Health A-Z

Medical Content Created by the Faculty of the
Harvard Medical School

Chronic Prostatitis

What Is It?

The prostate is a walnut-sized gland that sits below the bladder in men. This gland makes fluid that mixes with sperm to form semen.

Prostatitis is inflammation or swelling of the prostate gland. When symptoms start gradually and linger for more than a couple of weeks, the condition is called chronic prostatitis.

Three major types of chronic prostatitis are:

• Chronic bacterial prostatitis — In this condition, a bacterial infection causes swelling and inflammation of the prostate. Doctors can definitively make this diagnosis if bacteria and white blood cells are found in the urine. White blood cells are present when there is inflammation that may or may not be related to an actual infection. True chronic bacterial infection accounts for a small percentage of cases of chronic prostatitis. Sometimes doctors suspect a lingering bacterial infection even though no bacteria are identified.

• Chronic non-bacterial prostatitis, also called inflammatory chronic pelvic pain syndrome — Doctors make this diagnosis when patients have typical symptoms of chronic prostatitis, but no bacteria are found in a urine sample. The cause of most cases of non-bacterial prostatitis is not well understood. The urine often contains white blood cells. Some patients may have a persistent low-grade infection that cannot be detected in a routine urine sample. However, most patients with non-bacterial prostatitis have no evidence of infection, even when sophisticated tests are done.

• Prostadynia, also called non-inflammatory chronic pelvic pain syndrome — This term is used when symptoms of prostatitis are present, but there is no evidence of prostate infection or inflammation. Doctors understand very little about why some people — often young, otherwise healthy men — develop this problem. Theories to explain prostadynia include an abnormal buildup of pressure in the urinary tract, irritation resulting from an autoimmune or chemical process, or pain generated in the nerves and muscles within the pelvis.

Chronic prostatitis is common and affects adult men of all ages and from all backgrounds. About five percent of men experience symptoms of chronic prostatitis at some point in their lives. Chronic prostatitis is the reason for up to 25% of office visits to urologists. Urologists are doctors who specialize in diseases of the urinary tract.

Some men develop a chronic infection in the prostate that does not cause any symptoms. Men with this problem may be diagnosed during an evaluation for other urological conditions, such as enlarged prostate or infertility. Doctors often treat the infection with the same antibiotics used for chronic bacterial prostatitis.

Bacterial infection of the prostate gland also can cause acute prostatitis, which starts suddenly and usually causes fever and more serious symptoms. Acute prostatitis is less common than chronic prostatitis.