What are the possible etiologies of chronic bacterial prostatitis?

Updated: Nov 01, 2019
  • Author: Paul J Turek, MD; Chief Editor: Jeter (Jay) Pritchard Taylor, III, MD  more...
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Chronic bacterial prostatitis may be due to the following:

  • A primary voiding dysfunction problem, either structural or functional

  • E coli is responsible for 75-80% of chronic bacterial prostatitis cases. Enterococci and gram-negative aerobes such as Pseudomonas are usually isolated in the remainder of cases.

  • C trachomatis,Ureaplasma species, Trichomonas vaginalis

  • Uncommon organisms, such as M tuberculosis and Coccidioides, Histoplasma, and Candida species , must also be considered. Tuberculous prostatitis may be found in patients with renal tuberculosis

  • Human immunodeficiency virus

  • Cytomegalovirus

  • Inflammatory conditions (eg, sarcoidosis)

The etiology of chronic prostatitis and chronic pelvic pain syndrome is poorly understood but may involve an infectious or inflammatory initiator that results in neurologic injury and eventually in pelvic floor dysfunction in the form of increased pelvic tone. [2] The most prevalent site of pain is perineal (63% of patients), followed by testicular, pubic, and penile. Urogenital pain appears to be more bothersome to patients than urinary symptoms. Inflammatory bowel disease is present in 25% of patients with CPPS. [9] About 5-8% of men with this syndrome eventually have a bacterial pathogen isolated from urine or prostatic fluid.

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