PROSTATE INFECTION (PROSTATITIS)

Prostatitis is inflammation of the prostate gland. It is estimated that 50 % of men experience symptoms of an inflamed prostate. Although the symptoms are often the same, there can be different causes of prostatitis. Based on the cause, prostatitis can be classified into one of four categories.

  • Acute bacterial prostatitis is inflammation of the prostate gland caused by bacteria such as E-Coli and Klebsiella. It is most common in men aged 40-60.
  • Chronic bacterial prostatitis is when prostate infections keep coming back despite appropriate treatment. This is found most often in men aged 50-80.
  • Nonbacterial prostatitis is when the prostate gets inflamed without an infection. This is most common in men aged 30-50.
  • Prostatodynia, sometimes called chronic pelvic pain syndrome (CPPS), is the occurrence of prostatitis symptoms, without inflammation or bacterial infection.

Acute bacterial prostatitis can affect any age group. Another type that is caused by bacterial infection is chronic bacterial prostatitis which is characterized by recurrent urinary tract infections in men. When symptoms do appear, they are generally less severe than acute bacterial prostatitis and rarely have fever, but often recur. This condition can also affect any age group but is most common in young and middle-aged men.

Nonbacterial prostatitis and prostatodynia, now properly referred to as chronic pelvic pain syndrome, are the most common types of prostatitis. The exact cause of these non-bacterial prostatitis conditions is not known, but may be due to persistent infection, inflammation and/or pelvic muscle spasm. Inflammation in the prostate can also occur without symptoms.

What causes prostatitis?

The bacteria that cause acute and chronic bacterial prostatitis get into the prostate from the urethra by backward flow of infected urine into the prostate ducts. Bacterial prostatitis is not contagious and is not considered to be a sexually transmitted disease. A sexual partner cannot catch this infection.

Certain conditions or medical procedures increase the risk of contracting bacterial prostatitis. There is a higher risk if the man has recently had a catheter or other instrument inserted into his urethra, an abnormality of his urinary tract or a recent bladder infection.

Chronic prostatitis/chronic pelvic pain syndrome may be caused by atypical organisms such as chlamydia, mycoplasma (which may be transmitted by sexual contact) ureaplasma or may also be due to a chemical or immunologic reaction to an initial injury or previous infection. The nerves and muscles in the pelvis may cause pain in the area, either as a response to the prostate infection or inflammation or as an isolated problem itself.

What are the symptoms of prostatitis?

The symptoms of the various prostatitis syndromes depend upon the category.

In acute bacterial prostatitis, the symptoms are severe and sudden and may cause the patient to seek emergency medical care. Chills, fever, severe burning during urination and the inability to completely empty the bladder are common. In chronic bacterial prostatitis, the symptoms are similar but do not produce fever. They include: burning during urination; urinary frequency, especially at night; perineal, testicular, bladder and low back pain; and painful ejaculation. The condition can be episodic, with flare-ups and remissions, associated with infection, treatment and subsequent recurrence.

The symptoms of chronic prostatitis/chronic pelvic pain syndrome include difficult and sometimes painful urination, discomfort or pain in the perineum, bladder, testicles and penis as well as difficult and painful ejaculation. In some cases, these symptoms can be indistinguishable from those described above for chronic bacterial prostatitis.

For addition information, visit The American Urological Association Foundation at www.urologyhealth.org