Chronic Prostatitis - An Infectious Disease?

It has been estimated that up to half of all men suffer from symptoms of prostatitis at some time in their lives. It is the most frequent urological diagnosis in men less than 50 years of age and the third most common urological diagnosis in men greater than 50 years of age. Prostatitis is not a life-threatening disease, however, it has been clearly demonstrated that chronic prostatitis has an impact on a patient's quality of life. Prostatitis is a major health care issue, as important as the other two major prostatic diseases, BPH and prostate cancer. Even so, our knowledge of prostatitis is still somewhat limited.

Prostatitis can be classified as:

- acute bacterial prostatitis
- chronic bacterial prostatitis
- chronic nonbacterial prostatitis
- prostatodynia

Only the first two sorts of prostatitis are caused by pathogens and are infectious.

Which pathogens cause chronic prostatitis?

There is a continuing debate about which bacteria can be considered as pathogens. In the most conservative approach only those bacteria that can be localized to the expressed prostatic secretions and that cause documented recurrent urinary tract infections (UTIs) are included. By this definition, few bacteria other than E. coli, other Enterobacteriaceae, such as Klebsiella, Enterobacter, Proteus and Serratia spp, and Pseudomonas aeruginosa are considered to be pathogens. Enterococci and staphylococci would not be included even though these pathogens can often be localized to the prostate and may be associated with the chronic prostatitis syndrome. Furthermore, in several clinical studies, Gram-positive cocci have been cultured from prostatic secretions in numbers meeting the criteria of Meares & Stamey8 and these patients responded to antibiotic therapy.

A number of other microorganisms have been reported as likely causes of this syndrome: Trichomonas vaginalis, Chlamydia trachomatis, genital mycoplasmas, difficult-to-culture coryneforms, genital viruses and, rarely, mycobacteria, gonococci, parasites and fungi have all been implicated in prostatitis. Evidence of the misclassification of at least some cases of non-bacterial prostatitis is also accumulating.4 Immunological evidence, such as the existence of antibodies to uropathogenic bacteria in patients with negative cultures suggests a bacterial presence. This is supported by evidence of both bacterial DNA and cultured ‘cryptic’ bacteria detected in prostate biopsies and prostatic fluid of patients with sterile cultures. As many as 50% of transperineal prostatic biopsies in patients with chronic inflammatory prostatitis grow bacteria. Thus, the full impact of infection remains unresolved in chronic inflammatory prostatitis.

What is the treatment for prostatitis?

Acute bacterial prostatitis can be cured by antibiotic meds, and sometimes a short hospital stay is required. This is the most easiest one to cure.

Chronic bacterial prostatitis sometimes can be cured by antibiotics or antimicrobials. Actually, however, on lots of prostatitis patients, chronic nonbacterial prostatitis occurs. Which means, even the pathogens are killed, they still suffer from an inflamed prostate. Thus, it is suggested to take herbal medicine for chronic bacterial prostatitis and chronic nonbacterial prostatitis. Cause herbal remedies can persistently work in the prostate to kill the pathogen and subside swell. In recent years, it is proved that patented herbal remedy “Diuretic and Anti-inflammatory Pill” has very remarkable effect on curing prostatitis.