Some infective causes of prostatitis would include sexually transmitted infections or diseases (STI’s/STD’s) such as Chlamydia, Gonorrhea, and other organisms such as Ureaplasma or Mycoplasma bacteria.
Non-STI type bacteria can also cause infections – these are more commonly seen in older men with Benign Prostatic Hyperplasia (BPH), Diabetes, or Inflammatory Bowel Conditions, where bacteria can translocate through the wall of the colon to the prostate tissues. This bacterial translocation can also occur after instrumentation, whether through the urethra (cystoscopy), or through the colon (colonoscopy).
Prostatitis caused by infection can be treated with courses of antibiotics, but depending on the type and severity of infection, duration of treatment can range from a few days to a few weeks.
Other causes are less well understood and can cause chronic or recurrent symptoms. These conditions are complex and may be more challenging to diagnose and treat. Some diagnoses that you may hear include:
- Chronic prostatitis
- Pelvic floor dysfunction
- Interstitial cystitis
- Chronic pelvic pain syndrome
- Levator ani syndrome
- Pelvic migraine or headache
Symptoms may be triggered by sexual intercourse, periods of stress, and even sometimes by different weather or foods!
These forms of prostatitis can often be confused or misdiagnosed as other pelvic conditions, and many patients can be left frustrated and anxious by a lack of clarity with their condition and treatment plans.
Anxiety can play a large role in both the development of symptoms as well as a consequence of the condition – people who are more anxious tend to have more severe and frequent symptoms of pelvic pain, and this can lead to anxiety about the pain itself – it really is a vicious cycle. A significant group of men may find their symptoms started after a particular sexual encounter that they later regard with guilt, shame, or regret. There may be associated anxieties about having contracted a sexually transmitted infection, despite test results showing otherwise. Chronic pain can cause people to be socially withdrawn, impair their self-esteem, and burden intimate relationships.
In addition to medications, these types of prostatitis will respond more to psychotherapy/counselling, specialized pelvic floor therapy and rehabilitation, and may also be relieved in certain cases with low intensity extracorporeal shock wave therapy (ESWT).