Nonbacterial Prostatitis: Types, Symptoms, and What Causes Them

Prostatitis is inflammation of the prostate gland, a small gland below the bladder in men. Bacterial infection is not its only cause: in most men with chronic prostatitis, a nonbacterial form is identified. Below are the definitions of the forms, the mechanisms, and what examinations show.

Why prostatitis can occur without bacteria

Nonbacterial (abacterial) prostatitis is prolonged pain and urinary symptoms affecting the prostate or other parts of the lower urinary tract and genital area. There is no bacterial infection in it. Possible causes include a previous episode of bacterial prostatitis, cycling, rare types of bacteria not detected by routine tests, reflux of urine into the prostate, irritation by chemicals, a neurological problem of the lower urinary tract, parasites, pelvic floor muscle dysfunction, and viruses. Life stresses and emotional factors may also play a role.

Congestive prostatitis: what prostate congestion means

The list of possible causes of nonbacterial prostatitis includes reflux of urine into the prostate and irritation by chemicals.

Chronic prostatitis: when a urologist is needed

If symptoms persist for 3 months or longer, it is called chronic prostatitis; in this case, a referral to a urologist may be made.

Acute prostatitis: when the condition is dangerous

Acute prostatitis manifests as pain during urination (burning, stinging), difficulty urinating or straining, frequent urges, pain in the penis, scrotum, testicles, or anal area, pain during ejaculation, and fever. Prostatitis can be serious and requires urgent medical care; severe infection may lead to sepsis, the signs of which are sudden confusion, slurred speech, bluish, gray, or pale skin, and a rash that does not fade when pressed with a glass.

Why tests in prostatitis may be "clean"

In the nonbacterial form, physical examination is more often normal, although the prostate may be enlarged or tender. White or red cells are sometimes found in the urine. Semen analysis may show an increased number of white cells, a low sperm count, and poor motility. Urine culture or prostate culture does not detect bacteria.

What investigations are needed to clarify the form

Examination includes a physical examination, urine tests, semen analysis, urine culture, and culture of material from the prostate.

• Pain during urination, burning, or stinging
• Difficulty urinating, frequent urges
• Pain in the penis, scrotum, testicles, anal area
• Pain during ejaculation, blood in semen or urine
• Fever

The condition itself is not a reason to call an ambulance; 103 or 112 — if sudden confusion, slurred speech, bluish, gray, or pale skin, a rash that does not fade when pressed with a glass, or severe difficulty breathing appears.

If you are unable to urinate, you should see a doctor urgently.

This material is for reference purposes and does not replace consultation with a doctor.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer