Chronic prostatitis
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What is prostatitis?
Prostatitis is the inflammation of the prostate gland. It is a fairly common
condition which affects men of any age.
What is the prostate gland?
The prostate is a gland that lies internally between the penis and the
bladder. It produces the secretions (fluid) in which the sperm gets
carried to make up the semen which is released during ejaculation.
What causes prostatitis?
There are two main types of prostatiitis:
• Chronic prostatitis (sometimes called prostatodynia or
chronic pelvic pain syndrome) - this is the most common type
of prostatitis and the symptoms typically come and go over several
months. The cause of symptoms in these cases is not clear.
• Acute prostatitis - the symptoms are severe and develop
suddenly; this is more rare but can be serious and requires
immediate treatment. Acute prostatitis is usually caused by
bacteria in the urinary tract (the kidneys, bladder and the tubes
that connect them) entering the prostate.
What are the symptoms of prostatitis?
Symptoms of prostatitis include:
• Pain or discomfort
This may be felt anywhere around the genital area, including the
perineum (the area between the scrotum and the anus), testicles,
penis, groin area, lower abdomen, upper thighs and back passage.
The pains usually come and go, and may be dull and aching, or
sharp and stabbing.
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• Urinary disturbances
Changes which may be noticed when passing urine include
passing urine more frequently than usual, an urgent need to pass
urine, a poor or variable urine stream. Mild stinging sensations and
watery discharge from the penis may also sometimes occur.
• Ejaculatory disturbances
Pain or discomfort may occur at the moment of ejaculation, or
may occur after ejaculation and last for a period of minutes or
hours. Chronic prostatitis sometimes causes the semen to change
colour, or have blood in it. This is not a sign of something more
serious.
See your doctor or return to clinic if you have any of these
symptoms.
How long will the symptoms last?
The duration and pattern of symptoms in prostatitis are very variable,
but the problem often persists over quite a long period of time. The
symptoms generally occur in waves lasting days or weeks at a time.
Is there anything I can do to avoid or relieve the
symptoms?
If you notice that certain activities make your symptoms worse, then you
could try to avoid doing those things to see if this helps. For some men,
this might be to avoid certain types of exercise, or sitting for long
periods, or to avoid drinking coffee or alcohol, or avoid eating spicy
foods. Reduce stress and anxiety.
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How is prostatitis diagnosed?
You will normally undergo an examination which includes:
• A swab from the urethra
• Urine samples
• An examination of the prostate gland which involves the doctor
inserting a gloved finger gently into the anus to detect tenderness
of the prostate gland.
• Blood tests may also be requested and occasionally an ultrasound
examination of the urinary system (including the prostate and
bladder) may be arranged.
How is prostatitis treated?
The most common treatments are:
• Anti-inflammatory painkillers - such as ibuprofen (Brufen), or
diclofenac (Voltarol)
• Antibiotics - long courses of antibiotics (between 1 and 3 months
of treatments) are occasionally used to treat prostatitis. Suitable
antibiotics include doxycycline or ciprofloxacin
Other treatment options, considered in more severe or prolonged cases:
• Amitriptyline (or imipramine) - this is a painkiller which in other
patients and in higher dosage is sometimes used as an
antidepressant
• Alpha blockers - these are tablets which reduce muscular spasm
in the bladder neck
Other things which may help include:
• Drinking plenty of water
• Frequent ejaculation - thought to be beneficial as it 'flushes out'
the prostate gland
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• Hot baths - thought to help by improving the circulation and
relaxing the pelvic muscles
Does prostatitis have any long term effects?
Prostatitis is a great nuisance for many men, but fortunately it is not
usually a serious disease.
• There are no associations with serious underlying problems such
as cancer.
• Unless a sexually transmitted infection was found on your tests,
you will not pass the infection to your sexual partner.
• There is no evidence that prostatitis affects fertility.
In time, most men with prostatitis find that all their symptoms gradually
disappear.
What happens at Sexual Health Sheffield?
When you attend for your appointment, you will be asked to provide the
following:
• Your name and how we can contact you - any details you provide
will be treated confidentially
• During your visit you will be asked personal information so we can
provide the relevant and appropriate care
• We have a duty of care to all our patients, so if you are 17 or under
you will be asked relevant questions to assess your safety. If staff
are concerned, they may talk to you about what to do about this
and may contact other appropriate agencies. Sexual Health
Sheffield will not tell your parents or carers that you have visited
Sexual Health Sheffield
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This is the service you can expect when you attend Sexual Health
Sheffield:
• All advice, information, tests, contraception, condoms and
treatments are free at Sexual Health Sheffield
• No one should judge you because of your sexual behaviour or
lifestyle
• All our services are confidential
• All Sexual Health Sheffield workers are appropriately and fully
trained NHS staff
• All tests are optional; no examination will take place without your
permission
• Please ask questions to ensure you fully understand what services
have been offered, what tests carried out and what treatments
given
• You can have a chaperone to help you feel more comfortable –
please ask
• Our friendly and professional staff are here to help you. We will
give you as much support as you need (particularly if you need
help on how to inform any partners)
If you feel that we have not met the above or want to give us any other
feedback, please contact us via
[Link]/patients/tell-us-what-you-think
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Further information
Sexual Health Sheffield:
• [Link]
• 0114 226 8888
NHS Choices website
• [Link]
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PD4567-PIL1471 v4 Issue Date: June 2018. Review Date: June 2021