Rectum 

Bladder 

Urethra 

Pelvic bone 

Enlarged 

prostate 

The prostate is part of the male reproductive system. 

It surrounds the urethra just below the bladder 

opening. 

Kidney 

Ureter 

Bladder 

Prostate 

Urethra 

Prostatitis: Disorders 

of the Prostate 

National Kidney and Urologic Diseases Information Clearinghouse 

NATIONAL 

INSTITUTES 

OF HEALTH 

U.S. Department 

of Health and 

Human Services 

Prostatitis is a frequently painful condition 

that affects mostly young and middle-aged 

men. Doctors may have difficulty diagnosing prostatitis because the symptoms are 

not the same for every patient, and many of 

the symptoms—such as painful or burning 

urination and incomplete emptying of the 

bladder—could be signs of another disease. 

What is the prostate? 

The prostate is a walnut-sized gland that 

forms part of the male reproductive system. 

The gland is made of two lobes, or regions, 

enclosed by an outer layer of tissue. As 

the diagrams show, the prostate is located 

in front of the rectum and just below the 

bladder, where urine is stored. The prostate also surrounds the urethra, the canal 

through which urine and semen pass out 

of the body. The prostate squeezes fluid 

into the urethra to help make up semen as 

sperm move through during sexual climax. 

Researchers estimate that 10 to 12 percent 

of men experience prostatitis-like symptoms.1

 The term prostatitis means inflammation of the prostate, but doctors use the 

term to describe four different disorders. 

1

McNaughton-Collins M, Joyce GF, Wise M, Pontari 

MA. Prostatitis. In: Litwin MS, Saigal CS, editors. 

Urologic Diseases in America. U.S. Department of 

Health and Human Services, Public Health Service, 

National Institutes of Health, National Institute 

of Diabetes and Digestive and Kidney Diseases. 

Washington, DC: U.S. Government Publishing Office, 

2007; NIH Publication No. 07–5512 pp. 9–42. 
What are the types of 

prostatitis? 

•	 Acute bacterial prostatitis is the least 

common of the four types and is potentially life-threatening. Fortunately, it is 

the easiest to diagnose and treat effectively. Men with this disease often have 

chills; fever; pain in the lower back 

and genital area; urinary frequency 

and urgency, often at night; burning 

or painful urination; body aches; and a 

demonstrable infection of the urinary 

tract as evidenced by white blood cells 

and bacteria in the urine. The treatment is an antimicrobial, a medicine 

that kills microbes—organisms that 

can only be seen with a microscope, 

including bacteria, viruses, and fungi. 

Antimicrobials include antibiotics and 

related medicines. 

•	 Chronic bacterial prostatitis, also relatively uncommon, occurs when bacteria 

find a spot on the prostate where they 

can survive. Men have urinary tract 

infections that seem to go away but 

then come back with the same bacteria. 

Treatment usually requires the use of 

antimicrobials for a prolonged period 

of time. However, antimicrobials do 

not always cure this condition. 

•	 Chronic prostatitis/chronic pelvic 

pain syndrome is the most common 

but least understood form of prostatitis. It may be found in men of any 

age. Its symptoms go away and then 

return without warning, and it may be 

inflammatory or noninflammatory. In 

the inflammatory form, urine, semen, 

and prostatic fluid contain the kinds of 

cells the body usually produces to fight 

infection, but no bacteria can be found. 

In the noninflammatory form, not even 

the infection-fighting cells are present. 

•	 Asymptomatic inflammatory prostatitis is the diagnosis given when the 

patient does not complain of pain or 

discomfort but has infection-fighting 

cells in his prostate fluid and semen. 

Doctors usually find this form of 

prostatitis when looking for causes of 

infertility or testing for prostate cancer. 

How is prostatitis 

diagnosed? 

A doctor performs a digital rectal exam 

(DRE) by inserting a gloved and lubricated 

finger into the patient’s rectum, just behind 

the prostate. The doctor can feel the prostate to see if it is swollen or tender in spots. 

The doctor can diagnose the bacterial forms 

of prostatitis by examining a urine sample 

with a microscope. The sample may also be 

sent to a laboratory to perform a culture. 

In a urine culture, the bacteria are allowed 

to grow so they can be identified and tested 

for their resistance to different types of 

antimicrobials. 

To confirm the prostate infection, the doctor may obtain two urine samples—before 

and after prostate massage. To perform a 

prostate massage, the doctor will insert a 

gloved and lubricated finger into the rectum, as in a DRE, and stroke the prostate 

to release fluids from the gland. The postmassage urine sample will contain prostate 

fluid. If that second urine sample contains 

bacteria or infection-fighting cells that were 

not present in the premassage urine sample, 

this suggests the prostate contains infection. 

To diagnose chronic prostatitis/chronic pelvic pain syndrome, the doctor must rule out 

all other possible causes of urinary symptoms, such as kidney stones, bladder disorders, and infections. Since many different 

conditions must be considered, the doctor 

may order a full range of tests, including 

2	 Prostatitis: Disorders of the Prostate 
ultrasound or magnetic resonance imaging (MRI), biopsy, blood tests, and tests of 

bladder function. 

If all other possible causes of a patient’s 

symptoms are ruled out, the doctor may 

then diagnose chronic prostatitis/chronic 

pelvic pain syndrome. To aid in understanding the symptoms and measuring 

the effects of treatment, the doctor may 

ask a series of questions from a standard 

questionnaire, the NIH-Chronic Prostatitis 

Symptom Index. 

How is prostatitis treated? 

The bacterial forms of prostatitis are 

treated with antimicrobials. Acute prostatitis may require a short hospital stay so 

that fluids and antimicrobials can be given 

through an intravenous, or IV, tube. After 

the initial therapy, the patient will need to 

take antimicrobials for 2 to 4 weeks. 

Chronic bacterial prostatitis requires a 

longer course of therapy. The doctor may 

prescribe a low dose of antimicrobials for 

6 months to prevent recurrent infection. If 

a patient has trouble emptying his bladder, 

the doctor may recommend medicine or 

surgery to correct blockage. 

Antimicrobials will not help nonbacterial prostatitis. Each patient will have to 

work with his doctor to find an effective 

treatment. Changing diet or taking warm 

baths may help. The doctor may perscribe 

a medicine called an alpha blocker to 

relax the muscle tissue in the prostate. No 

single solution works for everyone with this 

condition. 

No treatment is needed for asymptomatic 

inflammatory prostatitis. 

Hope through Research 

The National Institute of Diabetes and 

Digestive and Kidney Diseases (NIDDK) 

has many research programs aimed at finding treatments for urinary disorders, including prostatitis. The NIDDK supports the 

Chronic Prostatitis Collaborative Research 

Network, which funds and coordinates 

multicenter clinical trials of new therapies 

to relieve the pain or discomfort of chronic 

prostatitis/chronic pelvic pain syndrome. 

For More Information 

American Urological Association 

Foundation 

1000 Corporate Boulevard 

Linthicum, MD 21090 

Phone: 1–866–RING–AUA (746–4282) 

 or 410–689–700 

Email: patienteducation@auafoundation.org 

Internet: www.auafoundation.org

 www.UrologyHealth.org 

The Prostatitis Foundation 

106 0th Street, Box 8 

Smithshire, IL 61478 

Phone: 1–888–891–4200 

Fax: 09–25–7184 

Internet: www.prostatitis.org 

 Prostatitis: Disorders of the Prostate 
You may also find additional information about this 

topic using the following databases: 

The NIDDK Reference Collection is a collection 

of thousands of materials produced for patients 

and health care professionals, including fact sheets, 

brochures, and audiovisual materials. Visit 

www.catalog.niddk.nih.gov/resources. 

MedlinePlus brings together a wealth of information 

from the National Library of Medicine, the National 

Institutes of Health, and other government agencies 

and health-related organizations. MedlinePlus offers 

easy access to medical journal articles, a medical 

dictionary and medical encyclopedia, health information in Spanish, hospital and physician directories, 

drug and supplement lists, interactive patient tutorials, links to hundreds of clinical trials, and the latest 

health news. Visit www.medlineplus.gov. 

This publication may contain information about 

medications used to treat a health condition. When 

this publication was prepared, the NIDDK included 

the most current information available. Occasionally, new information about medication is released. 

For updates or for questions about any medications, 

please contact the U.S. Food and Drug Administration at 1–888–INFO–FDA (46–62), a toll-free call, 

or visit their website at www.fda.gov. Consult your 

doctor for more information. 

National Kidney and 

Urologic Diseases 

Information Clearinghouse 

 Information Way 

Bethesda, MD 20892–580 

Phone: 1–800–891–590 

Fax: 70–78–4929 

Email: nkudic@info.niddk.nih.gov 

Internet: www.kidney.niddk.nih.gov 

The National Kidney and Urologic Diseases 

Information Clearinghouse (NKUDIC) is a 

service of the National Institute of Diabetes 

and Digestive and Kidney Diseases (NIDDK). 

The NIDDK is part of the National Institutes 

of Health of the U.S. Department of Health 

and Human Services. Established in 1987, the 

Clearinghouse provides information about 

diseases of the kidneys and urologic system to 

people with kidney and urologic disorders and 

to their families, health care professionals, and 

the public. The NKUDIC answers inquiries, 

develops and distributes publications, and works 

closely with professional and patient organizations and Government agencies to coordinate 

resources about kidney and urologic diseases. 

Publications produced by the Clearinghouse are 

carefully reviewed by both NIDDK scientists and 

outside experts. This publication was reviewed 

by Mark Litwin, M.D., University of California 

at Los Angeles, and Anthony Schaeffer, M.D., 

Northwestern University. 

This publication is not copyrighted. The 

Clearinghouse encourages users of this publication to 

duplicate and distribute as many copies as desired. 

This fact sheet is also available at 

www.urologic.niddk.nih.gov. 

U.S. DEPARTMENT OF HEALTH 

AND HUMAN SERVICES 

National Institutes of Health 

NIH Publication No. 08–455 

January 2008