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Diseases

Acute prostatitis

OVERVIEW

  • Highlights & Basics
  • Images

DIAGNOSIS

  • Diagnostic Approach
  • Risk Factors
  • History & Exam
  • Tests
  • Differential Diagnosis
  • Criteria
  • Screening

TREATMENT

  • Tx Approach
  • Tx Options
  • Emerging Tx
  • Prevention

FOLLOW-UP

  • Overview
  • Complications

REFERENCES

  • Citations
  • Guidelines
  • Credits

PATIENT RESOURCES

  • Patient Instructions

Highlights & Basics

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Key Highlights
  • Acute prostatitis is usually caused by organisms entering the prostate from urinary tract infections.

  • Commonly caused by Escherichia coli bacteria.

  • Symptoms include dysuria, perineal or genital pain, and urinary frequency alongside a clinical picture of sepsis.

  • May be successfully treated with antibiotics, but a prolonged course is frequently required if chronic prostatitis follows the acute occurrence.

Quick Reference

  • History & Exam

    • Key Factors

      • Other Factors

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      • Diagnostics Tests

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        • Treatment Options

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          Definition

          Epidemiology

          Etiology

          Pathophysiology

          content by BMJ Group
          Last updated

          Citations

            Key Articles

            • Rothman JR, Jaffe WI. Prostatitis: updates on diagnostic evaluation. Curr Urol Rep. 2007 Jul;8(4):301-6.[Abstract]

            • European Association of Urology. Guidelines on urological infections. Mar 2025 [internet publication].[Full Text]

            • Nickel JC. Prostatitis. Can Urol Assoc J. 2011 Oct;5(5):306-15.[Abstract][Full Text]

            • National Institute for Health and Care Excellence. Prostatitis (acute): antimicrobial prescribing. Oct 2018 [internet publication].[Full Text]

            Referenced Articles

            • 1. Brede CM, Shoskes DA. The etiology and management of acute prostatitis. Nat Rev Urol. 2011 Apr;8(4):207-12.[Abstract][Full Text]

            • 2. Rothman JR, Jaffe WI. Prostatitis: updates on diagnostic evaluation. Curr Urol Rep. 2007 Jul;8(4):301-6.[Abstract]

            • 3. Brehm TJ, Trautner BW, Kulkarni PA. Acute and chronic infectious prostatitis in older adults. Infect Dis Clin North Am. 2023 Mar;37(1):175-94.[Abstract]

            • 4. Khan FU, Ihsan AU, Khan HU, et al. Comprehensive overview of prostatitis. Biomed Pharmacother. 2017 Oct;94:1064-76.[Abstract]

            • 5. Meares EM Jr. Prostatitis. Med Clin North Am. 1991 Mar;75(2):405-24.[Abstract][Full Text]

            • 6. Krieger JN, Nyberg L Jr, Nickel JC. NIH consensus definition and classification of prostatitis. JAMA. 1999 Jul 21;282(3):236-7.[Abstract]

            • 7. Karlovsky ME, Pontari MA. Theories of prostatitis etiology. Curr Urol Rep. 2002 Aug;3(4):307-12.[Abstract]

            • 8. Krieger JN, Lee SW, Jeon J, et al. Epidemiology of prostatitis. Int J Antimicrob Agents. 2008 Feb;31(suppl 1):S85-90.[Abstract][Full Text]

            • 9. Potts J, Payne RE. Prostatitis: infection, neuromuscular disorder, or pain syndrome? Proper patient classification is key. Cleve Clin J Med. 2007 May;74(suppl 3):S63-71.[Abstract]

            • 10. Lipsky BA, Byren I, Hoey CT. Treatment of bacterial prostatitis. Clin Infect Dis. 2010 Jun 15;50(12):1641-52.[Abstract][Full Text]

            • 11. Roberts RO, Lieber MM, Rhodes T, et al. Prevalence of a physician-assigned diagnosis of prostatitis: the Olmsted County Study of Urinary Symptoms and Health Status Among Men. Urology. 1998 Apr;51(4):578-84.[Abstract]

            • 12. Gasperi M, Krieger JN, Panizzon MS, et al. Genetic and environmental influences on urinary conditions in men: a classical twin study. Urology. 2019 Jul;129:54-9.[Abstract][Full Text]

            • 13. Workowski KA, Bachmann LH, Chan PA, et al. Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR Recomm Rep. 2021 Jul 23;70(4):1-187.[Abstract][Full Text]

            • 14. European Association of Urology. Guidelines on urological infections. Mar 2025 [internet publication].[Full Text]

            • 15. Lummus WE, Thompson I. Prostatitis. Emerg Med Clin North Am. 2001 Aug;19(3):691-707.[Abstract]

            • 16. Terai A, Ishitoya S, Mitsumori K, et al. Molecular epidemiological evidence for ascending urethral infection in acute bacterial prostatitis. J Urol. 2000 Dec;164(6):1945-7.[Abstract]

            • 17. Weidner W, Schiefer HG, Krauss H, et al. Chronic prostatitis: a thorough search for etiologically involved microorganisms in 1,461 patients. Infection. 1991;19(suppl 3):S119-25.[Abstract]

            • 18. Schneider H, Ludwig M, Hossain HM, et al. The 2001 Giessen Cohort Study on patients with prostatitis syndrome: an evaluation of inflammatory status and search for microorganisms 10 years after a first analysis. Andrologia. 2003 Oct;35(5):258-62.[Abstract]

            • 19. Bergman B. On the relevance of gram-positive bacteria in prostatitis. Infection. 1994;22(suppl 1):S22.[Abstract]

            • 20. Marquez-Algaba E, Pigrau C, Bosch-Nicolau P, et al. Risk factors for relapse in acute bacterial prostatitis: the impact of antibiotic regimens. Microbiol Spectr. 2021 Oct 31;9(2):e0053421.[Abstract][Full Text]

            • 21. Wallner LP, Clemens JQ, Sarma AV. Prevalence of and risk factors for prostatitis in African American men: the Flint Men's Health Study. Prostate. 2009 Jan 1;69(1):24-32.[Abstract]

            • 22. Kang CI, Kim J, Park DW, et al. Clinical practice guidelines for the antibiotic treatment of community-acquired urinary tract infections. Infect Chemother. 2018 Mar;50(1):67-100.[Abstract][Full Text]

            • 23. Karakonstantis S, Kalemaki D. A significant percentage of patients with transrectal biopsy-related infections have positive blood cultures but negative urine cultures. A literature review and meta-analysis. Infect Dis (Lond). 2018 Nov - Dec;50(11-12):791-803.[Abstract][Full Text]

            • 24. Seo Y, Lee G. New bacterial infection in the prostate after transrectal prostate biopsy. J Korean Med Sci. 2018 Apr 23;33(17):e126.[Abstract][Full Text]

            • 25. Liang CZ, Li HJ, Wang ZP, et al. The prevalence of prostatitis-like symptoms in China. J Urol. 2009 Aug;182(2):558-63.[Abstract]

            • 26. Moreira DM, Nickel JC, Gerber L, et al. Smoking is associated with acute and chronic prostatic inflammation: results from the REDUCE study. Cancer Prev Res (Phila). 2015 Apr;8(4):312-7.[Abstract][Full Text]

            • 27. Nickel JC. Prostatitis. Can Urol Assoc J. 2011 Oct;5(5):306-15.[Abstract][Full Text]

            • 28. Matsumoto M, Yamamoto S. AAUS guideline for acute bacterial prostatitis 2021. J Infect Chemother. 2021 Sep;27(9):1277-83.

            • 29. Zermann DH, Ishigooka M, Doggweiler R, et al. Neurourological insights into the etiology of genitourinary pain in men. J Urol. 1999 Mar;161(3):903-8.[Abstract]

            • 30. Miller JM, Binnicker MJ, Campbell S, et al. Guide to utilization of the microbiology laboratory for diagnosis of infectious diseases: 2024 update by the Infectious Diseases Society of America (IDSA) and the American Society for Microbiology (ASM). Clin Infect Dis. 2024 Mar 5:ciae104.[Abstract][Full Text]

            • 31. Meares EM, Stamey TA. Bacteriologic localization patterns in bacterial prostatitis and urethritis. Invest Urol. 1968 Mar;5(5):492-518.[Abstract]

            • 32. Nickel JC, Shoskes D, Wang Y, et al. How does the pre-massage and post-massage 2-glass test compare to the Meares-Stamey 4-glass test in men with chronic prostatitis/chronic pelvic pain syndrome? J Urol. 2006 Jul;176(1):119-24.[Abstract]

            • 33. Sindhwani P, Wilson CM. Prostatitis and serum prostate-specific antigen. Curr Urol Rep. 2005 Jul;6(4):307-12.[Abstract]

            • 34. Stopiglia RM, Ferreira U, Silva MM Jr, et al. Prostate specific antigen decrease and prostate cancer diagnosis: antibiotic versus placebo prospective randomized clinical trial. J Urol. 2010 Mar;183(3):940-4.[Abstract]

            • 35. Compérat E, Amin MB, Cathomas R, et al. Current best practice for bladder cancer: a narrative review of diagnostics and treatments. Lancet. 2022 Nov 12;400(10364):1712-21.[Abstract]

            • 36. Langer JE, Cornud F. Inflammatory disorders of the prostate and the distal genital tract. Radiol Clin North Am. 2006 Sep;44(5):665-77.[Abstract]

            • 37. Wasserman NF. Prostatitis: clinical presentations and transrectal ultrasound findings. Semin Roentgenol. 1999 Oct;34(4):325-37.[Abstract]

            • 38. Ackerman AL, Parameshwar PS, Anger JT. Diagnosis and treatment of patients with prostatic abscess in the post-antibiotic era. Int J Urol. 2018 Feb;25(2):103-110.[Abstract][Full Text]

            • 39. Zaidi S, Gandhi J, Seyam O, et al. Etiology, diagnosis, and management of seminal vesicle stones. Curr Urol. 2019 May 10;12(3):113-20.[Abstract][Full Text]

            • 40. Lee JC, Muller CH, Rothman I, et al. Prostate biopsy culture findings of men with chronic pelvic pain syndrome do not differ from those of healthy controls. J Urol. 2003 Feb;169(2):584-7.[Abstract]

            • 41. ​European Association of Urology. Guidelines on non-muscle-invasive bladder cancer (TaT1 and CIS). Mar 2025 [internet publication].[Full Text]

            • 42. Pontari MA, Joyce GF, Wise M, et al. Prostatitis. J Urol. 2007 Jun;177(6):2050-7.[Abstract]

            • 43. Schiller DS, Parikh A. Identification, pharmacologic considerations, and management of prostatitis. Am J Geriatr Pharmacother. 2011 Feb;9(1):37-48.[Abstract]

            • 44. National Institute for Health and Care Excellence. Prostatitis (acute): antimicrobial prescribing. Oct 2018 [internet publication].[Full Text]

            • 45. Ludwig M. Diagnosis and therapy of acute prostatitis, epididymitis and orchitis. Andrologia. 2008 Apr;40(2):76-80.[Abstract][Full Text]

            • 46. Rusu A, Munteanu AC, Arbănași EM, et al. Overview of side-effects of antibacterial fluoroquinolones: new drugs versus old drugs, a step forward in the safety profile? Pharmaceutics. 2023 Mar 1;15(3):804.[Abstract][Full Text]

            • 47. Barbalias GA, Nikiforidis G, Liatsikos EN. Alpha-blockers for the treatment of chronic prostatitis in combination with antibiotics. J Urol. 1998 Mar;159(3):883-7.[Abstract]

            • 48. Schaeffer AJ. Prostatitis: US perspective. Int J Antimicrob Agents. 1999 May;11(3-4):205-11.[Abstract]

            • 49. Rees J, Abrahams M, Doble A, et al. Diagnosis and treatment of chronic bacterial prostatitis and chronic prostatitis/chronic pelvic pain syndrome: a consensus guideline. BJU Int. 2015 Oct;116(4):509-25.[Abstract][Full Text]

            • 50. Abdelmoteleb H, Rashed F, Hawary A. Management of prostate abscess in the absence of guidelines. Int Braz J Urol. 2017 Sep-Oct;43(5):835-40.[Abstract][Full Text]

            • 51. Franco JV, Turk T, Jung JH, et al. Pharmacological interventions for treating chronic prostatitis/chronic pelvic pain syndrome. Cochrane Database Syst Rev. 2019 Oct 6;10:CD012552.[Abstract][Full Text]

            • 52. Bowen DK, Dielubanza E, Schaeffer AJ. Chronic bacterial prostatitis and chronic pelvic pain syndrome. BMJ Clin Evid. 2015 Aug 27;2015.[Abstract][Full Text]

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