Prostatitis


What Is Prostatitis
Prostatitis is inflammation of the prostate gland, often associated with painful or difficult urination. The prostate gland, located below the bladder in men, surrounds the urethra and produces fluid for semen.
Prostatitis affects men of all ages and can lead to discomfort in the pelvic area or genitals. Early diagnosis and treatment alleviate symptoms and prevent complications.
Types Of Prostatitis
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Acute Bacterial Prostatitis
This type of prostatitis is caused by a sudden bacterial infection in the prostate gland. Symptoms can be severe and include fever, chills, painful urination, and urinary retention. Immediate medical treatment, typically with antibiotics, is required to prevent complications such as bloodstream infection or abscess formation in the prostate.
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Chronic Bacterial Prostatitis
Chronic bacterial prostatitis is an ongoing or recurring bacterial infection in the prostate gland. Symptoms are generally less severe than acute bacterial prostatitis and may include discomfort during urination, frequent urination, and pelvic pain. Treatment usually involves a longer course of antibiotics, and the condition may recur.
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Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CPPS)
CPPS is a common type of prostatitis characterized by chronic pelvic pain and urinary tract symptoms without evidence of bacterial infection. The cause of CPPS is not well understood, and symptoms may vary in intensity. Treatment may include pain management, physical therapy, and lifestyle changes.
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Asymptomatic Inflammatory Prostatitis
This type of prostatitis involves inflammation of the prostate without any noticeable symptoms. It is often discovered during an examination for other medical conditions and does not require treatment. The cause of asymptomatic inflammatory prostatitis is unknown.
Symptoms Associated with Different Types of Prostatitis
- Acute Bacterial Prostatitis: Symptoms include fever, chills, painful urination, urinary retention, and lower back pain.
- Chronic Bacterial Prostatitis: Symptoms may include discomfort during urination, frequent urination, and pelvic pain.
- Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CPPS): Symptoms include chronic pelvic pain, discomfort in the perineal area, urinary frequency, and urgency.
- Asymptomatic Inflammatory Prostatitis: This type does not present noticeable symptoms.
Causes and Risk Factors
- Bacterial Infections: Acute and chronic bacterial prostatitis are caused by bacterial infections. The bacteria may enter the prostate from the urinary tract or bloodstream.
- Nervous System Dysfunction: Dysfunction in the nerves around the prostate may contribute to CPPS.
- Immune System Dysfunction: An abnormal immune response may cause inflammation in the prostate, leading to CPPS.
- Psychological Stress: Stress may exacerbate symptoms of CPPS.
- Irregular Hormone Activity: Hormonal changes may be linked to prostatitis, although the relationship is not fully understood.
Diagnosis and Tests
Procedures and Tests Used for Diagnosis
Diagnosing prostatitis involves a combination of medical history, physical examination, and specific tests. The following are commonly used:
- Medical History: Gathering information about symptoms, medical history, and sexual activities.
- Physical Examination: Includes a digital rectal exam (DRE) to feel the prostate for abnormalities.
- Urine Tests: Analyzing urine samples for signs of infection or inflammation.
- Blood Tests: Checking for signs of infection and prostate-specific antigen (PSA) levels.
- Urodynamic Tests: Assessing bladder function.
- Prostate Fluid Analysis: Examining fluid expressed from the prostate for signs of infection.
- Imaging Tests: Such as ultrasound, to visualize the prostate and surrounding structures.
Importance of Accurate Diagnosis
An accurate diagnosis is key to determining the type of prostatitis and the appropriate treatment plan. Misdiagnosis can lead to ineffective treatment and prolonged symptoms.
Digital Rectal Exam (DRE)
The digital rectal exam is a standard procedure in diagnosing prostatitis. The physician inserts a gloved, lubricated finger into the rectum to feel the prostate gland. The DRE can reveal abnormalities in size, shape, or texture that may indicate prostatitis or other prostate problems.
The process of diagnosing prostatitis is multifaceted, involving a combination of examinations, tests, and patient history. Accurate diagnosis is essential for effective treatment, and the digital rectal exam plays a crucial role in this process.
Management and Treatment of Prostatitis
Treatment for Chronic Pelvic Pain Syndrome (CPPS)
Management of CPPS may require a multifaceted approach, as the exact cause is often unclear. Treatment options include:
- Pain Relievers: Over-the-counter pain medications may alleviate discomfort.
- Muscle Relaxants: These can help with muscle spasms in the pelvic area.
- Physical Therapy: Exercises and techniques to relax pelvic floor muscles.
- Stress Management: Techniques to reduce stress that may exacerbate symptoms.
Treatment for Bacterial Forms of Prostatitis
Treatment for bacterial prostatitis, both acute and chronic, typically involves:
- Antibiotics: The type and duration depend on the bacteria causing the infection. Treatment may last from a few weeks to several months.
- Alpha Blockers: These medications can help with urinary symptoms.
- Anti-Inflammatory Agents: To reduce inflammation and discomfort.
Antibiotics are central to the treatment of bacterial prostatitis. The choice of antibiotic depends on the specific bacteria identified. Other medications, such as alpha blockers and anti-inflammatory agents, may be used in conjunction with antibiotics to manage symptoms.
Surgical Interventions if Necessary
Surgery is rarely required for prostatitis but may be considered if:
- Abscess Formation: Drainage of a prostate abscess if present.
- Urinary Obstruction: Procedures to relieve obstruction caused by an enlarged prostate.
Prevention
Steps to Prevent Prostatitis
Preventing prostatitis involves several measures, including:
- Hydration: Drinking sufficient fluids helps in flushing bacteria from the urinary system.
- Urination Habits: Urinating when the need arises and emptying the bladder completely can prevent urinary tract infections (UTIs), a potential cause of prostatitis.
- Diet and Lifestyle: A balanced diet and regular exercise may support overall prostate health.
Safe Sex Practices
Practicing safe sex, including the use of condoms, can reduce the risk of sexually transmitted infections, which may lead to prostatitis.
Importance of Prompt Treatment for UTIs
UTIs can cause bacterial prostatitis if not treated promptly. Early treatment of UTIs with appropriate antibiotics minimizes the risk of the infection spreading to the prostate gland.
Get an Accurate Diagnosis & Proper Treatment
for Your Urological Conditions

Dr Lee Fang Jann
Dr Lee is a urologist and kidney transplant surgeon with a broad-based expertise of all urological disorders
He has subspecialty focus on men’s health and male infertility, and special interest in minimally invasive prostate enlargement therapy and kidney stone treatment. Dr Lee has received numerous awards for service excellence such as the Service With A Heart Award (2006-2008, 2011) and the Singapore Health Quality Service Award (2016).
- Bachelor of Medicine and Bachelor of Surgery (Singapore)
- Membership of The Royal College of Surgeons (Edin)
- Master of Medicine (Surgery) (Singapore)
- Fellowship of the Academy of Medicine (Urology)
- Clinical fellowship at Oxford Transplant Centre in the UK
Prior to entering private practice, Dr Lee served in the public sector for 16 years at SGH, where he initiated dedicated clinics evaluating and treating patients with complex men’s health and fertility issues. He also led the Renal Transplant Program and laparoscopic donor nephrectomy service as Surgical Director.
Apart from clinical work, Dr Lee is active in academia and believes in the importance of grooming the next generation of doctor. He was Senior Clinical Lecturer at NUS’ Yong Loo Lin School of Medicine and currently, Adjunct Assistant Professor at the Duke-NUS Medical School. Dr Lee is also regularly invited to share his experiences locally and regionally through lectures, workshops and surgical demonstrations.
Our Clinic Locations
Farrer Park Medical Centre, #08-05
1 Farrer Park Station Rd, Singapore 217562
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Mon – Fri: 8:30am to 5:30pm
Sat: 8:30am to 12:30pm
Frequently Asked Questions
What is Prostatitis, and how common is it?
Prostatitis is inflammation of the prostate gland, often causing urinary or pelvic discomfort. It affects men of all ages and is one of the most common urological conditions in men under 50.
What are the different types of Prostatitis, and how do they differ?
Prostatitis is classified into four types:
- Acute Bacterial Prostatitis: Sudden infection with severe symptoms.
- Chronic Bacterial Prostatitis: Ongoing or recurring infection with milder symptoms.
Chronic Prostatitis/Chronic Pelvic Pain - Syndrome (CPPS): Persistent pain and urinary symptoms without infection.
- Asymptomatic Inflammatory Prostatitis: Inflammation without symptoms.
How is Prostatitis diagnosed?
Diagnosis involves a combination of medical history, physical examination, including a digital rectal exam, urine tests, blood tests, urodynamic tests, prostate fluid analysis, and imaging tests such as ultrasound.
What are the treatment options for Prostatitis?
- Bacterial Prostatitis: Antibiotics, alpha blockers, and anti-inflammatory agents.
- CPPS: Pain relievers, muscle relaxants, physical therapy, and stress management.
- Asymptomatic Inflammatory Prostatitis: No treatment required.
Can Prostatitis be prevented?
Prevention includes hydration, regular urination, balanced diet, safe sex practices, and prompt treatment of UTIs.
Is Prostatitis a sign of prostate cancer?
Prostatitis is not a sign of prostate cancer, but symptoms may overlap. Proper diagnosis is essential to distinguish between the two.
What are the complications associated with Prostatitis?
Complications may include chronic pain, sexual dysfunction, infertility, urinary retention, abscess formation in the prostate, and, in rare cases, systemic infection.