Chronic prostatitis refers to pain in the prostate that lasts at least 3 months. It happens due to inflammation of the prostate. It can affect sexual function and the ability to urinate. Possible causes include bacterial infections and damage to the pelvic nerves.

Acute prostatitis is an infection or pain in the prostate gland lasting less than 3 months.

In this article, we look at the causes and symptoms of chronic prostatitis. We also cover diagnosis, treatment, and home and alternative remedies.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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The prostate is a small gland that forms part of the lower urinary tract in males. It sits in front of the rectum, under the bladder, and surrounds the urethra, the tube that carries urine and semen out through the penis.

The prostate is part of the male reproductive system and produces one of the fluids that make up semen. The muscles of this gland also help push semen into the urethra during ejaculation.

Due to its location and function, prostate problems can affect urination as well as sexual function.

Prostatitis is an inflammation of the prostate that can often be painful. It can be chronic or acute.

Chronic prostatitis develops gradually and can last for months or even years. Doctors consider prostatitis to be chronic if symptoms continue for 3 months or more. It may not respond well to initial treatment.

Acute prostatitis appears suddenly and is temporary. It may only last a few days or weeks and often responds well to treatment. If it persists, it may become chronic prostatitis.

Prostatitis is the leading cause of urinary tract issues for men under 50 years of age, and the third most common urinary tract issue for men over 50.

What other prostate problems are there?

Prostatitis can be bacterial or nonbacterial.

Chronic bacterial prostatitis

A bacterial infection of the prostate causes chronic bacterial prostatitis.

It can result from:

  • various bacteria, such as Klebsiella, Proteus, or Escherichia coli
  • Chlamydia
  • bacteria that remain despite antibiotic treatment for another infection, such as an acute prostate infection or urinary tract infection

The symptoms of chronic bacterial prostatitis are often less severe than those of acute bacterial prostatitis. A person who has previously had an acute infection might notice that their symptoms get better but do not go away.

Chronic non-bacterial prostatitis, or chronic pelvic pain syndrome

This is a non-bacterial form of prostatitis that can have many causes and is harder to treat.

It can occur when:

  • Chronic pain persists after a previous prostate infection goes away.
  • The urinary sphincter does not relax while emptying the bladder, so that pressure on the urinary tract causes urine flows into the prostate, causing an inflammatory response.
  • Nerve damage leads to overactivity in the pelvic nerves, triggering pain without inflammation.
  • Damage to the urinary tract results from surgery or a physical injury.
  • A person is facing psychological stress.
  • Microorganisms other than bacteria infect the prostate gland.

The main symptom of chronic prostatitis is genital or pelvic pain. For some people, the pain feels like a gnawing ache. For others, it is intense and sharp. The pain may come and go or always be present.

Other symptoms of chronic prostatitis include:

Anyone with these symptoms should see a doctor as soon as possible. They may be a sign of another health condition that needs urgent attention. Untreated, they could lead to complications.

Is there a link between prostatitis and prostate cancer?

People with symptoms of prostatitis should see a doctor. If a bacterial infection is present, seeking medical help as soon as possible can help prevent it spreading.

To diagnose prostatitis, a doctor will most likely:

  • ask about symptoms
  • ask about the person’s medical history
  • carry out a rectal or prostate examination

During a rectal exam, a doctor inserts a finger into the person’s rectum to check the prostate for swelling and inflammation. They may also look for signs of infection, such as discharge from the penis or swollen lymph nodes.

A doctor may recommend antibiotics if they suspect the problem is due to a bacterial infection.

They may recommend further tests if symptoms do not improve with antibiotics or there are no signs of an infection.

Options include:

  • a urine test, semen test, or blood test to look for signs of infection or other prostate issues
  • a urine test before and after prostatic massage, which may help identify signs of infection
  • urodynamic tests to see how well the urinary system stores and releases urine
  • a prostate biopsy, where a doctor uses a needle to remove a small sample of tissue from the prostate for analysis
  • an ultrasound of the prostate or urethra
  • a cystoscopy, where a doctor uses a small scope to look inside the bladder or urethra

What types of physical examination are there?

Treatment for chronic prostatitis will depend on the cause.

People with chronic prostatitis due to a bacterial infection or recurrent infections may need antibiotics for up to 6 months.

Other treatment options include:

  • intravenous antibiotics for severe infections
  • muscle relaxants to relieve spasms of the pelvic muscles
  • non-steroidal anti-inflammatory drugs (NSAIDs) to relieve pain
  • alpha-blockers to treat urination difficulties
  • surgery to remove scar tissue in the urethra, which can help with urination difficulties
  • counseling to help with psychological stress and anxiety

Various home and alternative treatments may support medical treatment for chronic prostatitis.

Kegel exercises

Kegel exercises, also known as pelvic floor exercises, can help improve urination difficulties in people with chronic prostatitis. The exercises work by strengthening the muscles around the bladder and penis.

To do these exercises:

  1. Sit in a comfortable position.
  2. Locate the pelvic muscles by pretending to stop urination mid-flow.
  3. Tighten and relax the pelvic muscles 10 to 15 times in a row.
  4. Repeat several times a day.
  5. As the excises get easier, increase the time for holding the muscle in and the number of repetitions.

It may take a few months before a person notices the results.

What are Kegel exercises for males?

Other remedies

Other home and alternative remedies that may provide symptom relief for people with chronic prostatitis include:

People should always speak with a doctor before trying a new or alternative remedy, as some options may interact with other medications or may be unsafe for some people.

Can saw palmetto help reduce an enlarged prostate gland?

Here are some questions people often ask about prostatitis.

What are some common signs and symptoms of prostatitis?

Common signs of prostatitis include:

  • needing to pee more frequently or more urgently but having difficulty when doing so
  • needing to urinate more at night
  • pain in the genitals, pelvis, or lower back
  • having a urinary tract infection
  • painful ejaculation

What is the fastest way to get rid of prostatitis?

A doctor will prescribe antibiotics if a bacterial infection appears to be present. If tests show another cause, they will prescribe treatment appropriately. Some home and alternative remedies may help support medical treatment.

Does prostatitis go away?

Acute prostatitis may go away with antibiotics, but it may return or linger and become chronic prostatitis. If prostatitis does not go away with initial treatment, a person should speak with their doctor. They will help find a solution.

Chronic prostatitis is a long-term condition that can cause pain and difficulties with urination. Anyone with symptoms of prostatitis should see a doctor.

Treatment depends on the cause and symptoms. If an infection is present, a person may need antibiotics. Kegel exercises and certain home and alternative remedies may also help relieve symptoms.