Prostatitis is a condition involving inflammation or infection of the prostate gland, which sits just below the bladder in people assigned male at birth. It can cause a range of symptoms, from pain and urinary issues to flu-like signs, depending on the type.

Prostatitis is caused by a variety of factors depending on its specific type.

Acute and chronic bacterial prostatitis result from bacterial infections, often due to bacteria ascending the urinary tract, urinary tract infections (UTIs ), bladder or prostate stones, or sexually transmitted infections like chlamydia and gonorrhea.

The most common type, Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS), is typically non-bacterial and is believed to stem from a complex combination of pelvic floor muscle dysfunction, nerve irritation or damage, unresolved previous infections, autoimmune responses, and psychological stress.

Finally, asymptomatic inflammatory prostatitis is usually discovered incidentally during examinations, presenting inflammation without noticeable symptoms, and its underlying causes often remain unclear.

Acute Bacterial Prostatitis (ABP): This is a sudden and severe bacterial infection of the prostate. It's often accompanied by a high fever, chills, body aches, frequent and painful urination, and sometimes blood in the urine. This type is usually diagnosed with urine tests.

Chronic Bacterial Prostatitis (CBP): This is a recurrent or persistent bacterial infection of the prostate. Symptoms are similar to acute bacterial prostatitis but tend to be less severe and come and go over time.

Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS): is the most common yet least understood form of prostatitis, characterized by persistent pelvic pain and urinary symptoms in the absence of a bacterial infection.

It is typically classified into two subtypes: inflammatory CP/CPPS, where white blood cells are present in prostatic fluid, semen, or urine, indicating inflammation; and non-inflammatory CP/CPPS, which shows no signs of infection or inflammation.

Although the exact causes remain unclear, contributing factors may include nerve dysfunction, muscle spasms, past infections, or psychological influences.

Asymptomatic Inflammatory Prostatitis: In this type, there are no symptoms, and the inflammation is often discovered incidentally during tests for other conditions (e.g., elevated PSA levels during a prostate cancer screening).

Prostatitis is diagnosed through a combination of evaluating a patient's medical history and symptoms, a physical examination typically starting with a digital rectal exam (DRE) to check for prostate tenderness or swelling and assess its overall condition.

Healthcare providers will also order various laboratory tests, including urine tests such as urinalysis and urine cultures to detect bacteria and signs of infection, and sometimes fractionated urine tests or analysis of expressed prostatic secretions (EPS) following a prostatic massage to pinpoint the source of inflammation, though this massage is often avoided in cases of suspected acute bacterial prostatitis to prevent bacterial spread.

Additionally, blood tests, including a PSA (prostate-specific antigen) test, may be conducted to check for prostate inflammation. If no infection is found or to investigate other issues, further diagnostic tools like urodynamic studies to assess bladder function or imaging tests such as ultrasound, MRI, or cystoscopy may be used to rule out other causes of pelvic pain or urinary symptoms or to investigate complications.

The goal of this approach is to identify the specific type of prostatitis so that treatment can be tailored accordingly.

Prostatitis treatment requires effective medication that works by targeting, killing, and inhibiting the growth of bacteria that are causing the infection and bacterial forms of prostatitis in the prostate gland. These medications effectively penetrate the prostate tissue and eliminate the infection at its source to reduce inflammation, relieve symptoms like pain and urinary issues, and prevent complications.