Acute prostatitis is a fast-onset disease with symptoms including fever, fatigue, and often difficulty urinating.

This needs to be distinguished from chronic prostatitis with or without evidence of bacteria, which persists for months and causes chronic pain in the pelvis.

Questions about the diagnosis and treatment of prostatitis

Prostatitis develops when a urinary tract infection spreads to the prostate. In most cases, an enlarged prostate is the main contributing factor to the development of urinary tract infections in men.

The prostate gland enlarges with increasing age due to the male sex hormone, a process known as benign prostate enlargement. This disease is not related to prostate cancer.

Many are unaware that the urethra runs through the middle of the prostate after it leaves the bladder. Therefore, if the prostate is enlarged, it can constrict the urethra. This can lead to difficulty urinating and formation of residual urine, meaning that the bladder no longer properly empties. Bacteria like to settle in this environment. This is also the reason why prostatitis tends to occur at an advanced age.

Since prostatitis usually develops on the basis of a urinary tract infection, it is often preceded by symptoms such as frequent urination and burning. Fever is usually the first indication of prostate involvement. In addition, pain may also occur in the region of the anus. Over the course of the disease, headaches and fatigue may also severely impair the patient’s general condition.

The urologist usually makes a diagnosis on the basis of the common symptoms. A laboratory test is carried out in addition to a physical examination and ultrasound diagnostics. The laboratory test may determine an increase in PSA value in the blood. In this case, this value, which is usually used in prostate cancer screening, is the result of acute inflammation and not an indication of a malignant issue.

Treatment is carried out by administering antibiotics. In the case of residual urine formation, the insertion of a catheter may also be necessary. The medication must be taken for a sufficiently long period of time, to avoid the development of chronic issues. Often, the PSA level is permanently elevated, making cancer screening more difficult.

Chronic prostatitis is present if symptoms persist for longer than 3 months and germs are repeatedly detected in the urine. Abacterial prostatitis or pelvic pain syndrome occurs if there are symptoms without evidence of germs, the causes of which can be manifold. Treatment can be medicinal, but physical therapies can also be effective. Despite treatment often lasting many months, prognosis is normally very good.  

About this page:


Prof. Dr. med. Sven Lahme
Urology specialist

Medical director of the Goldstadt-Privatklinik.
Specialist for Urology, Mini-PCNL and robot-assisted da Vinci procedures.

Member in Scientific Societies and Reviewer of scientific journals.

Creation Date: 08.03.2020Modification date: 08.03.2020