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Last reviewed: 19 Sep 2025
Last updated: 17 Sep 2025

Summary

Definition

History and exam

Key diagnostic factors

  • fever, chills, malaise
  • tender prostate

Other diagnostic factors

  • age <50 years
  • urinary frequency
  • dysuria
  • diminished urinary stream
  • perineal pain
  • warm or soft, boggy gland
  • indwelling urinary catheter
  • recent transrectal prostate biopsy
  • recent transurethral surgery

Risk factors

  • urinary tract infection (UTI)
  • benign prostatic enlargement
  • urinary tract instrumentation/manipulation
  • poor general health/immunosuppression
  • smoking and alcohol consumption
  • genetics

Diagnostic tests

1st tests to order

  • urinalysis
  • urine culture
  • blood cultures

Investigations to avoid

  • serum prostate-specific antigen (PSA)

Tests to consider

  • transrectal ultrasound
  • 4-glass or 2-glass test
  • urine cytology

Treatment algorithm

Contributors

Authors

Altaf Mangera, MBChB (Hons), MD, FRCS (Urol)

Consultant Urologist

Department of Urology

Royal Hallamshire Hospital

Sheffield

UK

Disclosures

AM declares that he has no competing interests.

Acknowledgements

Altaf Mangera would like to gratefully acknowledge Christopher Chapple and Robyn Webber, previous contributors to this topic. CC is a consultant for Proverum, MUVON Therapeutics, and Pierre Fabre.

Peer reviewers

Hans Hedelin, MD

Department of Urology and Centre for Research and Development

Karnsjukhuset

Skovde

Sweden

Disclosures

HH declares that he has no competing interests.

Benjamin A. Lipsky, MD, FACP, FIDSA, FRCP

Professor of Medicine

University of Washington

VA Puget Sound Health Care System

Seattle

WA

Disclosures

BAL has received research funding from, and been a consultant to, several pharmaceutical companies that make antibiotic agents that might be used for treating bacterial prostatitis.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

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.Full text  Abstract

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

Reference articles

A full list of sources referenced in this topic is available here.

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