Prostatodynia
Key points
- Nonbacterial prostatitis is an inflammation of the prostate gland with no known cause.
- There are many theories about the cause of nonbacterial prostatitis: fungi, viruses, trichomonads, and obligate anaerobic bacteria have been suspected.
- The symptoms of nonbacterial prostatitis are the same as those of chronic bacterial prostatitis.
- A physical examination usually will not reveal anything unusual, although the prostate may be swollen, firm, warm, and tender.
Alternative names
NBP; Prostatitis - nonbacterial; Pelvic pain syndrome
Definition
Nonbacterial prostatitis is an inflammation of the prostate gland with no known cause.
Causes, incidence, and risk factors
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.
Symptoms
The common symptoms associated with nonbacterial prostatitis include:
- Pain
o Perineal
o Suprapubic
o Scrotal
o Low back
o Urethral
o Tip of penis - Frequent urination
- Pain or burning with urination
- Decreased urinary stream
- Pain with ejaculation
- Pain with bowel movements
- Blood in the urine
- Blood in the semen
The symptoms of nonbacterial prostatitis are the same as those of chronic bacterial prostatitis.
Signs and tests
A physical examination usually will not reveal anything unusual, although the prostate may be swollen, firm, warm, and tender.
Triple-void urine specimens may be collected for urinalysis and urine culture:
- #1 - initial stream
- #2 - mid-stream
- #3 - after prostatic massage by examiner
A urinalysis reveals increased white blood cells, but no bacterial growth, upon culture of urine #3. Blood may be detected in the urine. Prostatic secretions also contain increased levels of white blood cells and no bacteria.
A semen culture will not demonstrate bacterial infection but may demonstrate increased numbers of white blood cells and decreased numbers of sperm, with poor motility.
Treatment
Treatment for nonbacterial prostatitis is difficult and is aimed at treating the symptoms.
Written and revised by
Andrey Nailor, M.D.
Our doctors write and review articles for accuracy and keep them up to date.
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