What Is It?

The prostate is a walnut-sized gland that sits below the bladder in men. This gland makes fluid that mixes with sperm to form semen.

Prostatitis is inflammation or swelling of the prostate gland. When symptoms start gradually and linger for more than a couple of weeks, the condition is called chronic prostatitis. Doctors previously believed that all chronic prostatitis was caused by infection of the prostate by bacteria. However, it is now clear that symptoms of chronic prostatitis can be caused by several different conditions, and that infection plays a role in only some of these. Three major types of chronic prostatitis are:

• Chronic bacterial prostatitis - In this condition, a bacterial infection causes swelling and inflammation of the prostate. Doctors make this diagnosis only if bacteria and white blood cells, which fight infection, are found in the urine. Chronic bacterial infection accounts for only a small percentage of cases of chronic prostatitis.

• Chronic non-bacterial prostatitis, also called inflammatory chronic pelvic pain syndrome - Doctors make this diagnosis when patients have typical symptoms of chronic prostatitis, but no bacteria are found in a urine sample. The cause of most cases of non-bacterial prostatitis is not well understood. The urine often contains white blood cells, which suggests that there is inflammation or infection. Some patients may have a persistent low-grade infection that cannot be detected in a routine urine sample. However, most patients with non-bacterial prostatitis have no evidence of infection, even when sophisticated tests are done.

• Prostadynia, also called noninflammatory chronic pelvic pain syndrome - This term is used when symptoms of prostatitis are present, but there is no evidence of prostate infection or inflammation. Doctors understand very little about why some people - often young, otherwise healthy men - develop this problem. Theories to explain prostadynia include an abnormal buildup of pressure in the urinary tract, irritation resulting from an autoimmune or chemical process, or pain generated in the nerves and muscles within the pelvis.