PROSTATITIS

To put it simply, prostatitis is inflammation of the prostate gland.

There are four main classifications of prostatitis.

  1. Acute Bacterial Prostatitis

    Acute infection of the prostate gland. It’s caused by a bacterial infection and comes on suddenly. There is often blood in the urine and the PSA blood test result may be higher than normal.

  2. Chronic Bacterial Prostatitis

    Recurrent infection of the prostate, occurs in men aged 50 to 80 years. It is associated with chronic urinary infection and, commonly, calcifications in the prostate (prostatic stones). In the cases of bacterial prostatitis, the culprit usually is a bacteria known as Escherichia coli. The cause of bacterial prostatitis is not well defined, but one theory suggests a reflux of urine from the bladder into prostatic ducts. This reflux of urine may lead to prostatitis. The most common symptom is recurrent bladder infections.

  3. Chronic Prostatitis

    The most common yet least understood form. Found in men of any age, the symptoms include pain in the groin or bladder, and come and go without warning.

  4. Asymptomatic Inflammatory Prostatitis

    This form of prostatitis has no symptoms, and is often found when undergoing tests for other conditions.

 

Symptoms of Prostatitis

Each form of prostatitis has a slight variation in signs and symptoms.

Acute Bacterial Prostatitis

  • Sudden onset of fever and chills
  • Pain in lower back or rectum
  • Irritative or obstructive urinary symptoms
  • Prostate is warm, swollen, and tender upon examination

Chronic Bacterial Prostatitis

  • Relapsing urinary tract infections
  • Painful urination or other voiding problems
  • Ejaculatory pain
  • Pelvic or genital pain
  • Some men may not have any symptoms

Chronic Prostatitis

  • Chronic pelvic pain (testicular, penile, lower abdominal, ejaculatory)
  • Persistent inflammation of the prostate
  • Absence of infectious bacteria in urine

 

Diagnosing Prostatitis

Doctors usually diagnose prostatitis by examining prostate secretions for white blood cells and bacteria. One of the most thorough methods is the Meares-Stamey Four-Glass Test, which separates urine and prostate fluid into different samples for targeted examination.

In some men, especially when standard polymerase chain reaction (PCR) cultures are negative but symptoms persist, next generation sequencing (NGS) may be used to identify hard-to-detect bacteria or microbial communities that traditional tests can miss. NGS can provide additional insight into chronic or recurrent prostatitis cases and help guide more personalized treatment.