Prostatitis refers to inflammation of the prostate, a male reproductive gland that produces part of the seminal fluid. The prostate exists only in men and plays an important role in reproductive function. When prostatitis occurs, it can cause a variety of symptoms, including pain, urinary problems, and decreased sexual function.
Common symptoms include lower abdominal pain around the pubic area, pain in the perineum between the scrotum and anus, and discomfort in the testicles, penis, or pelvic region. Urinary symptoms such as frequent urination, urgency, delayed urination, and nocturia may also appear. In some cases, patients may experience reduced erectile function or premature ejaculation. One of the major challenges of prostatitis is that it often recurs even after treatment.
According to the classification of the National Institutes of Health (NIH), prostatitis can be divided into five major categories. The first is acute bacterial prostatitis, which presents with acute symptoms such as fever or chills and is confirmed by the presence of bacteria in culture tests. The second is chronic bacterial prostatitis, in which patients experience persistent symptoms such as pain, urinary difficulties, and sexual dysfunction, along with confirmed bacterial infection.
The third category is inflammatory chronic pelvic pain syndrome. In this condition, patients have symptoms similar to chronic prostatitis, and inflammation is detected in prostatic fluid, semen analysis, or urine tests after prostate massage. The fourth type is non-inflammatory chronic pelvic pain syndrome, in which prostatitis-like symptoms exist but no inflammatory markers are detected in prostatic fluid. The final type is asymptomatic inflammatory prostatitis, where patients have no symptoms but inflammation is discovered during prostate fluid analysis or prostate biopsy.
Because prostatitis has multiple classifications, treatment must be tailored according to the specific type. This individualized approach is essential for preventing recurrence. Acute bacterial prostatitis is typically caused by bacterial infection, so identifying the responsible organism through testing and administering appropriate antibiotics and injections is the primary treatment. Similarly, chronic bacterial prostatitis is treated mainly with medications. However, because prostate tissue has relatively low permeability to drugs, treatment generally requires a longer duration, usually at least four to six weeks.
For non-bacterial prostatitis, medication is still commonly used, but additional therapies are often combined. One commonly used method is prostate massage, which involves gently massaging the prostate through the rectum. This technique, described in medical textbooks, is typically performed two to three times per week and has been reported to be effective for symptom relief. Other treatment options may include magnetic therapy, biofeedback, behavioral therapy, physical therapy, and heat therapy.
Beyond medical treatment, lifestyle modification also plays an important role in improving symptoms and preventing recurrence. Alcohol consumption can significantly worsen prostatitis symptoms and should be avoided. Coffee intake is also not recommended because caffeine may aggravate symptoms. Spicy foods can irritate the bladder lining and should likewise be limited. Instead, increasing the intake of fruits and vegetables may help support recovery.
Dr. Lee Min-jong of Goldman Urology Clinic’s Gangnam branch recommends regular aerobic exercise after prostatitis treatment. Improved blood circulation from aerobic activity can aid recovery. Exercises such as jogging, swimming, and walking are generally recommended. However, activities that place pressure on the perineal area, such as cycling or horseback riding, should be avoided.