Nonbacterial Prostatitis: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Nonbacterial Prostatitis?
A urologist, a doctor who specializes in the urinary tract and male reproductive system, usually treats nonbacterial prostatitis. A physical therapist may also help with the muscles of the pelvis. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is nonbacterial prostatitis?
Nonbacterial prostatitis causes long-term pain and urinary symptoms. It involves the prostate gland or other parts of a man's lower urinary tract or genital area. It is not caused by an infection with bacteria. Doctors also call it chronic pelvic pain syndrome, or CPPS.
The prostate is a walnut-shaped gland in the male reproductive system. Its main job is to make a fluid that goes into semen. Most men with chronic prostatitis have the nonbacterial form. It is the most common and least understood form of prostatitis.
Symptoms
The main symptom is pain or discomfort that lasts 3 or more months. It can be in the lower belly, the penis, the scrotum, the lower back, or between the scrotum and anus. The pain may come and go. It may start suddenly or slowly.
Other symptoms can include:
- Pain during or after ejaculation.
- Pain in the urethra or penis during or after urination. The urethra is the tube that carries urine out of the body.
- The bladder may squeeze even when it holds only a little urine, so you need to urinate often.
- Not being able to put off urinating.
- A weak or interrupted urine stream.
- Pain with bowel movements.
- Blood in the semen or in the urine.
Causes and who gets it
Doctors do not know the exact cause. Possible causes include a past bacterial prostatitis infection and a problem with the pelvic floor muscles. Irritation from chemicals, or from urine backing up into the prostate, may also play a part. A nerve problem in the lower urinary tract is another possible cause.
Men with nerve damage in the lower urinary tract from surgery or injury may be more likely to develop it. Psychological stress may also raise the chance. Life stresses and emotional factors may play a part. It can occur in men of any age.
How doctors diagnose it
A provider diagnoses prostatitis using your medical history, a physical exam, and tests. The provider may need to rule out other conditions that cause similar symptoms.
Most of the time, a physical exam is normal. The prostate may be swollen or tender. In a digital rectal exam, the provider slides a gloved finger into the rectum. This lets the provider feel the prostate. This helps show if the prostate is enlarged or tender.
Urine tests may show white or red blood cells. A urine culture tries to grow bacteria from a urine sample. In this condition, it does not show bacteria. A semen test may show more white blood cells. Blood tests can show signs of infection and other prostate problems, such as prostate cancer.
Treatment
This condition is hard to cure, so the main goal is to control symptoms. No single treatment works for every man. Antibiotics will not help treat nonbacterial prostatitis. A urologist may still try them at first, until an infection is ruled out.
Other treatments that may be tried include:
- Alpha blockers, medicines that relax the muscles of the prostate gland. They often take about 6 weeks to start working, and many people do not get relief.
- Pain relievers called NSAIDs, such as aspirin and ibuprofen, which may relieve symptoms for some men.
- Muscle relaxers, which can help reduce spasms in the pelvic floor.
- Warm baths to ease some of the pain.
- Pelvic floor physical therapy.
- Relaxation exercises.
- Changes in diet to avoid things that irritate the bladder and urinary tract.
If stress affects your symptoms, stress reduction may reduce how often symptoms come back. Surgery may be done in rare cases if medicine does not help. It can cause serious problems, including sterility, impotence, and trouble holding urine. Many people respond to treatment, but others do not get relief. Symptoms often come back.
When to see a doctor
Contact your health care provider if you have symptoms of prostatitis. Untreated symptoms may lead to sexual and urinary problems. Call 911 or go to the emergency room if symptoms come on suddenly and are severe, or if you have fever, chills, or cannot urinate at all. These can mean acute bacterial prostatitis, an infection of the prostate.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either can review your symptoms, help you decide when to see a urologist, and follow up with you over time.
Common questions
Is nonbacterial prostatitis an infection?
No, it is not caused by an infection with bacteria. Antibiotics will not help treat it. A urologist may still try them at first, until an infection is ruled out.
Can nonbacterial prostatitis be cured?
It is hard to cure, so treatment focuses on controlling symptoms. Many people respond to treatment, but symptoms often come back.
Can nonbacterial prostatitis be prevented?
No, men cannot prevent prostatitis. Researchers are trying to better understand what causes it.
How common is nonbacterial prostatitis?
Most men with chronic prostatitis have the nonbacterial form. Prostatitis is the most common urinary tract problem for men younger than age 50.
Sources
- MedlinePlus - Prostatitis - nonbacterial
- National Institute of Diabetes and Digestive and Kidney Diseases - Prostatitis: Inflammation of the Prostate
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
