There are three different types of prostatitis – acute and chronic bacterial prostatitis and non-bacterial prostatitis. Both acute and chronic bacterial prostatitis are caused by a bacterial infection that usually originates in the urethra. Non-bacterial prostatitis is not an infection, but rather an inflammation of the prostate, with a variety of possible causes. Symptoms can be severe and sudden (as in the case of acute bacterial prostatitis) or can come on gradually. Symptoms may include chills; fever; burning or painful urination; difficulty or frequent urinating; perineal, testicular, bladder and/or lower back pain; painful ejaculation.

What causes prostatitis?

The bacteria that cause acute and chronic bacterial prostatitis get into the prostate from the urethra by backward flow of infected urine into the prostate ducts . Bacterial prostatitis is not contagious and is not considered to be a sexually transmitted disease. A sexual partner cannot catch this infection.

Certain conditions or medical procedures increase the risk of contracting bacterial prostatitis. There is a higher risk if the man has recently had a catheter or other instrument inserted into his urethra, an abnormality of his urinary tract or a recent bladder infection.

Chronic prostatitis/chronic pelvic pain syndrome can be inflammatory (non-bacterial prostatitis) possibly caused by a typical organisms called chlamydia or mycoplasma (which may be transmitted by sexual contact) or may also be due to a chemical or immunologic reaction, perhaps even to urine itself flowing backwards into the prostate ducts.

There is no known cause for the noninflammatory type of chronic prostatitis/chronic pelvic pain syndrome (prostatodynia). It does not appear to be related to bacteria or inflammation of the prostate gland but may be related to a disorder of the nerves and muscles surrounding the prostate gland.

What are the symptoms of prostatitis?

The symptoms of the various prostatitis syndromes are extremely variable and although they depend on the type of disease you have, there is much overlap.

In acute bacterial prostatitis , the symptoms are severe and sudden and may cause the patient to seek emergency medical care. Chills, fever, severe burning during urination and the inability to completely empty the bladder are common.

In chronic bacterial prostatitis , the symptoms are similar but much less severe. They include: burning during urination; urinary frequency, especially at night; perineal , testicular , bladder and low back pain; and painful ejaculation. The physician may note, in bacterial prostatitis, that the prostate is swollen and tender upon examination. The condition can be episodic, with flareups and remissions, associated with infection, treatment and subsequent recurrence.

The symptoms of chronic prostatitis /chronic pelvic pain syndrome include difficult and sometimes painful urination, discomfort or pain in the perineum , bladder, testicles and penis as well as difficult and painful ejaculation. In some cases, these symptoms can be indistinguishable from those described above for chronic bacterial prostatitis.