Dr. Stacy McBroom
Dr. John Upshaw
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Prostatitis

Overview

Prostatitis is a term used to describe inflammatory conditions of the prostate gland. It is thought that most cases of prostatitis result from bacterial infection, but evidence of infection is not always found. An infected or inflamed prostate can cause painful urination and ejaculation, and if left untreated, serious complications.

Incidence and Prevalence

Prostatitis can affect men of any age and it is estimated that 50% of men experience the disorder during their lifetime. Prostatitis is the most common urological disorder in men over the age of 50 and the third most common disorder in men younger than 50.

According to the National Institutes of Health, prostatitis accounts for 25% of all office visits involving the genitourinary system by young and middle-aged men.

Nonbacterial prostatitis and prostatodynia, which is also called chronic pelvic pain syndrome (CPPS), are the most common diagnoses. Bacterial prostatitis (acute and chronic) accounts for less than 510% of cases. Acute bacterial prostatitis occurs most often in men under age 35, and chronic bacterial prostatitis primarily affects men between the ages of 40 and 70.

Anatomy

The prostate is a walnut-sized gland located below the bladder and in front of the rectum. It secretes seminal fluid, a milky substance that combines with sperm to form semen. During sexual climax, muscles in the prostate propel the semen through the urethra and out through the penis.

Types
There are four types of prostatitis: acute bacterial prostatitis, chronic bacterial prostatitis, nonbacterial prostatitis, and prostatodynia.

Acute bacterial prostatitis (ABP) is inflammation of the prostate gland caused by bacteria such as Escherichia coli and Klebsiella. Severe complications may develop if not promptly treated. ABP can be fatal if the bacterial infection is untreated and travels to the bloodstream (sepsis).

Chronic bacterial prostatitis (CBP) is a recurrent infection and inflammation of the prostate and urinary tract. Symptoms are less severe than those associated with acute bacterial prostatitis.

Nonbacterial prostatitis is an inflamed prostate without bacterial infection.

Prostatodynia, sometimes called chronic pelvic pain syndrome (CPPS), is the occurrence of prostatitis symptoms, without inflammation or bacterial infection.

Risk Factors

Risk factors include bladder outlet obstruction (e.g., stone, tumor, BPH), diabetes mellitus, a suppressed immune system, and urethral catheterization (small tube inserted into the bladder through the urethra to drain urine). Some sexually transmitted diseases (STDs) (e.g., nongonnococcal urethritis, gonorrhea increase the risk for developing bacterial prostatatis). Unprotected anal and vaginal intercourse can allow bacteria to enter the urethra and travel to the prostate.

Causes

Bacterial prostatitis is caused by the growth of bacteria that are normally found in prostatic fluid, such as Escherichia coli and Klebsiella. Urine reflux (urine that flows back into the urethra) that enters the prostate can also cause the condition. There is no known cause for nonbacterial prostatitis or prostatodynia, but atypical organisms (viruses, chlamydial organisms) have recently been suggested.