Chronic bacterial prostatitis

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Chronic bacterial prostatitis
Synonyms	Chronic bacterial prostatitis syndrome
Pronounce	N/A
Specialty	N/A
Symptoms	Pelvic pain, urinary tract infection symptoms, dysuria, urinary frequency, urinary urgency, perineal pain
Complications	Epididymitis, infertility, prostate abscess
Onset	Gradual
Duration	Long-term
Types	N/A
Causes	Bacterial infection
Risks	Urinary tract infection, catheterization, prostate biopsy
Diagnosis	Urine culture, prostate massage
Differential diagnosis	Chronic prostatitis/chronic pelvic pain syndrome, benign prostatic hyperplasia, prostate cancer
Prevention	N/A
Treatment	Antibiotics, alpha blockers, anti-inflammatory medications
Medication	Fluoroquinolones, trimethoprim/sulfamethoxazole
Prognosis	N/A
Frequency	Less common than other forms of prostatitis
Deaths	N/A

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Chronic Bacterial Prostatitis is a condition that represents a recurrent infection of the prostate gland. It is characterized by the persistence of bacteria in the prostate after treatment. Unlike its acute counterpart, chronic bacterial prostatitis presents with more subtle symptoms over a longer period, making diagnosis and treatment more challenging.

Symptoms

Symptoms of chronic bacterial prostatitis may include:

• Pain in the pelvis, genitals, or lower back
• Frequent and urgent need to urinate
• Burning or painful urination (Dysuria)
• Cloudy urine
• Blood in the urine (Hematuria)
• Painful ejaculation

Causes

The condition is often caused by a recurrent urinary tract infection (UTI) that has spread to the prostate gland. Common bacteria responsible for this condition include Escherichia coli and other Gram-negative bacteria. Factors that may increase the risk of developing chronic bacterial prostatitis include:

• Previous UTIs
• Bladder obstruction
• Catheter use
• Dehydration
• Engaging in anal intercourse

Diagnosis

Diagnosis of chronic bacterial prostatitis involves a combination of clinical history, physical examination, and laboratory tests. Key diagnostic tests include:

• Urinalysis and urine culture to identify bacteria
• Prostate secretion tests after prostate massage
• Ultrasound or CT scan of the urinary tract
• Cystoscopy (in some cases)

Treatment

Treatment typically involves a prolonged course of antibiotics, often lasting from 4 to 12 weeks. The choice of antibiotic depends on the type of bacteria identified in the cultures. In addition to antibiotics, treatment may include:

• Anti-inflammatory drugs to reduce pain and inflammation
• Alpha-blockers to ease urine flow
• Prostate massage (in some cases)
• Warm baths

Prevention

Preventive measures for chronic bacterial prostatitis focus on reducing the risk of UTIs and include:

• Adequate hydration
• Urinating soon after sex
• Avoiding bladder irritants such as caffeine and alcohol
• Good personal hygiene

Complications

If left untreated, chronic bacterial prostatitis can lead to:

• Recurrent urinary tract infections
• Prostate abscess
• Reduced fertility
• Chronic pelvic pain syndrome

See Also

• Prostatitis
• Acute bacterial prostatitis
• Chronic nonbacterial prostatitis
• Benign prostatic hyperplasia