once things have settled.
  4. Imaging – ultrasound or MRI is reserved for persistent symptoms, suspected prostate abscess or to investigate a raised PSA.

Not every man needs every test; evaluation is individualised.

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    How is prostatitis treated?

    Treatment depends on whether the prostatitis is bacterial or non-bacterial. Bacterial cases often clear up with a course of antibiotics, sometimes taken for several weeks. Pain relief and anti-inflammatory medications are also used to manage discomfort and speed up recovery.

    Chronic prostatitis, especially non-bacterial forms, is more complex and often needs a tailored, multi-approach plan. Treatments aim to reduce symptoms, address triggers, and improve quality of life over time. Your doctor may recommend a combination of therapies such as:

    • Alpha-blockers to relax muscles in the prostate and bladder
    • Pelvic floor physiotherapy
    • Psychological support or stress-management techniques (CBT/mindfulness)
    • Dietary adjustments and targeted supplements
    • Some men find warm baths, ejaculation at comfortable intervals, avoiding long spells of sitting and moderating caffeine / alcohol / spicy foods helpful

    The Focal Therapy Clinic’s expert team tailors each treatment plan based on your personal history, lifestyle, and symptom pattern. This ensures men receive care that supports both physical recovery and long-term wellbeing. Ongoing monitoring also helps adjust treatment as needed for the best outcomes.

    How can prostatitis be prevented?

    There is no guaranteed way to prevent prostatitis, but sensible lifestyle measures can promote prostate health and may reduce the likelihood, or recurrence, of symptoms:

    • Practice good genital hygiene
    • Break-up long periods of sitting
    • Exercise at least three times a week
    • Stay well-hydrated (unless on fluid restriction)
    • Empty the bladder after sexual activity
    • Practise safer sex
    • Manage stress proactively
    • Seek treatment for suspected urinary infections

    A healthy lifestyle, including following prostate cancer diet tips, can also support the immune system and reduce inflammation. These changes may not guarantee prevention, but they offer long-term benefits for both prostate and overall health. Prevention is often about small, consistent choices that can add up over time.

    FAQs

    FAQs

    Is prostatitis a serious condition?

    Prostatitis is inflammation of the prostate gland — not cancer — but it can have a serious impact on a man’s comfort and quality of life. Acute bacterial prostatitis requires urgent antibiotic treatment and can occasionally lead to complications if untreated. Chronic prostatitis (CP/CPPS) is not dangerous but may persist for months or years without appropriate management. Most men improve with the right combination of therapies.

    What is the main cause of prostatitis?

    Bacterial infections are the most identifiable cause, particularly in acute prostatitis, where bacteria reach the prostate via the urethra or bloodstream. Chronic prostatitis / chronic pelvic pain syndrome (CP/CPPS) — the most common form — has no single cause. It is thought to involve a combination of pelvic-floor muscle tension, nerve hypersensitivity, stress and sometimes prior infection (EAU Guidelines, 2024).

    Can ejaculating help prostatitis?

    Gentle, pain-free ejaculation can improve drainage of prostatic fluid, and some men report temporary symptom relief. However, it is not a guaranteed treatment and should be part of a broader management plan discussed with your doctor. If ejaculation causes pain, this itself is a symptom that should be evaluated.

    Can prostatitis go away on its own?

    Some mild, non-bacterial cases of prostatitis can improve without formal treatment, particularly if triggered by a short-term stressor. However, bacterial prostatitis always requires antibiotic treatment, and chronic forms often need medical support to manage symptoms effectively. Seeking advice early gives the best chance of fast and lasting relief.

    References

     

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