NIH - Prostatitis – acute (Medical Encyclopedia) “Causes: Acute prostatitis is usually caused by a bacterial infection of the prostate gland. Any organism capable of causing an urinary tract infection (UTI) is also capable of causing acute bacterial prostatitis, including enterococci, Escherichia coli, Klebsiella pneumonia, Proteus mirabilis, Pseudomonas aeruginosa, and Staphylococcus aureus. Some sexually transmitted diseases (STDs) can cause acute prostatitis, typically seen in men younger than 35. These include gonorrhea, chlamydia, urealyticum, and trichomonas. Prostatitis from an STD typically closely follows sexual contact with an infected partner. In men older than 35, E. coli and other common bacteria are more often the cause of prostatitis. E. coli prostatitis may follow urinary tract infections, urethritis, or epididymitis. Acute prostatitis may also develop as a result of procedures involving the urethra, such as: • Catheterization or cystoscope • Trauma • Bladder outlet obstruction • An infection elsewhere in the body. Prostatitis is rare in young boys. … Symptoms: Acute prostatitis often begins with chills and fever, lower abdominal discomfort, perineal pain (pain in the area between the genitals and the anus), and burning with urination. Symptoms of more advanced prostatitis include a diminished urine stream and difficulty urinating. Prostatitis may occur in conjunction with epididymitis or orchitis, especially if caused by an STD, in which case symptoms of the accompanying condition may also be present. Symptoms of acute prostatitis include the following: • Fever • Chills • Low back pain • Abdominal pain (above the pubic bone) • Perineal pain (pelvic floor) • Pain and burning with urination (dysuria) • Urinary retention (inability to completely empty bladder) • Pain with ejaculation • Pain with bowel movement “

NIH - Prostatitis – chronic (Medical Encyclopedia) “Chronic prostatitis is an inflammation of the prostate gland that develops gradually, continues for a prolonged period, and typically has subtle symptoms. Causes: Chronic prostatitis is usually caused by a bacterial infection. It may be associated with or follow urinary tract infection, urethritis, epididymitis, or acute prostatitis. The most common causes are Escherichia coli and proteus, Enterobacter, and klebsiella bacteria. … DIET: Avoid substances that irritate the bladder, such as alcohol, caffeinated food and beverages, citrus juices, and hot or spicy foods. Increasing the intake of fluids (64 to 128 ounces per day) encourages frequent urination that will help flush the bacteria from the bladder. … Possible Complications” If the enlarged prostate restricts the flow of urine through the urethra, urinary retention may cause kidney damage.”

NIH - Prostatitis – nonbacterial (Medical Encyclopedia) “Nonbacterial prostatitis is an inflammation of the prostate gland with no known cause. Causes: There are many theories about the cause of nonbacterial prostatitis: fungi, viruses, trichomonads, and obligate anaerobic bacteria have been suspected. Irritation caused by a reflux of urine flowing into the prostate may also be a cause. Up to 65% of patients with chronic prostatitis have the nonbacterial form. The disorder is seen in 5 of every 10,000 outpatient visits by men.”

NHS - Prostate disease “There are two types of prostatitis: acute and chronic. Acute prostatitis is usually caused by a bacterial infection. The cause of chronic prostatitis is usually unknown, but some studies show it can be caused by stress, depression and anxiety. Always letting your bladder completely fill up before you pass urine may also be a cause of prostatitis, as some urine can then leak into parts of your prostate causing inflammation. Bacterial infections that cause acute prostatitis can be transmitted as a sexually transmitted infection (STI) such as chlamydia or gonorrhoea. This means that you can catch them by having unprotected sex. Prostatitis can also be caused when common bacteria (such as those found in your bowels) travel up your urethra and infect your prostate, or other parts of your urinary system such as your bladder or kidneys. … Prostatitis is treated by taking prescribed antibiotics to treat the infection that is causing it. Typically, antibiotics will need to be taken for about 4-6 weeks, but it will depend on what infection you have. You can also paracetamol and ibuprofen can be taken to ease pain and inflammation. If the cause of your prostatitis is unknown, your doctor may still prescribe antibiotics for you. This is because some infections may not show up in blood or urine samples.”

Chronic prostatitis/chronic pelvic pain syndrome: finding a way forward in the United kingdom: report from the first United kingdom symposium on chronic prostatitis, january 30, 2008, london, United kingdom. (Rev Urol. 2008) “Chronic prostatitis or chronic pelvic pain syndrome (CP/CPPS) is a painful, prevalent, and economically important condition. Despite recent advances it remains the least understood of the 3 prostate-related conditions (the other 2 being benign prostatic hyperplasia and prostate cancer).”

Prostatitis And Inflammatory Conditions Of The Prostate (2008)“Only about 5% men with CP/CPPS have bacteriologically documented infection and these patients benefit from antibiotic treatment especially when newly-diagnosed. Men with culture-positive CP/CPPS who have Category 2 Chronic Bacterial Prostatitis may benefit from antibiotic treatment with one of the fluoroquinolones (that penetrate the prostate) especially if newly-diagnosed. Alpha-blockers are useful in men with Category 3 CP/CPPS with negative cultures. Like with antibiotics, newly-diagnosed, alpha-blocker naïve patients benefit most from long courses (3-6 months) of alpha-blocker therapy. Randomized controlled trials have not shown significant benefit for either alpha-blockers or antibiotics in chronic, pre-treated CP/CPPS patients. Adjuvant therapy with a variety of oral drugs is frequently necessary. - including anti-inflammatory agents, phytotherapeutic drugs, Tricyclic anti-depressants, analgesics, muscle relaxants, pentosanpolysulfate, finasteride etc. Complimentary therapies such as acupuncture, psychological counseling, and pelvic floor physical therapy are commonly employed in combination with alpha-blockers/antibiotics as part of a multi-modality treatment paradigm. Rarely used are the minimally invasive surgical treatments such as transurethral microware thermotherapy, transurethral needle ablation.”

Epidemiology of prostatitis. (Int J Antimicrob Agents. 2007) “BACKGROUND: Prostatitis describes a combination of infectious diseases (acute and chronic bacterial prostatitis), chronic pelvic pain syndrome, and asymptomatic inflammation. … A history of sexually transmitted diseases was associated with an increased risk for prostatitis symptoms. Men reporting a history of prostatitis symptoms had a substantially increased rate of benign prostatic hyperplasia, lower urinary tract symptoms and prostate cancer.”

The role of inflammation and infection in the pathogenesis of prostate carcinoma. (BJU Int. 2007) "Summarising these epidemiological, genetic and cell biological aspects, infectious prostatitis might have a causative role in the complex and multifactorial process of prostate carcinogenesis."