Causes Of Prostatitis

What are the different types of prostatitis and their causes?

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There are 4 different types of Prostatitis:

  • Acute Bacterial Prostatitis – least common
  • Chronic Bacterial Prostatitis – more common
  • Chronic Non-Bacterial Prostatitis / Pelvic Pain Syndrome (CP/CPPS) – most common
  • Asymptomatic inflammatory prostatitis – incidental finding on prostate biopsy.

Acute bacterial prostatitis

Acute bacterial prostatitis is is caused by bacteria.  It is a bacterial infection of urinary tract that involves the prostate gland. It is often associated with epididymo-orchitis.  Occasionally prostatic abscess can develop and this requires surgical treatment.  The signs of  acute  prostatitis include a sudden onset of difficulty urinating, burning with urination often accompanied by fevers and chills, as well as pain in the pelvis and lower back.  Sometimes acute bacterial prostatitis may be related to sexually-transmitted diseases.  Therefore a careful evaluation and testing is necessary. Treatment with antibiotics usually resolves acute prostatitis without any long-term consequences.

Chronic bacterial prostatitis

Chronic bacterial prostatitis is caused by persistent infection of the prostate gland with bacteria. Infection tends to be less severe with mild to moderate symptoms that typically did not include fevers and chills.  It is typically manifested by a recurrent urinary tract infections, burning with urination and pelvic pain.

The diagnosis is made by culture of bacteria for prostatic secretions after a prostatic exam. Bacteria may also be present in semen culture.  The treatment is usually antibiotics however surgical treatment with TURP may be beneficial to some men.

Chronic prostatitis/chronic pelvic pain syndrome (Also known as Nonbacterial prostatitis and prostatodynia)

The “chronic prostatitis / pelvic pain syndrome” commonly abbreviated as CP/CPPS is the most common type of prostatitis. It is very prevalent among men in particular younger men in their 30s to 40s and 50s.  The diagnosis of CP/CPPS is more challenging.  Chronic prostatitis/pelvic pain syndrome is manifested by persistent or recurrent pelvic pain and may or may not be associated with painful ejaculation as well as urinary symptoms. Typically urine and semen cultures do not show growth of any organisms.

Chronic Prostatitis / Pelvic Pain Syndrome is likely an amalgam of problems with different problems united  by similar symptoms.  It is likely that both infectious causes such as viral and nano-bacteria may be involved in some cases.  Neuromuscular causes likely cause symptoms in some other patients.  Auto-immune or inflammatory responses may also underlie symptoms in some men.

Causes of Chronic prostatitis and pelvic pain syndrome.

Causes of CP/CPPS include musculoskeletal spasms as well increased neural sensitivity of and around the prostate. Unrecognized bacterial or viral infections and inflammatory processes may also be contributory.

A variety of treatments are available for chronic prostatitis/pelvic pain syndrome.  Pelvic floor massage has been shown to be effective in alleviating pain and symptoms.  A variety of medications that affect the nervous system and pain perception can also be used including SSRI.

Asymptomatic inflammatory prostatitis

Asymptomatic inflammatory prostatitis is a pathological diagnosis usually made from prostate biopsy specimen. The man is typically asymptomatic (has no symptoms) and no further evaluation nor treatment is necessary.

Dr. Alex Shteynshlyuger is a fellowship trained board certified urologist with expertise in treating men acute and chronic prostatitis and pelvic pain and related problems. If you or someone you know has been diagnosed with prostatitis, make an appointment to take advantage of Dr. Shteynshlyuger’s expert advice.

Last modified on October 5, 2013