What Causes Prostatitis?

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Prostatitis is a relatively common condition in which the prostate becomes infected or inflamed. The condition is often difficult to treat, in part because several forms of the disease exist and the cause of the most common form is unknown. Some men experience acute flare-ups caused by a bacterial infection of the prostate. This acute bacterial prostatitis is associated with a sudden and continuous pain that lasts for several days. Some men have signs of inflammation, such as white blood cells in their semen, but not the painful symptoms of prostatitis.

More common, however, is chronic prostatitis, which can arise from a bacterial infection or, more commonly, an unidentified nonbacterial source. Most men with prostatitis are believed to have the chronic nonbacterial form (also known as chronic prostatitis/chronic pelvic pain syndrome, or CP/CPPS). Chronic nonbacterial prostatitis may last for several weeks or longer, only to disappear and then flare up again.

The cause of bacterial prostatitis is obvious and easy to detect—infection with some type of bacteria. But researchers are not sure why some men develop the more common, nonbacterial form. Some evidence suggests that an initial triggering event, either within the prostate or within the pelvis where the prostate is located, promotes inflammation. Then the nerves that are affected by this inflammation are sensitized and inappropriately send pain messages that persist long after the trigger has disappeared. Trigger events could be anything causing inflammation in or around the prostate, such as an infection within the prostate, trauma to the perineal area, or a prostate biopsy.

Others suggest that chronic prostatitis is not a prostate problem at all. They attribute flare-ups to a pelvic muscle spasm or some other factor that mimics symptoms originating in the prostate. Another theory is that prostatitis may be an autoimmune disorder in which the immune system mistakenly attacks healthy prostate tissue and promotes inflammation.

Recent evidence suggests that any of these problems or a combination of them can trigger chronic prostatitis. Once the chronic pain syndrome is initiated, flare-ups could be triggered by a number of things such as stress, emotional problems, or certain foods or beverages.

Other possible culprits include urinary tract abnormalities, infrequent ejaculation, dysfunctional urination, and lower urinary tract infection. It is important to note that none of these potential causes of nonbacterial prostatitis has been confirmed by solid research.