If you’re experiencing pain or discomfort in your pelvic area alongside urinary problems, prostatitis might be the culprit.
This condition, which involves inflammation of the prostate gland, affects many men at some point in their lives.
Understanding what causes prostatitis can help you recognise the symptoms early and seek appropriate treatment.
What is prostatitis?
Prostatitis is inflammation of the prostate gland, a small walnut-shaped organ that sits below the bladder and surrounds the urethra in men. The prostate produces fluid that forms part of semen, and when it becomes inflamed, it can cause a range of uncomfortable symptoms.
Prostatitis can affect men of any age, though it’s more common in men under 50. The condition can develop suddenly (acute prostatitis) or persist over a long period (chronic prostatitis), and the causes can vary significantly depending on the type.
Types of prostatitis and their causes
Prostatitis is classified into four main types, each with different causes and characteristics.
Acute bacterial prostatitis
This type is caused by a bacterial infection and develops suddenly, with severe symptoms. Commonly responsible bacteria include E. coli and other bacteria found in the urinary tract or bowel. The infection typically enters the prostate through the urethra or spreads from a urinary tract infection.
Acute bacterial prostatitis is less common than other types but requires immediate medical attention, as it can lead to serious complications if left untreated.
Chronic bacterial prostatitis
Like the acute form, this type is also caused by bacterial infection, but the symptoms develop more gradually and persist for at least three months. The same bacteria that cause acute prostatitis can be responsible, but the infection is harder to treat because bacteria can hide deep within the prostate tissue.
Men with chronic bacterial prostatitis often experience recurring UTIs and may have difficulty completely clearing the infection even with antibiotics.
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)
This is the most common form of prostatitis, accounting for approximately 90% of cases. Despite being the most prevalent type, the exact cause of CP/CPPS remains unclear in most cases.
Unlike bacterial forms, CP/CPPS doesn’t appear to be caused by an active bacterial infection. Possible contributing factors include:
- Previous infections that have triggered ongoing inflammation
- Nerve damage or irritation in the pelvic area
- Immune system responses
- Stress and psychological factors
- Pelvic floor muscle tension or dysfunction
- Physical trauma to the pelvic region
The lack of a clear bacterial cause makes this type of prostatitis particularly challenging to diagnose and treat.
Asymptomatic inflammatory prostatitis
This type causes no noticeable symptoms and is usually discovered during tests for other conditions. The cause is unknown, and treatment isn’t typically required unless it’s affecting fertility or causing elevated PSA levels.
So, what’s the most common cause of prostatitis overall?
When considering all types of prostatitis together, chronic prostatitis/chronic pelvic pain syndrome is by far the most common cause of prostatitis symptoms. However, the term “cause” becomes complicated here because CP/CPPS itself doesn’t have a single, identifiable cause.
If we’re looking specifically at infectious causes, bacterial infections from the urinary tract are the most common culprits. These bacteria typically originate from the bowel and enter the urinary system, eventually reaching the prostate.
Risk factors that increase your chances
Certain factors can make you more susceptible to developing prostatitis.
- A recent bladder infection or UTI increases your risk, particularly for bacterial forms of the condition.
- Having a urinary catheter or undergoing certain medical procedures involving the urinary tract can introduce bacteria.
- Prostate enlargement can trap urine in the bladder, creating an environment where bacteria can thrive.
- Dehydration and infrequent urination can also increase risk by allowing bacteria to remain in the urinary tract longer.
Additionally, cycling or activities that put pressure on the prostate may contribute to inflammation, particularly in cases of chronic pelvic pain syndrome.
Recognising the symptoms
Common symptoms of prostatitis include:
- Difficulty passing urine
- Burning sensation when urinating
- Frequent urination (especially at night)
- Pelvic, groin, or lower back pain.
- Some men also experience painful ejaculation or discomfort in the genital area.
If you’re experiencing acute symptoms such as fever, chills, severe pain, or complete inability to urinate, seek medical attention immediately, as these could indicate acute bacterial prostatitis or another serious condition.
Getting the right diagnosis
Your doctor will typically perform a physical examination, including a digital rectal examination, to check for tenderness or swelling in the prostate. Urine tests can identify bacterial infections, whilst blood tests may check for signs of infection or elevated PSA levels.
In some cases, your consultant might recommend additional tests such as prostate fluid analysis or imaging studies to rule out other conditions and determine the best course of treatment.
Understanding what causes prostatitis helps you recognise when something’s not right and encourages you to seek appropriate medical care. Whether your prostatitis is caused by bacteria or falls into the more common chronic pelvic pain syndrome category, effective treatments are available to help manage your symptoms and improve your quality of life.
Related reading: Why Does It Hurt To Sit With Prostatitis?
