Prostatitis is a condition that causes inflammation of the prostate gland. Inflammation may be caused by infection, or may be due to other factors. One quarter of all men who have urinary problems have prostatitis.
There are 4 classifications of prostatitis:
The first two types (ABP and CBP) are infections of the prostate. These are caused by bacterial infection. Of all men who show symptoms of prostatitis, only about 5-10% actually have a true bacterial condition. Most men who experience prostatitis symptoms will be diagnosed with CPPS.
Acute bacterial prostatitis (ABP) is an infection of the prostate caused by bacteria. These bacteria are often the same bacteria that cause bladder infections, including E. coli, and Klebsiella. Men with ABP with signs of infection may have the following symptoms:
These symptoms may happen very quickly and be severe, resulting in a quick trip to emergency or your doctor's office. Antibiotics are used to treat this type of prostatitis, typically with good results.
Chronic bacterial prostatitis (CBP) is an illness in which there is an ongoing bacterial infection in the prostate.
Men with CBP may not have any symptoms. If symptoms develop, they can be similar to ABP, but are generally less severe. For example, there may be an inability to empty the bladder, or frequent urination. The most common symptom is that men with CPB may experience regular, recurring urinary tract infections.
The prostate, because of its anatomic configuration, lends itelf to recurrent infection. Prostate tissue is made of a series of glands and ducts with a poor drainage system, which can prevent proper drainage of prostate secretions. Moreover, as the prostate enlarges with age the urethra may become narrowed or obstructed causing urine to flow back into the prostatic ducts. Anywhere where the flow is obstructed may provide an opportunity for infections to grow.
Most men (about 90%) who present with symptoms of prostatitis will be diagnosed with chronic pelvic pain syndrome (CPPS). CPPS is the classification for prostatitis without any bacterial infection. The cause of this type of prostatitis is unknown, but some possible causes could include:
Men with CPPS may have symptoms of prostatitis, such as groin or pelvic pain, pain with ejaculation, pain or difficulty urinating, but there is no evidence of infection (no bacteria found) in their urine or prostatic secretions. Commonly, men with CPPS also experience general psychosocial helath problems such as disturbances in their normal sex lives, stress, frustration and depression.
There are two sub-types of CPPS: inflammatory, and non-inflammatory. Inflammatory CPPS is characterized by the presence of white blood cells in semen, prostatic secretions, or urine. Men with non-inflammatory CPPS will not have these white blood cells.
Both the inflammatory and non-inflammatory types of CPPS often get better over time without serious complications. However men suffering from this condition may experience long-term recurring symptoms that cause them serious distress and frustration. There are a number of treatment techniques that may help with the symptoms of CPPS, however since the cause is unknown there is no specific preventative or treatment strategy at this time.
Men with asymptomatic inflammatory prostatitis have no symptoms, and often they do not know they have the condition until it is discovered while testing for something else. This type of prostatitis is often diagnosed during tests for infertility or elevated prostate-specific antigen (PSA) levels.
Asymptomatic inflammatory prostatitis produces elevated white blood cells in semen (leukocytospermia) and may be a cause of male infertility. It is usually left untreated, unless treatment for infertility is desired.