Also known as inflammation of the prostate, prostatitis is a relatively common and often frustrating problem, particularly when the cause is not obvious. Prostatitis can cause pain in the lower back and in the area between the scrotum and rectum (perineum). Another possible symptom is an urgent or frequent need to urinate. Some men complain of painful ejaculation, but others report that ejaculation relieves pain. Prostatitis may be accompanied by chills, fever, and a general feeling of malaise when caused by bacteria.
However, nearly 95 percent of 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 (for example, from riding a bicycle), 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.