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Prostatitis

Prostatitis is swelling and inflammation of the prostate gland, a walnut-sized gland located directly below the bladder in men. The prostate gland produces fluid (semen) that nourishes and transports sperm.

Prostatitis often causes painful or difficult urination. Other symptoms of prostatitis 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 years of age or younger. Prostatitis can be caused by a number of different things. If it's caused by a bacterial infection, it can usually be treated with antibiotics. However, sometimes prostatitis isn't caused by a bacterial infection or an exact cause is never identified.

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

Symptoms Causes Risk factors Complications

Prostatitis symptoms vary depending on the cause. They may 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
  • 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 orgasms (ejaculations)
  • Flu-like symptoms (with bacterial prostatitis)

When to see a doctor

If you experience pelvic pain, difficult or painful urination, or painful orgasms (ejaculations), see your doctor. If left untreated, some types of prostatitis can cause worsening infection or other health problems.

Acute bacterial prostatitis is often caused by common strains of bacteria. The infection may start when bacteria carried in urine leaks into your prostate. Antibiotics are used to treat it. If bacteria aren't eliminated with antibiotics because they "hide" in the prostate, prostatitis may recur or be difficult to treat. This is called chronic bacterial prostatitis.

Bacterial infection isn't the only cause of prostatitis. Other causes can include:

  • Immune system disorder
  • Nervous system disorder
  • Injury to the prostate or prostate area

In many cases of prostatitis, however, the cause is never identified.

Risk factors for prostatitis include:

  • Being a young or middle-aged man
  • Having a past episode of prostatitis
  • Having an infection in the bladder or the tube that transports semen and urine to the penis (urethra)
  • Having a pelvic trauma, such as injury from bicycling or horseback riding
  • Not drinking enough fluids (dehydration)
  • Using a urinary catheter, a tube inserted into the urethra to drain the bladder
  • Having unprotected sexual intercourse
  • Having HIV/AIDS
  • Being under stress
  • Having certain inherited traits — particular genes may make some men more susceptible to prostatitis

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 (this can occur with chronic prostatitis)
  • Elevated prostate-specific antigen (PSA) levels

Prostatitis, cancer and PSA levels

Prostatitis can cause elevated levels of prostate-specific antigen (PSA), a protein produced by the prostate. PSA testing is generally used to screen for prostate cancer. Cancerous cells produce more PSA than do noncancerous cells, so higher than normal levels of PSA in the blood may indicate prostate cancer. However, conditions other than prostate cancer, including prostatitis, also can increase PSA levels.

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

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