Causes of Prostatitis
The direct cause of the condition is not well understood, but we do know that chronic inflammation of the prostate is caused by the introduction of bacteria into the gland.
Often, the prostate becomes colonized with more than one type of bacteria — most entering the gland via the urethra.
Bacteria can also enter the prostate via blood circulation from other infected areas of the body, such as the lower bowel, gallbladder, sinuses and infected gums and teeth. Once in the gland, the bacteria reside in tiny sacs (acini), which become clogged with pus causing inflammation, swelling and, of course, pain. The sacs, now filled with pus, close off and prevent the body’s natural immune system and natural blood flow from entering the gland. If the blood cannot get in, then it follows that antibiotics cannot penetrate inside the prostate very well either. Further, oxygen supply is insufficient to stimulate regression of the inflammation, and bacteria present in the gland often cover themselves with a protective coating (biofilm) that renders the antibiotics ineffective.
In some cases where men have so-called “non-bacterial prostatitis”, the inflammation can be supported by a fungal infection present in the prostate, or a backflow of urine or seminal fluid from the urethra.
Prostatitis Causes (Overview):
Chronic bacterial prostatitis (CBP)
CBP is caused by bacteria, and the symptoms are similar to ABP, but are not usually as severe or sudden.
Non-bacterial prostatitis (NBP)
NBP has the same symptoms as CBP, but the cause is not known.
We cannot detect any bacteria in the urine or prostatic fluid (it does not mean it is not there), but we find pus cells (WBCs’) on microscopy of EPS (Expressed Prostatic Secretion) or urine.
We cannot detect any bacteria in either the urine or EPS and the EPS/urine looks normal (no WBCs’ on microscopy). Non-inflammatory prostatitis is often referred to as Chronic Pelvic Pain Syndrome. Men who suffer from Chronic Pelvic Pain Syndrome are often severely affected by the condition to the degree that they resort to taking narcotic drugs to deal with the pain, and some of them develop drug dependency. In those cases it is critical to establish a proper diagnosis. It may be some other disorder, and not prostatitis that is responsible for their pain. These men may have been mis-treated for years.
Note: it is not uncommon for men with BPH to also have chronic prostatitis, a circumstance that may confuse patients and their doctors and, therefore, lead to ineffective treatment of the condition.