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Prostatitis is inflammation of the prostate gland. Prostatitis often causes painful or difficult urination and pain in the groin, pelvic area, or genitals. It can be bacterial or non-bacterial.  It is not a sexually transmitted infection (STI), but a bacterial STI infection can lead to prostatitis. Bacterial prostatitis is usually treated with a course of antibiotics. There are several ways to treat the symptoms of non-bacterial prostatitis, but it can not always be cured.

Prostatitis is not prostate cancer and is different from having an “enlarged prostate.” It can impact a person of any gender with a prostate. 

What’s the prostate gland?

The prostate is a small, rubbery gland about the size of a ping-pong ball, located deep inside the groin, between the base of the penis and the rectum. The main anatomical function of the prostate is to produce fluid that supports sperm function. Some sex work services involve stimulation of the prostate. 

Other bacteria (especially sexually transmitted bacteria) may also cause prostatitis.

Signs and Symptoms

Signs and symptoms of prostatitis can vary depending on the type of disorder.

Prostatitis can be asymptomatic, but symptoms and effects of prostatitis may include: 

• Pain or burning sensation when you pee/urinate
• Difficulty urinating, such as dribbling or hesitant urination
• Frequent urination, particularly at night 
• Urgent need to urinate
• Cloudy urine
• Blood in the urine
• Pain in the abdomen, groin or lower back
• Pain in the area between the scrotum and rectum (the perineum)
• Pain or discomfort of the penis or testicles
• Painful ejaculation
• Fever, chills, muscle aches and other flu-like symptoms (in the case of acute bacterial prostatitis)

Common Causes

Causes vary depending on the type of prostatitis.

Bacterial prostatitis is usually caused by common strains of bacteria, like those that cause chlamydia, gonorrhoea, or urinary tract infections (UTI). The infection may have spread from other parts of the urinary or reproductive systems. Bacterial prostatitis can be acute or chronic.

Non-bacterial Prostatitis is inflammation of the prostate that is not due to a bacterial infection. It may be caused by stress, nerve irritation, injuries or past urinary tract infections. 

Prevention

Because prostatitis can be a complication of certain STI, your best prevention methods are STI-related. You can prevent prostatitis by: 

• reducing your STI risk, particularly for chlamydia and gonorrhoea,
• getting regular sexual health screening to detect any STI that could cause prostatitis,
• treating known STI infections quickly and thoroughly, and/or
• avoiding holding on to urine for long periods.
  

Testing 

Several conditions can contribute to the signs and symptoms of prostatitis. It is important to get an accurate diagnosis and treatment as soon as possible.

Here’s some information about testing for prostatitis. You can view a list of sex worker-friendly sexual health clinics at our Where To Test page.

Testing Method

• Digital rectal exam (an examination in which a doctor inserts a lubricated, gloved finger into the rectum to feel for abnormalities)
• Urine test
• Blood test
• Prostatic specimen test (Health care provider may gently massage the prostate during a rectal exam to release prostate fluid into your urethra. A urine sample after the massage expels the prostate fluid for bacterial testing.)

When to Test

• You should see your doctor as soon as possible if you are experiencing symptoms of prostatitis.
• Get immediate care if you have any of the following:
  • Inability to urinate
  • Painful or difficult urination, accompanied by fever
  • Blood in your urine
  • Severe discomfort or pain in the pelvic area or genitals

Other Info

• Prostatitis is not included in standard sexual health screening, but a recent STI diagnosis may help inform a prostatitis diagnosis. 
• Prostatitis can be asymptomatic.
• Sexual health clinic testing is often bulk billed, even if you don’t have Medicare, so the test will most likely be free.
• If you see a GP, you may pay a fee or be bulk billed.

Treatment

Bacterial prostatitis is usually treated with antibiotics prescribed by a doctor. Non-bacterial prostatitis can be treated in several ways to help with painful symptoms, but is not always cured.

Treatment for prostatitis depends on the specific type diagnosed and your symptoms. Your doctor will advise you on this. 

How might this impact my work? 

• You don’t need to avoid sex if you have prostatitis, and sex will not make prostatitis worse. 
• Some people who have prostatitis experience pain when ejaculating.
• Severe prostatitis can also cause erectile dysfunction.
• If your prostatitis is caused by a STI or other infection, there’s a risk of passing this on during sex. You will need to treat that infection to protect yourself and others.