What Causes Chronic Prostatitis?

Chronic prostatitis is one of the most common urology-related medical problems for American men, accounting for almost 2 million doctor visits every year. In fact, for about 25% of all men who see their doctors for urogenital symptoms, chronic prostatitis is the underlying cause.

Despite its prevalence, chronic prostatitis doesn't always cause major symptoms, and often, those symptoms are attributed to another cause, like “getting older.” That means many more men may have the condition without seeking medical care.

Alfred Shtainer, MD, FACS, and the team at Adult and Pediatric Urology help men in Manhattan, Brooklyn, and Queens, New York, manage chronic prostatitis with patient-centered treatment plans tailored to their symptoms and needs. In this post, learn what causes chronic prostatitis and how Dr. Shtainer can help.

Chronic prostatitis: The basics

Chronic prostatitis involves long-term inflammation of the prostate gland lasting for three months or longer. Typically affecting men who are middle-aged or younger, chronic prostatitis can cause significant pain and discomfort in the lower belly or pelvic region.

There are two primary types of chronic prostatitis. Chronic bacterial prostatitis is the least common type, caused by a lingering bacterial infection in the prostate gland and usually requiring long-term use of antibiotics. Combined, chronic bacterial prostatitis and acute bacterial prostatitis account for only about 2%-5% of prostatitis cases.

Chronic pelvic pain syndrome (CPPS) is by far the most common, accounting for about 95% of all prostatitis cases. Also called nonbacterial prostatitis, this is what most people are referring to when they talk about chronic prostatitis. 

The exact cause of CPPS can be difficult to pinpoint, but possible factors include:

• Viral infection
• Parasitic infection
• Chemical irritation
• Urine backing up into the prostate gland
• Frequent bicycle riding
• Nerve problems involving the urinary tract
• Pelvic floor muscle issues
• Sexual abuse
• Chronic or acute stress
• Hormonal imbalances

Having a prior bacterial infection of the prostate can also trigger chronic prostatitis.

Prostatitis symptoms

Many men with prostatitis frequently have pain that can occur in the lower belly or pelvic area, the scrotum, the penis, the perineum, or the lower back. Symptoms may include:

• Painful or uncomfortable urination
• Intermittent or weak urinary stream
• Increased urgency or frequency of urination
• Blood in the urine

Chronic prostatitis can also cause pain during ejaculation.

Treating chronic prostatitis

Before recommending treatment, Dr. Shtainer performs a series of texts and exams to explore possible causes of your symptoms. These tests include urine and blood tests, digital rectal exams (DRE), semen cultures, and ultrasound exams.

If cultures reveal the presence of bacteria, he prescribes antibiotics to fight off the infection, along with medications to relieve your symptoms in the meantime. For nonbacterial chronic prostatitis, treatments may include:

• Medications to relieve pain
• Medications to reduce inflammation
• Prostatic massages
• Low-intensity shockwave therapy

Depending on your symptoms and other factors, he may recommend additional therapies to help you manage your symptoms and help your prostate recover.

Don’t ignore your symptoms

Chronic prostatitis is one possible cause of pain and urinary symptoms, but there are other potential causes, too, including cancer. If you have any unusual symptoms, they need to be evaluated right away.

To learn what’s causing your symptoms and how we can help relieve them, book an appointment online or over the phone with Dr. Shtainer and the team at Adult and Pediatric Urology today.