PROSTATITIS

Prostatitis has been characterized in several ways, the most common being acute and chronic. When no bacterial infection is present, it is termed non-bacterial prostatitis. Non-bacterial prostatitis accounts for ninety to ninety-five percent of all prostatitis.

ACUTE BACTERIAL PROSTATITIS

Causes
Reflux of infected urine into prostatic or ejaculatory ducts. Ascending urethral infection. Lymphatic seeding. Hematogenous seeding.

Organisms
From the GI tract or sexually transmitted.
1. E. Coli - 80%.
2. Pseudomonas aeruginosa
3. Serratia
4. Klebsiella
5. Enterococci

Symptoms
1. Sudden onset of fever, chills.
2. Pelvic and/or low back pain.
3. Urgency, frequency of urination, burning with urination, decreased force of urinary stream, urinary retention.

Treatment
1. Antibiotics (oral and/or intravenous for four to six weeks).
2. Stool softeners.
3. Suprapubic catheter if needed.

Potential Adverse Outcomes
1. Prostate abscess.
2. Chronic bacterial prostatitis.

CHRONIC BACTERIAL PROSTATITIS

Causes
1. Reflux of infected urine into prostatic/ejaculatory ducts with inspissation of prostatic secretions.
2. Secretory dysfunction of the prostate associated with low zinc levels, increased semen pH.

Organisms
From the GI tract or sexually transmitted.
1. E. Coli - 80%
2. Pseudomonas aeruginosa
3. Serratia
4. Klebsiella
5. Enterococci

Symptoms
1. Similar but less severe than acute prostatitis.
2. Recurring fever and chills are rare.

Treatment
1. Oral antibiotics for three to four months.
2. Chronic suppressive antibiotics.

Potential Adverse Outcomes
1. Recurrent urinary tract infections.
2. Infertility.