About 1 in 10 men get prostatitis at some point, and most are younger than you would expect. Prostatitis is inflammation or irritation of the prostate, with symptoms like pain when urinating, pelvic pressure and needing to pee more often. Despite what many assume, this is not an older-men condition: prostate inflammation is actually the most common prostate complaint in men under 50.
At Caliber Health we see many men brush these symptoms off for too long, or mistake them for a bladder infection. That is a shame, because the sooner you know what is going on, the more targeted your doctor can be.
This article explains what prostatitis is, which forms exist, and when symptoms are a reason to seek help quickly.
Want the bigger picture first? Read our complete guide to prostate health, screening and prevention.
What is prostatitis?
Prostatitis is inflammation or painful irritation of the prostate, the small gland below your bladder that makes fluid for semen. It can appear suddenly through a bacterial infection, or build up slowly with no clear cause. Symptoms range from mild to severe.
The prostate sits just below the bladder and wraps around the urethra. That is why inflammation quickly causes urinary and pelvic complaints. If you want to know exactly where the prostate sits and what it does, that helps you make sense of the symptoms.
Prostatitis is different from an enlarged prostate or prostate cancer. It is a separate condition with its own causes and its own approach.
The fact that it mainly affects younger and middle-aged men surprises a lot of people. The 25 to 55 age group, busy with work, sport and family, is exactly where prostatitis is most common. An enlarged prostate usually shows up later.
That makes it more frustrating, because the symptoms often land in a phase when you rarely think about your prostate. Many men suspect a bladder infection or overexertion first.
Worth knowing: prostate inflammation can temporarily raise your PSA level. On its own that says little about cancer. Read how the PSA test works and when to have it done before worrying about a high result.
What are the symptoms of prostatitis?
The symptoms of prostatitis usually centre on urination, pain and pressure in the pelvic area. Common prostatitis symptoms include pain or burning when you pee, needing to urinate more often and urgently, and a nagging ache around the pelvis, scrotum or lower back.
Not everyone has every symptom. The combination and severity vary a lot per person and per type of prostatitis.
Typical symptoms include:
- Pain or burning when urinating, sometimes also during or after ejaculation
- Urinating more often, especially at night, with a strong urge
- Pelvic pain or pressure between the scrotum and anus, in the lower abdomen or lower back
- A weak or interrupted stream and a feeling that the bladder is not empty
- General symptoms like fever, chills or a flu-like feeling in the acute form
If the symptoms last longer than a few weeks, we call it chronic prostatitis. Pain then often stands out more than the urinary complaints.
The symptoms can also come in waves. One week you feel nothing, the next it flares up again. That changing pattern is normal with chronic prostatitis and says nothing about severity.
What causes prostate inflammation?
Prostate inflammation can be caused by bacteria, but far from always. In the acute and chronic bacterial forms, an infection is behind the symptoms. In the most common form, chronic pelvic pain syndrome, no bacteria are usually found and several factors play a role.
Bacteria usually reach the prostate through the urethra, for example after a bladder infection or a procedure.
Possible causes and risk factors include:
- A bacterial infection, often gut bacteria travelling up through the urinary tract
- A recent bladder infection, urinary catheter or urological procedure
- Tension in the pelvic floor muscles, which can sustain pain and urinary symptoms without infection
- Prolonged stress, long periods of sitting or intensive cycling, which put pressure on the pelvis
The Dutch GP guideline on male urinary symptoms notes that these complaints often have several causes at once (NHG, 2024). That is why pinning down a cause yourself is hard, and why your doctor needs to investigate.
Which types of prostatitis are there?
There are four official types of prostatitis, set out in the international classification by Krieger and colleagues (Krieger et al., JAMA 1999). They differ in cause, symptoms and urgency. The acute bacterial form is the most urgent, while chronic pelvic pain syndrome is by far the most common.
The table below helps you tell the types apart. It does not replace a diagnosis: only your doctor can determine which type you have.
| Type | Characteristic | How common | Urgency |
|---|---|---|---|
| Acute bacterial | Sudden fever, chills, severe pain when urinating | Rare | High: see a doctor right away |
| Chronic bacterial | Recurring bladder infections, mild ongoing symptoms | Occasional | Moderate: get it checked |
| Chronic pelvic pain syndrome (CPPS) | Persistent pelvic pain, no detectable bacteria | Most common | Not acute: discuss with your doctor |
| Asymptomatic inflammatory prostatitis | Inflammation without symptoms, often a chance finding | Variable | Low: usually no treatment needed |
For chronic pelvic pain syndrome, treatment often targets the symptoms themselves, because an infection is absent. The EAU guideline stresses that several approaches may be needed at the same time (EAU, 2024).
When should you see a GP about prostatitis?
See your GP if urinary or pelvic symptoms last longer than a few days, or straight away with fever and severe pain. Prostatitis treatment is always decided by a doctor, because the type and cause make the difference between rest, antibiotics or further testing.
Some symptoms cannot wait. The checklist below is a guide, not a complete list.
Go to a GP or out-of-hours clinic right away if you have:
- High fever with chills
- Being completely unable to urinate (urinary retention)
- Severe, rapidly worsening pain in the pelvis or lower abdomen
- Blood in your urine
In an emergency, always call 112.
For mild, persistent symptoms, a blood test can help you prepare better for the conversation with your doctor. Our Prostate Health Check gives you insight into values that are relevant with prostate complaints, such as PSA.
Frequently asked questions
Is prostatitis an STI?
No, prostatitis is usually not an STI. The inflammation often comes from ordinary gut bacteria or has no bacterial cause at all. In a small share of cases an STI can play a role, so discuss your situation honestly with your doctor.
Does prostatitis raise your PSA level?
It can. Inflammation of the prostate can temporarily raise your PSA level, sometimes considerably. A raised PSA with prostatitis does not by itself mean there is cancer. Your doctor looks at the whole picture and often repeats the test after treatment.
Does chronic prostatitis go away on its own?
Sometimes yes, sometimes no. Mild symptoms can ease, but chronic prostatitis can also linger for a long time or return. Do not wait too long to seek help: the sooner your doctor is involved, the more targeted the approach can be.
The next step is simple: note your symptoms and how long you have had them, and book an appointment with your GP. Unsure about your PSA, or want to walk into that conversation prepared? Take a look at the Prostate Health Check.
References
- Krieger JN, Nyberg L Jr, Nickel JC. NIH consensus definition and classification of prostatitis. JAMA. 1999;282(3):236-237. PMID: 10422990.
- Dutch College of General Practitioners (NHG). NHG Guideline on Male Urinary Symptoms. 2024.
- European Association of Urology. EAU Guidelines on Urological Infections. 2024.
Disclaimer
Caliberhealth works with BIG-registered doctors who review your blood results. This article provides general information and is not a substitute for medical advice from a GP or specialist. A blood test is a tool to inform your conversation with your doctor, not a diagnosis on its own. For severe symptoms or concerns about your health: contact your GP, or call 112 in an emergency.
Author
