Prostatitis refers to inflammation of the prostate gland in men. The prostate is an organ found only in males and plays an important role in producing a portion of semen. Prostatitis can cause a variety of symptoms, most commonly pain, urinary problems, and decreased sexual function. Patients may experience lower abdominal pain around the pubic area, perineal pain between the testicles and anus, as well as pain in the testicles, penis, or pelvis. Urinary symptoms such as frequent urination, urgency, difficulty starting urination, and nocturia are also common. In addition, some patients experience sexual dysfunction, including decreased erectile function or premature ejaculation.
According to the classification system of the U.S. National Institutes of Health (NIH), prostatitis can be divided into several types. The first is acute bacterial prostatitis, characterized by acute symptoms such as fever or chills with a confirmed bacterial infection on culture tests. The second is chronic bacterial prostatitis, in which persistent symptoms such as chronic pain, urinary difficulties, and sexual dysfunction occur with identifiable bacteria. The third category is inflammatory chronic pelvic pain syndrome, where prostatitis-like symptoms are present and inflammation is detected in prostatic fluid, semen, or urine after prostate massage. The fourth type is non-inflammatory chronic pelvic pain syndrome, in which symptoms are present but no inflammatory findings are identified. The final category is asymptomatic inflammatory prostatitis, in which no symptoms are present but inflammation is detected during testing.
Because prostatitis has multiple classifications, treatment is often complex. In cases of acute bacterial prostatitis, treatment begins by identifying the causative bacteria and administering appropriate antibiotics and injections. Chronic bacterial prostatitis also relies primarily on medication, but because drugs penetrate prostate tissue poorly, a sufficiently long treatment period—often four to six weeks or longer—is required.
Non-bacterial prostatitis requires an even more comprehensive treatment approach. Many people assume that prostatitis is treated solely with antibiotics, but in reality antibiotics are only one component of treatment. Anti-inflammatory pain relievers may be used, along with medications that help control urinary symptoms and drugs for neuropathic pain. In some cases, treatment may also involve pain management approaches or psychiatric medications. In other words, the key to prostatitis treatment is not simply whether medication is used, but how accurately and appropriately it is prescribed.
One treatment option is prostate massage. This technique involves stimulating the prostate through the rectum to relieve congestion, and when performed two to three times per week, it can help alleviate symptoms in some patients. In addition, various non-drug therapies may be used, including magnetic therapy, biofeedback, behavioral therapy, physical therapy, and heat therapy.
In some cases, patients who initially visit the hospital with suspected prostatitis may later be diagnosed with other conditions such as urethral stricture or interstitial cystitis after detailed testing. Because the symptoms are similar, it can be difficult to distinguish these conditions based solely on a patient interview, making accurate diagnostic testing and clinical experience essential. It is also common for patients to initially visit an internal medicine clinic for symptoms resembling fatigue or flu-like illness and later receive a diagnosis of prostatitis after evaluation by a urologist. This reflects how challenging prostatitis can be to diagnose.
Prostatitis is therefore considered a complex condition both in diagnosis and treatment. If treatment is insufficient or misdiagnosis occurs repeatedly, the disease may recur frequently and eventually become chronic, leading to a poorer prognosis. For this reason, patients with persistent or recurring symptoms should seek evaluation by medical professionals with extensive experience in treating prostatitis to ensure accurate diagnosis and systematic treatment.
Dr. Lee Min-jong of Goldman Urology Clinic Gangnam Branch emphasized that lifestyle modifications play an important role in preventing recurrence alongside medical treatment. Alcohol consumption should be avoided because it can significantly worsen prostatitis symptoms, and spicy foods should also be limited as they may irritate the bladder lining and aggravate symptoms. He added that regular aerobic exercise—such as jogging, swimming, or walking—can improve blood circulation and help relieve prostatitis symptoms, while activities that place strong pressure on the perineal area, such as cycling or horseback riding, should be avoided.