What is the pathophysiology of chronic bacterial prostatitis (CBP)?

Updated: Jan 15, 2019
  • Author: Samantha D Kraemer, MD; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

Bacterial P-fimbriae facilitate colonization of the lower urinary tract by binding to urothelial receptors. E coli has mannose-sensitive fimbria with receptors that has been associated with the development of cystitis and prostatitis. 

Biofilm formation by bacteria allows the bacteria to persist despite antibiotic treatment. Biofilms are protective aggregates of bacteria that form in response to host defenses or antibiotic therapy; in prostatitis, they develop deep in the ducts of the prostate. [13] Patients with organisms persisting in biofilms or within obstructed ducts may have persistent symptoms despite sterile cultures. Hemolysin may also increase the ability of bacteria to persist as biofilms, as seen with certain strains of E coli causing CBP. [1]

Even after bacteria have been eradicated, the virulence of the specific bacteria may influence the development of CPPS. [1]


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