Non-bacterial Prostatitis

Alternate Names
prostatitis, non-bacterial
prostatodynia

Definition of Non-bacterial Prostatitis

In non-bacterial prostatitis, men have the symptoms of prostatitis, or inflammation of the prostate gland, but do not have a bacterial infection, at least not one that is evident on bacterial culture. The symptoms include difficulty with urination and pain in the groin area.

What is going on in the body?

In this syndrome, men have the symptoms of prostate infection but do not have any evidence of a bacterial infection. Some researchers believe that the organism Chlamydia may be responsible in many culture-negative cases, but this is controversial. The symptoms are probably caused by spasms of the sphincter muscles of the bladder and the pelvic floor. This may also increase the pressure in the urethra, which forces urine down into the prostate.

What are the signs and symptoms of the disease?

The syndrome usually affects men between 18 and 50 years old. The symptoms may be constant, or they may come and go. Usually there is a combination of irritative and obstructive problems with urination. Irritative symptoms are the need to urinate often, an urgent need to urinate, and nocturia, or having to get up at night to urinate.

Obstructive symptoms include a weak force of stream and hesitant urine flow. Most men have some pain behind or in the scrotum, over the bladder, or in the urethra. Sometimes pain also occurs in the lower back. Not uncommonly, men may have symptoms of painful ejaculation or erectile dysfunction.

What are the causes and risks of the disease?

Since the cause is not completely understood, it is hard to know what the risks are. Anxiety about the symptoms can make them worse. Men should be reassured that the condition cannot turn into anything more serious.

How is the disease diagnosed?

A physical exam is not usually enough to make the diagnosis. But often it reveals that the anal sphincter, prostate, and groin muscles are tight. Secretions from the prostate are examined to aid in the diagnosis. The healthcare professional inserts a gloved finger into the man's rectum and massages the prostate vigorously. The gland produces a drop of prostatic fluid that can be milked out of the urethra. The fluid is then cultured. If no bacteria are found, the diagnosis is made.

What are the long-term effects of the disease?

Non-bacterial prostatitis can certainly affect the man's quality of life. Otherwise, there are no serious long-term effects.

What are the risks to others?

This is not a communicable disease.

What are the treatments for the disease?

A combination of medications are used to lessen the spasms in the sphincter and pelvic muscles, and to calm the inflammation in the prostate. Alpha-blockers such as terazosin (i.e., Hytrin) can be used for spasms. Sometimes a short course of a muscle relaxant like diazepam (i.e., Valium) is used to help break the spasm. Anti-inflammatory agents such as ibuprofen (i.e., Advil, Motrin) can address the inflammation. Warm baths once or twice a day may also help.

What are the side effects of the treatments?

Alpha-blockers can cause nasal congestion and headache. Diazepam and other muscle relaxants can cause drowsiness.

What happens after treatment for the disease?

Non-bacterial prostatitis usually cannot be cured, but it can be managed. It helps a lot for the man to know that this is not a dangerous condition.

How is the disease monitored?

Once symptoms are gone there is no need for further monitoring. The man should contact a healthcare professional if symptoms persist or return.