Prostatitis is an infection or inflammation of the prostate gland that presents as several syndromes with varying clinical features. The term prostatitis is defined as microscopic inflammation of the tissue of the prostate gland and is a diagnosis that spans a broad range of clinical conditions.
The presence of acute inflammatory cells in the glandular epithelium and lumens of the prostate, with chronic inflammatory cells in the periglandular tissue, characterizes prostatitis. However, the presence and quantity of inflammatory cells in the urine or prostatic secretions does not correlate with the severity of the clinical symptoms. Chronic pelvic pain syndrome is diagnosed based on pain in the setting of negative cultures of urine and prostatic secretions. Neuromuscular dysfunction or congenital reflux of urine into the ejaculatory and prostatic ducts may be a precipitating factor.
Etiology: Prostatitis may be caused by ascending infection through the urethra, refluxing urine into prostate ducts, or direct extension or lymphatic spread from the rectum. Approximately 80% of the pathogens are gram-negative organisms (eg, Escherichia coli, Enterobacter, Serratia, Pseudomonas, Enterococcus, and Proteus species.