Chronic nonbacterial prostatitis causes long-term pain and urinary symptoms. It involves the prostate gland or other parts of a man's lower urinary tract or genital area. This condition is not caused by an infection with bacteria.
Possible causes of nonbacterial prostatitis include:
A past bacterial prostatitis infection
Less common types of bacteria
Irritation caused by a backup of urine flowing into the prostate
Irritation from chemicals
Nerve problem involving the lower urinary tract
Pelvic floor muscle problem
Life stresses and emotional factors may play a part in the problem.
Most men with chronic prostatitis have the nonbacterial form.
Blood in the semen
Blood in the urine
Pain in the genital area and lower back
Pain with bowel movements
Pain with ejaculation
Problems with urinating
Exams and Tests
Most of the time a physical exam is normal. However, the prostate may be swollen or tender.
Urine tests may show white or red blood cells in the urine. A semen culture may show a higher number of white blood cells and low sperm count with poor movement.
Urine culture or culture from the prostate does not show bacteria.
Treatment for nonbacterial prostatitis is difficult. The problem is hard to cure, so the goal is to control symptoms.
Several types of medicines may be used to treat the condition. These include:
Long-term antibiotics to make sure that the prostatitis is not caused by bacteria. However, people who have had symptoms for a long time that are not helped by antibiotics should stop taking these medicines.
Drugs called alpha-adrenergic blockers help relax the muscles of the prostate gland. It often takes about 6 weeks before these medicines start working. Many people do not get relief from these medicines.
Aspirin, ibuprofen, and other nonsteroidal anti-inflammatory drugs (NSAIDs), which may relieve symptoms for some men.
Some people have found some relief from pollen extract (Cernitin) and allopurinol, although research does not confirm their benefit. Stool softeners may help reduce discomfort with bowel movements.