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Bacterial vs. Non-bacterial Prostatitis

The inflammation of the prostate, or more commonly known as prostatitis can either be infectious or non-infectious.  Infectious prostatitis is primarily caused by bacteria and therefore can be treated with antimicrobial medication.  Non-infectious or non-bacterial prostatitis, as the name suggests,  cannot be treated with antimicrobial medication.  The cause is unknown but this condition affects a majority of prostatitis patients, making it very frustrating to men whose lives are adversely affected.

In cases of acute bacterial prostatitis, the onset is sudden and severe, often accompanied with fever and chills.  In these cases, a visit to the doctor or even to the emergency room is usually necessary.    With chronic bacterial prostatitis,  the symptoms are just recurring and would be alleviated by antibiotics or antimicrobial medication.

Despite the term, bacterial prostatitis is not contagious.  It is not known exactly how the prostate becomes infected.  It is possible that the bacteria comes from the urethra via the backflow of  infected urine or even from rectal bacteria.   It can also be caused by coliform bacteria migrating from the intestinal tract.

The risk for prostatitis are increased with certain conditions such as:

- an abnormal urinary tract

- a recent bout of urinary tract infection (UTI) or bladder infection

- an enlarged prostate

- engaging in rectal intercourse

- the use of a urinary catherer or similar instrument inserted for a medical procedure


While some patients experience no symptoms at all, symptoms can range from mild to severe, including, difficulty urinating, frequent urination especially at night,  burning/painful urination,  low back pain, painful prostate, swollen prostate, pain during intercourse/ejaculation, blood in urine, fever, and chills.   When the symptoms are severe, it is best to seek medical help immediately.


The correct diagnosis is key to getting the proper treatment.  Non-bacterial prostatitis will not improve with bacterial medication and vice versa.  With acute bacterial prostatitis, bacterial medication can eliminate infection in 7-14 days.  Pain medication (analgesic)  can also be taken at the onset of treatment to help alleviate the pain.  Other home remedies such as bedrest and staying hydrated are also recommended, but if the pain is severe, hospitalization may be required.

A longer period of time usually up to 12 weeks may be required for antimicrobial medication to work in cases of chronic bacterial prostatitis.

For non-bacterial prostatitis, a number of treatments may be employed, depending on the symptoms:

- home remedies such as warm baths

- diet changes, including:

> consuming more fish, soy, tomatoes, fresh fruits, steamed vegetables, whole grains

> consuming less alcoholic and caffeinated drinks, less red meat and fatty foods, avoiding acidic foods

> taking natural supplements that are known to have anti-inflammatory properties

- lifestyle changes, such as:

> avoiding riding bicycles, prolonged sitting

> staying active, exercising

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Prostate Infections

The prostate gland is a part of a man’s reproductive system, secreting fluids that help transport sperm. The gland lies just below the bladder and surrounds the urethra-the tube that drains the bladder.

Infection that irritates the prostate can inflame the gland, causing swelling. Prostate infections or prostatitis occurs most often in men aged 30-50 years but can occur in older men.

  • Prostatitis is classified into 4 types. Of these, infection causes the first 2 syndromes listed. No one is sure what causes the other syndromes.
  1. Acute bacterial prostatitis
  2. Chronic bacterial prostatitis
  3. Chronic abacterial prostatitis
  4. Prostatodynia (pain in the prostate gland)
  • A recent Wisconsin survey estimated the incidence of prostatitis at 6%. A population-based study found the prevalence rate to be higher than 8%.
  • Half of all men are estimated to develop symptoms of prostatitis at some time in their lives. In 1985, more office visits occurred for prostatitis than for either benign prostatic hypertrophy or prostate cancer. In the early 1990s, prostatitis resulted in 2 million office visits per year in the United States. It is the most common urologic diagnosis in men younger than 50 years.
  • In spite of it being a common and an important problem, prostatitis is poorly studied and not well understood.

Prostate Infections Causes

Bacterial infections cause only 5% of cases of prostatitis. In the other 95%, the cause is not known.

  • Different organisms, fungi, genital viruses, and parasites have been implicated. Some have familiar names such as Escherichia coli (E coli).
  • Rarely staphylococcal and streptococcal organisms have been found to be the cause.
  • The disease can reach the prostate in 2 ways.
  1. The bacteria from a previous urethral infection move through prostatic ducts into the prostate.
  2. Movement of infected urine into the glandular prostate tissue can infect via ejaculatory and prostatic ducts.


Prostate infections can be acute or chronic.

Acute bacterial prostatitis:

Because acute prostate infection often is associated with infections in other parts of the urinary tract, symptoms include the following:

  1. Increased urinary frequency
  2. Urgency to pass urine
  3. Pain with urination
  4. Difficulty producing a normal stream
  5. Pain in your genital area
  6. Pain with ejaculation
  7. Generalized symptoms that should not be ignored include the following:
    • High fever and chills
    • Generalized malaise and fatigue
    • Examination reveals an enlarged, tender, warm, firm, and irregular prostate.
    • The doctor should not perform a vigorous digital exam of your prostate to prevent possible spread of the infection to your bloodstream.

Chronic bacterial prostatitis:

This disease is a common cause of recurrent urinary tract infections (UTIs) in men. Typically, the same strain of bacteria in prostatic fluid or urine will cause the same infection to persist or recur.

Symptoms may be similar to acute bacterial prostatitis but are less intense. They include the following:

  1. Increased urinary frequency along with pain and difficulty urinating
  2. Pain in your lower back, testes, epididymis, or penis
  3. Sexual dysfunction
  4. Low-grade fever, joint pains, and muscle aches
  5. Examination may reveal urethral discharge and tender testes, or epididymis.

Stress and depression are very common in men with this condition. It is not clear whether psychological concerns cause this problem or vice versa.

When to seek medical care:

Contact your doctor for any of the following symptoms. These symptoms are even more significant if accompanied with high fever and chills:

  • Urinary burning or pain
  • Difficulty passing urine
  • Difficulty or pain when starting urination
  • Pain in your genital area
  • Pain with ejaculation

Doctors usually diagnose and treat prostate infections on an outpatient basis. If you develop high fever with chills or a new onset of difficulty in urinating, go to a hospital’s emergency department.

Article courtesy of emedicinehealth.

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