Understanding the Two Types of Prostatitis
Some medical issues put life at risk while others gradually peck away at the daily quality of life. In cases of the latter, effects and complications of illnesses make every task more tedious, and any untreated ailment will eventually create superficial or significant calamity in a number of ways.
Some conditions do a little bit of everything to you, depending on the condition. Prostatitis is a form of prostate inflammation that affects men across a broad age spectrum. Symptoms can be slight to severe depending on the variation and resiliency of the prostatitis, and by variation, we mean either bacterial or nonbacterial prostatitis, both of which have their own variations.
Understanding prostatitis duality
While there are four significant variations of prostatitis, it can also be discussed in terms of two broader categories of distinction: bacterial and nonbacterial.
The prostate, a walnut-sized gland located below a man's bladder, contains bacteria in very small amounts, said Amin Herati, M.D., director of Male Infertility and Men's Health at Johns Hopkins Medicine in Baltimore.
"Bacteria reside within the prostate, but the prostate can typically keep those bacteria in check so that they do not flourish and gain additional volume and have more of an aggressive effect on the tissue," Herati said.
Bacterial prostatitis is inflammation, which occurs due to an overgrowth or infection of bacteria that is counterproductive or damaging to the normal biological functions and bacterial population of the prostate. Prostatitis may correlate to a urinary tract infection (UTI) or other exposure to bacteria through illness.
Bacterial prostatitis can occur acutely or chronically. Acute bacterial prostatitis is treated with antibiotics and can clear up within a month or less. Chronic bacterial prostatitis is a more challenging problem because it is more resistant to antibiotics and, by its very nature, a more persistent source of symptomatic and secondary health problems.
Diagnosing the difference
Both bacterial and nonbacterial prostatitis are often associated with symptoms involving changes to urination, such as frequency or a decrease in force behind the urinary stream. Urination can be painful, and a man can also feel pain or soreness around the pelvic and/or groin areas.
A key difference between the two general categories of prostatitis is that the bacterial iteration is often associated with flu-like symptoms such as vomiting, nausea, fever and chills.
Herati said these conditions of fever and/or malaise are part of what makes bacterial prostatitis distinguishable from its nonbacterial counterpart. The systemic symptoms tend to be more commonly associated with a bacterial case of prostatitis. He also said testing for the presence of a positive urine culture can be a critical step in determining which type of prostatitis is causing problems for the patient.
Untreated bacterial prostatitis can develop into sepsis, which is widespread inflammation that can be life-threatening. Nonbacterial prostatitis, alternatively, doesn't threaten life as much as it does the quality of life for the patient. The pain, urinary symptoms and sexual dysfunction often associated with this form of prostate inflammation can lead to significant primary and secondary determinants in personal, professional and sexual aspects.
Prostatitis and sex
Side effects of prostatitis may impact sex and reproduction. For example, prostatitis patients may need to refrain from intercourse because of the pain associated with ejaculation during a flare-up, said Matthew Mutter, M.D., a urologist and assistant professor at the Louisiana State University School of Medicine.
Other than that, there are no significant long-term sexual risks, though it should be noted that chronic or repeated instances of prostatitis can have adverse effects on the body.
A sexual partner cannot "catch" prostatitis, but it is suggested that practicing safe sex—using barrier protection and health-conscious sexual behaviors—can reduce your risk of developing prostatitis as a result of certain infections and the bacterial exposure that results from those infections.
But bacterial prostatitis poses no risk of exposure to unwanted bacteria in sexual partners, said Mutter, who also serves as a member of the grant committee for the Sexual Medicine Society of North America (SMSNA).
More prostatitis considerations
Bacterial prostatitis is more likely to occur in older people, which is thought to be due to an increased likelihood of urine flowing backward—a condition called retrograde—from the prostate to the bladder. This causes bacteria to spread and propagate, which, of course, can lead to bacterial prostatitis.
Another category of prostatitis to be aware of is chronic nonbacterial prostatitis, sometimes referred to as chronic pelvic pain syndrome (CPPS). In these cases, patients present the symptoms and meet certain parameters for bacterial infection, but a urine culture test does not reveal the presence of bacterial infection. CPPS is considered the cause of most urological problems for men younger than age 50, which makes it one of the most common forms of prostatitis, as well as one of the most difficult to treat. Doctors may prescribe a spectrum of antibiotics and other medications to treat this form of prostatitis.
In most cases, a healthy lifestyle equals a healthy prostate—unfortunately, that's about as specific as the advice gets for avoiding either bacterial or nonbacterial prostatitis.
It's also important to point out that the symptoms of prostate inflammation can overlap and seem similar to those associated with conditions such as prostate cancer. However, prostatitis is benign and does not increase your risk of cancer.
Chronic prostatitis can have a lasting effect on the body, including an impact on the ability to have children. Additionally, the same bacteria that is sometimes transferred with certain sexually transmitted infections (STIs) can also cause bacterial prostatitis.
"Recurrent episodes of prostatitis, and typically it's nonbacterial, can really affect your quality of life," Mutter said. "Not so much from a sexual standpoint, but just overall quality of life."
Researchers are steadily learning more about the prostate and how prostate health typically corresponds to many other significant health indicators, such as heart health and obesity. In most cases, a healthy lifestyle equals a healthy prostate—unfortunately, that's about as specific as the advice gets for avoiding either bacterial or nonbacterial prostatitis.
In terms of which is worse, that's up to prostatitis sufferers to decide.
"In general, bacterial [prostatitis] can be much more life-threatening and serious," Herati said. "The one that's going to pose a risk to somebody's life is going to be the bacterial prostatitis, because the patient can become septic from that infection."
On the other hand, he explained that nonbacterial prostatitis can lead to significant pain, urinary symptoms and sexual dysfunction.
In other words, one type of prostatitis can affect quality of life while the other can threaten life itself. In either case, an inflamed prostate is a good reminder for everyone to be better informed about the prostate gland and other aspects of the human body.
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