Acute Prostatitis: Causes, Symptoms, Treatment & Diagnosis

What is Acute Prostatitis?

Acute prostatitis is the sudden onset of inflammation in the prostate. The prostate gland is a small, walnut-shaped organ located at the base of the bladder, in front of the rectum. The prostate provides 70 percent of the fluid for ejaculation. Contraction of the prostate during ejaculation prevents semen from flowing backward into the bladder.

Acute prostatitis is usually caused by the same bacteria that result in urinary tract infections and sexually transmitted diseases (STDs). Bacteria can travel to the prostate from the blood, or enter the prostate during or after a procedure such as a biopsy. It can also be caused by infections in other parts of the male genitourinary tract.

Acute prostatitis is caused by a bacterial infection of the prostate gland. Symptoms include pain, mainly at the base of the penis and around the anus. A bladder infection commonly occurs at the same time. Treatment includes a four-week course of antibiotics.

What is the prostate gland?

Only men have a prostate gland. It lies just beneath the bladder. It is normally about the size of a chestnut. The urethra (the tube that urine travels along from the bladder to the outside) runs through the middle of the prostate and then through the penis. The prostate helps to make semen, but most semen is made by another gland nearby (the seminal vesicle).

What causes Acute Prostatitis?

Infection by bacteria that normally live in your bowel

This is the usual cause. Some bacteria that live harmlessly in the bowel commonly get on to the skin near to the anus when we pass faeces. In some people they may then multiply. Some of these bacteria may then travel up the urethra and cause infection anywhere in the urinary tract – that is, the kidneys, bladder, prostate, or urethra.

Urine infection with cystitis (bladder infection) is the common ‘urinary tract infection’. But, a prostate infection may also occur with or without other parts of the urinary tract being infected. Some conditions that cause pooling or blockage of urine increase the risk of a ‘urinary tract infection’. For example, having an enlarged prostate, kidney stones, etc. This is because bacteria often thrive and multiply quickly in pooled urine.

Less common causes

• Damage to the prostate makes it more prone to infection – for example, after prostate surgery.
• A catheter passed into the bladder through the urethra may sometimes let bacteria travel to the prostate. This can also happen after a telescopic instrument is passed through the urethra into the bladder (as happens during investigation of the prostate gland and the bladder).
• Sometimes the prostate is infected by bacteria in the bloodstream that have travelled from other infections in the body.

Acute prostatitis is not considered a sexually transmitted infection, so a sexual partner is not at risk.

Who gets Acute Prostatitis?

Acute bacterial prostatitis is not that common. Only about 2 in 10,000 men will develop acute prostatitis at some point in their lives.

What are the symptoms of Acute Prostatitis?

In acute prostatitis, symptoms develop quickly typically over a few days or so. It usually occurs at the same time as a urine infection. Therefore, you may also have a bladder infection (cystitis). Bacteria (germs) are found in your urine if a urine sample is taken. Symptoms include:

• Pain from your prostate, which may be severe. You feel this mainly at the base of your penis, around your anus, just above your pubic bone and/or in your lower back. Pain may spread to your penis and testes. Passing stools (faeces) can be painful.
• Symptoms of a urine infection. For example: pain when you pass urine, passing urine frequently, an urgent desire to pass urine, and sometimes blood in your urine. Some people can develop problems so that they are unable to pass urine and the urine builds up in the bladder (this is called urinary retention).
• Fever (high temperature). General aches and pains. You generally feel ill.
• A slight discharge (thick fluid) may come out of your penis from your urethra.
• Your prostate feels tender if a doctor examines it with a gloved finger in your rectum.

What is the treatment for acute prostatitis?

• Antibiotics. A four-week course is needed. Antibiotics are generally started before the confirmatory urine test results are back. The first antibiotic may be changed after the result of the urine test is back. The urine test finds exactly which bacterium is causing the infection, and the best antibiotic to treat it. Four weeks of antibiotics are thought to be necessary to reduce the chance that you develop chronic (persistent) prostatitis.
• Paracetamol or ibuprofen ease pain and fever (high temperature). They are best taken regularly rather than now and then. Stronger painkillers are sometimes needed.
• Laxatives can keep your stools (faeces) soft, if needed. They may help to ease pain if you have hard stools in your rectum (back passage), pressing on your infected prostate.