Prostatitis is not one disease but a group of conditions with different causes and treatments. Doctors divide it into four types under the internationally used classification, and the most common is chronic non-bacterial prostatitis, known as chronic pelvic pain syndrome. Getting the type right is the most important step.
Medically reviewed by Prof. Dr. Samir Ahmed Al-Samarrai, consultant urologist. Last reviewed:
Types of prostatitis
| Type | What it is | Main symptoms |
|---|---|---|
| 1. Acute bacterial prostatitis | A sudden bacterial infection of the prostate | Fever and shivering, pelvic or perineal pain, burning and difficult urination |
| 2. Chronic bacterial prostatitis | Recurrent infection with the same bacteria | Repeated urinary infections and pelvic discomfort |
| 3. Chronic non-bacterial prostatitis (chronic pelvic pain syndrome) | Pelvic pain for 3 months or more in the last 6 months without proven bacterial infection | Pain in the perineum, testicles, lower abdomen or on ejaculation, sometimes with urinary symptoms |
| 4. Asymptomatic inflammatory prostatitis | Found by chance in a test or biopsy | No symptoms; usually needs no treatment |
Acute bacterial prostatitis is urgent
If you have fever and shivering with painful, burning or difficult urination, see a doctor or go to the emergency department the same day. You need a urine test and culture and an appropriate antibiotic chosen by the doctor, and possibly hospital admission if you are very unwell or cannot pass urine. Prostate massage is not done in acute infection.
Chronic bacterial prostatitis
It is diagnosed with urine cultures before and after prostate massage to show the infection comes from the prostate, and treated with a suitable antibiotic for longer than a simple urinary infection, as guidelines recommend.
Chronic pelvic pain syndrome
This is the most common type. Its cause is not fully understood and involves local inflammation, tension of the pelvic floor muscles, nerves and stress. Because it is not an infection, repeated antibiotics usually do not help. European guidelines recommend multimodal treatment tailored to each patient’s symptoms, such as:
- A questionnaire to score and follow symptoms (NIH-CPSI).
- Alpha-blockers when there are urinary symptoms.
- Pelvic floor physiotherapy.
- Suitable pain relief, and support for stress or anxiety when present.
- Lifestyle changes such as avoiding long periods of sitting and foods or drinks that worsen your symptoms.
When should you see a doctor?
- Immediately with fever and urinary symptoms, or if you cannot pass urine.
- Pelvic, perineal or ejaculatory pain lasting more than a few weeks.
- Repeated urinary infections.
- Blood in the urine or semen.
Articles on prostatitis
Frequently asked questions
Is prostatitis contagious?
Bacterial prostatitis is caused by a bacterial infection, which in some cases is sexually transmitted. Chronic non-bacterial prostatitis (chronic pelvic pain syndrome) is not contagious.
Does every prostatitis need antibiotics?
No. Antibiotics are essential in bacterial prostatitis, but they usually do not help chronic pelvic pain syndrome, the most common type, which is treated in other ways.
What is “prostate congestion”?
It is a popular term rather than a medical diagnosis, usually describing pelvic pain and discomfort on urination or after ejaculation. The doctor works out whether it is bacterial infection, chronic pelvic pain syndrome or something else.
Does prostatitis affect erections?
Chronic prostatitis can come with painful ejaculation or erection problems related to pain and stress, which usually improve as symptoms are treated.
Does prostatitis cause cancer?
There is no evidence that prostatitis causes cancer. It can raise PSA temporarily, so the test may be repeated after treatment when needed.
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Book a consultation
Prof. Al-Samarrai and Dr. Amer Mousa assess prostatitis and pelvic pain symptoms at Prof. Al-Samarrai Medical Center, Dubai Healthcare City, and discuss the options that suit your case. Medical consultations are confidential.
This information is for health education and does not replace a medical examination. See our medical content policy.