Pain in the prostate


Pain of prostate can be due to a variety of causes that do not always have to be in the prostate itself. For one thing, a benign enlargement of the prostateProstate pain, as it occurs in most men in the course of life, from the mere expansion or partial displacement of the urethra and the resulting backlog of urine. But also acute or chronic inflammation of the prostate (Prostatitis) as well as a tumor or Prostate stones are possible causes. In addition, a treatment carried out in the area of ​​the small pelvis, whether through surgery or radiation, can be accompanied by hardening and adhesions in the pelvic floor or the prostate itself. These then cause pain and tension by disrupting the natural structure. In the worst case, the prostate pain occurs in the form of the so-called Pelvic pain syndrome on. Thereby the pain is on the whole pelvic floor extensive, chronic, and difficult to treat. For example, let's examine the prostate with an MRI.

Pain character

Prostate pain is usually not limited to the organ itself. Since the prostate is in close contact with the urethra, genitals and pelvic floor due to its anatomical position, these areas are usually affected by a painful process in the prostate area. Pain in the prostate itself, as well as at the base of the penis and in the anal area is typical. But these can also be in the Testicles radiate or cause a painful sensation throughout the pelvic floor or also Lower abdomen to lead. The severity of the pain can vary greatly from the so-called vegetative sensation, e.g. also from Stress levels, general well-being or the digestion depend. The pain is usually aggravated by mechanical stress, such as occurs when cycling or sitting. But also Painful urinationSexual intercourse, and especially when ejaculating, suggest a cause in the prostate.



As Prostatitis, so Prostate inflammation, in the narrower sense one describes an infection and inflammation of the prostate through Microorganisms. This acute inflammation of the prostate by bacteria, however, only accounts for about 10% of the inflammation of the prostate. Pathogens make it here, especially in the case of general weakness of the Immune system, starting from the urethra, to establish itself in the area of ​​the prostate. This infection in turn leads to increased blood flow and swelling of the prostate, which causes pain, especially when sitting and urinating. If prostatitis is detected too late, it can lead to strong general symptoms such as fever, chills and a strong feeling of illness come. The bacterial infections of the prostate are often protracted, even with targeted treatment Antibiotics. In addition to antibiotics, one should drink a lot and avoid sexual intercourse during the acute infection.

You can find more information on this topic at: Inflammation of the prostate

Chronic prostatitis pain - pelvic pain syndrome

As mentioned above, a very common cause of prostate pain is chronic prostatitis, a prolonged inflammation of the prostate. In contrast to acute prostatitis, this is usually not caused by bacteria. Poor bacterial prostatitis is rarely the cause. The non-bacterial, chronic form is also called the so-called chronic pelvic pain syndrome. This designation makes it clear that the pain is not limited to the prostate itself. Usually these radiate to the entire perineum and anal region. The exact reasons for this are not conclusively known, but are probably one of the reasons vegetative dysfunction. They can start from the prostate itself or from the surrounding tissue, whereby the two causes can ultimately be mutually dependent and reinforce one another.

Irritation of the prostate can lead to cramping of the pelvic floor with venous congestion of the surrounding blood vessels and nerve irritation, and a tense pelvic floor can cause irritation of the prostate. This can occur especially after previous operations in the pelvic area or as a result of therapeutic radiation. Also Prostate stones or chronic irritation to the surrounding nerves may be responsible as well Cysts or Adhesions. The pelvic pain syndrome is a Elimination diagnosis This means that only when an acute inflammation, Tumors or other causes could be ruled out by the doctor, can speak of a pelvic pain syndrome.

Prostatodynia - prostatopathy

As Prostatodynia is called one Irritation of the prostatethat is not caused by bacterial pathogens. In contrast to pelvic pain syndrome, however, it is limited to the prostate itself. It can be triggered by mechanical stimuli, e.g. occur on long bike rides, while riding, through cold and wet stimuli (e.g. wet swimming trunks) or through long phases of sexual inactivity. An increased stress level can also have a direct effect on the prostate and Tension and cause pain. In addition to the pain of the prostate, pain in the urethra or testicle area usually occurs. Long periods of sitting or poor eating habits that too constipation can also cause pain.

Benign prostatic hyperplasia

In the benign prostatic hyperplasia it is a benign enlargement of the prostate that affects more than 2/3 of men over 70 years of age. The tissue of the prostate increases and also presses on the urethra, among other things. Due to the limited space in the pool and in the vicinity of the urethra and pelvic floor, the enlargement also leads to pain, including the prostate itself. Most of the time, however, the other symptoms are in the foreground, such as the obstruction of drainage around the urethra that causes problems with urination. Depending on the extent of the enlargement, prostate hyperplasia can be treated with medication or surgery.

Prostate cancer

Also a tumor the prostate, above all that Prostate cancer, can cause prostate pain. Prostate cancer is the most common in men in Germany most common cancer and also a very common cause of death. However, early detection of the tumor, especially through regular screening examinations, can significantly improve the success of the therapy. In prostate cancer, prostate pain does not occur until a later stage. They are often difficult to distinguish from the symptoms of a benign enlargement of the prostate. The pain itself can arise both from the growth of the tumor and from accompanying inflammation. They are often accompanied by blood in the urine or seminal fluid. Otherwise, the symptoms are similar to those of benign prostatic hyperplasia.

Prostate Pain - An indication of prostate cancer?

Prostate cancer is one of the tumor diseases only become symptomatic late and even then tend to cause unspecific complaints. Pain in the prostate can be a symptom and should therefore be clarified by a doctor.
However, other diseases such as inflammation of the prostate, the so-called prostatitis, are also possible and often even more likely. They are the most common reason for prostate problems.
A benign increase in the size of the prostate gland, the prostate adenoma, is a common cause of pain or abnormal sensations and should also be considered as a possible cause.
The pain is with cancer often not just limited to the prostatebut is affected by the growth of the tumor in the surrounding tissues and neighboring organs such as the rectum. As a result, you can Pain in the perineal area and Painful bowel movements occur. In prostate cancer, prostate pain is more likely to occur in conjunction with other symptoms and less often alone. Symptoms of prostate cancer can appear more often much earlier than the pain Burning sensation or problems urinating be.

Please also read our topic: Prostate cancer

Prostate pain in different circumstances

Pain in the prostate after ejaculation

Step Prostata pain immediately after ejaculation, this can be an indication of a inflammatory process be in the area of ​​the prostate gland. This so-called Prostatitis can occur in acute or chronic form and both bacterial (by Intestinal germs or STDs caused) as well as abacterial (chronic pelvic pain syndrome).
In addition to the pain in the prostate you can Fever, bloody semen, pain when urinating and when defecating, and a feeling of pain and pressure in the perineal region occur.
If the pain in the prostate has existed for a long time or if it is increasing in intensity, it can also be a Progression of inflammation with abscess formation act.
Also one Prostate enlargement, the so-called Prostate adenoma, due to the increase in size of the prostate gland can become a Narrowing of the seminal ducts and thus lead to pain during and after ejaculation. Typical of this are still a weakened and breaking stream of urine when urinating.
Another possible cause of ejaculation pain can be Prostate cysts be. Similar to the prostate adenoma, the Narrowing of the seminal ducts the symptoms, in this case due to the cysts. A painful ejaculation with sensation of pain and pressure in the prostate area can also be psychologically conditioned. Problems in the partnership, experienced abuse, stress and numerous other factors can play a role here.
The Prostate cancer can also cause prostate pain when ejaculating. Since prostate cancer usually does not show any early symptoms, prostate pain after ejaculation can be a late symptom of an already advanced disease.

Pain in the prostate during / after urination

To step Prostate pain new on along with burning sensation when urinating and frequent urination can cause a bacterial inflammation the prostate gland (Prostatitis) be a possible cause. Depending on the accompanying symptoms such as radiating pain in the perineal area, in the genitals and groin and fever, the disease of the prostate may be advanced.
In old age can the Increase in size of the prostate cause discomfort and sometimes pain in the prostate when urinating. Additionally kick frequent need to urinate, weakened urine stream and "night dripping".

Also read our topic: Pain when urinating in men

Pain in the prostate during / after bowel movements

Constipation and hard stools put stress on the prostate and can therefore lead to pain in the prostate gland during and after defecation. Hence a high fiber diet recommended, which makes the stool softer and makes it more regular.
Also one Prostatitis, an inflammation (bacterial) the prostate gland, can cause painful bowel movements.
Abscesses, purulent accumulations on the prostate can also cause prostate pain during or after a bowel movement.

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Pain in the prostate when sitting

Prostate pain when sitting can have different causes. The discomfort occurs in phases and above all at rest, i.e. when sitting, lying down or standing up, the cause could be that chronic pelvic pain syndrome be. This usually occurs in phases and lasts over days to weeks on. More symptoms can be radiating pain in the groin, testicles and penis as well as an increased need to urinate be.
Is the prostate pain New occurred, it may be a acute prostatitis act. Here, the inflammation of the prostate leads to a uncomfortable feeling of pressure in the perineal regionwhich manifests itself more often when sitting. You may also experience pain when urinating, defecating and ejaculating as well as fever.
Of the Irritation of the prostate called prostatodynia, can also cause prostate discomfort when sitting. Here the prostate being overstrained and mechanically irritated by sitting for too long and thus lead to pain.

Prostate pain after alcohol

Occur prostate pain after drinking alcohol on, it can be a (chronic) Prostatitis act, taking the alcohol as Stimulus trigger can work and so on Worsening of symptoms leads.
In addition, alcohol, even if the prostate gland is not inflamed, can cause pain, burning or abnormal sensations in the prostate area in some men. This can be the case especially with frequent or heavy alcohol consumption. Exact reasons for this are not yet known. It is believed that the alcohol as a toxic substance to an irritant condition leads. In this case, it is advisable to limit your consumption or to do without it completely.

Pain in the prostate especially at night

Nocturnal prostate pain can occur from inflammation of the prostate be evoked. These then usually also occur during the day. You can also do this Painful urination occur, whereby the urge to urinate can be increased at night and thus worsen the symptoms. Increased need to urinate at night can also with that Prostate adenoma occur where the difficulty in urinating can be expressed by pain in the prostate area.
When the prostate is irritated, for example after a bike ride, the symptoms can also reappear the night after or lead to an aggravation of the pain. This swells the prostate and can lead to abnormal sensations.

Pain in the prostate when it is cold

If pain in the prostate mainly occurs when it's cold, that's one Prostate inflammation a possible cause for this. The Cold plays a role as an inflammatory stimulus and aggravates existing symptoms or makes the disease symptomatic for the first time.
Also can Cold itself can be considered a trigger for acute prostatitis.
Furthermore, cold due to reduced blood supply of the small basin lead to swelling of the prostate and thus cause the complaints. The resulting irritation of the prostate can also lead to pain through and in the cold.

Pain in the prostate after exercise

Prostate pain after or during exercise can be caused by an Einflammation of the prostate gland be evoked. This event can be acute or, if chronic and therefore longer lasting, have a more wave-like character with increasing and decreasing pain intensity.
Can also Prostatodynia, an irritant condition of the prostatelike him too can occur after extreme sporting activity or mechanical irritationlead to pain after exercise.

Pain in the prostate after cycling

Many men complain after long or frequent bike tours Pain in the perineal area and the prostate. This occurs above all wrong saddle choice on. The wrong fit leads to pressure Micro injuries to the prostate and thus to a prostate irritation. Pain and discomfort are the result. If the prostate gland is permanently and improperly stressed, it can swell and lead to inflammation (prostatitis). Potency and fertility can also be reduced. It is advisable to use saddles with cutouts in the perineal area or padded cycling shorts.

Pain after prostate surgery

Pain after prostate surgery are up to one a normal and frequent consequence of a certain intensity and duration. Since the prostate tissue was irritated during the operation, it swells and can cause discomfort in addition to the wound cavity. The pain as a possible side effect of the operation will be pointed out during the pre-operation consultation. The pain may occur while sitting, urinating, or defecating. The doctor can usually take action against the pain Painkiller prescribe on prescription or recommend over-the-counter preparations from the pharmacy.
In case of pain when defecatingcaused by prostate irritation laxatives if necessary be prescribed.Care should be taken to keep the stool soft, to drain it regularly and not to press. The duration of the complaints varies depending on the procedure. Of the The healing process often takes 4-6 weeks, however, the pain usually lasts much shorter and decrease in their pain intensity over time. In general, if the pain persists and cannot be controlled despite medication, the patient should consult his / her urologist. Also should be sufficient drink a lot of water and take care of physical restraint to promote the healing process.


Against the root causes of prostate pain there are no preventive measures. It is sometimes pointed out that a reduced stress level and the associated reduced tension of the pelvic floor can at least have a positive effect on the development of a pelvic pain syndrome. Also a rather Far Eastern-influenced diet with many Phytoestrogens is intended to prevent the development of diseases of the prostate. However, it is questionable whether this effect justifies the side effects of these plant oestrogens or is even detectable. For all of the symptoms described above, it is important to get an early medical diagnosis or, in the case of prostate cancer, to take part in the preventive medical check-up. Because this is the only way to prevent acute inflammation at an early stage antibiotic adequately treated, prostatic hyperplasia treated or a possible tumor removed.


Therapy for prostate pain depends primarily on the underlying cause. The general measures that can be taken are reduction of stress, Malnutrition, sedentary activities or mechanical stress and other stimuli count. Good sexual hygiene can also improve symptoms. So can regular ejaculation through the improved outflow of the Prostate secretions contribute to an improvement in pain. Also one Massage the prostate can be beneficial.

Common over-the-counter pain relievers such as Ibuprofen or Paracetamol. However, these should only be taken after clarifying the causes and in consultation with the doctor. Since these agents have an additional decongestant and anti-inflammatory effect, they help with several mechanisms of action in parallel. As a supplement, others can also do this anti-inflammatory preparations be taken. In the case of acute inflammation, antibiotic treatment is in the foreground, in the case of benign prostatic hyperplasia, drug or surgical treatment. Especially with Pelvic pain syndrome Psychotherapeutic or pain therapy co-treatment can also be helpful; especially to break the vicious circle of pain, fear of pain, and tension. Also lighter Sports, autogenic training and other self-administered methods of muscle relaxation can be used well.

Medicines for prostate pain

Often come with pain in the prostate analgesic, antipyretic and anti-inflammatory substances for use. The pain relievers used include ibuprofen, acetylsalicylic acid, diclofenac and indomethacin. Depending on the dosage recommended by the doctor, these can be bought freely in the pharmacy or, for higher doses, by prescription. Also can muscle relaxing drugs be used, for example with the active ingredient Baclofen. This will be Spasmodic tension and muscle hardening in the pelvic area are released and thus reduce the pain in the prostate. However, both substance groups are only to be regarded as supportive, as they only alleviate the symptoms but do not eliminate their cause. Depending on the underlying disease, the doctor will initiate targeted therapy.