Prostatitis (Pelvic Pain Syndrome)

Prostatitis often causes painful or difficult urination. Other symptoms include pain in the groin, pelvic area or genitals and sometimes flu-like symptoms.

Prostatitis affects men of all ages but tends to be more common in men 50 or younger. The condition has a number of causes. Sometimes the cause isn’t identified. If prostatitis is caused by a bacterial infection, it can usually be treated with antibiotics.

Depending on the cause, prostatitis can come on gradually or suddenly. It might improve quickly, either on its own or with treatment. Some types of prostatitis last for months or keep recurring (chronic prostatitis).

Symptoms

Prostatitis signs and symptoms depend on the cause. They can include:

Pain or burning sensation when urinating (dysuria)
Difficulty urinating, such as dribbling or hesitant urination
Frequent urination, particularly at night (nocturia)
Urgent need to urinate
Cloudy urine
Blood in the urine
Pain in the abdomen, groin or lower back
Pain in the area between the scrotum and rectum (perineum)
Pain or discomfort of the penis or testicles
Painful ejaculation
Flu-like signs and symptoms (with bacterial prostatitis)

When to see a doctor

If you have pelvic pain, difficult or painful urination, or painful ejaculation, see your doctor. If left untreated, some types of prostatitis can cause worsening infection or other health problems.

Causes

Acute bacterial prostatitis is often caused by common strains of bacteria. The infection can start when bacteria in urine leak into your prostate. Antibiotics are used to treat the infection. If they don’t eliminate the bacteria prostatitis might recur or be difficult to treat (chronic bacterial prostatitis).

Nerve damage in the lower urinary tract, which can be caused by surgery or trauma to the area, might contribute to prostatitis not caused by a bacterial infection. In many cases of prostatitis, the cause isn’t identified.

Risk factors

Risk factors for prostatitis include:

Being young or middle-aged
Having had prostatitis previously
Having an infection in the bladder or the tube that transports semen and urine to the penis (urethra)
Having pelvic trauma, such as an injury from bicycling or horseback riding
Using a tube inserted into the urethra to drain the bladder (urinary catheter)
Having HIV/AIDS
Having had a prostate biopsy

Complications

Complications of prostatitis can include:

Bacterial infection of the blood (bacteremia)
Inflammation of the coiled tube attached to the back of the testicle (epididymitis)
Pus-filled cavity in the prostate (prostatic abscess)
Semen abnormalities and infertility, which can occur with chronic prostatitis

There’s no direct evidence that prostatitis can lead to prostate cancer.

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