Infection of the prostate gland is mainly due to bacteria and is therefore known as bacterial prostatitis. it can be acute or chronic and is often associated with other prostate or urinary tract pathology. The microorganisms are usually present in the urine but can reach the prostate through the blood stream, lymphatic system or directly from neighboring structures like the rectum.
The risk of developing prostatitis increases substantially if there is a history of urinary tract infections, bladder outlet obstruction, benign prostatic hyperplasia, sexually transmitted diseases (STDs), unprotected anal intercourse, transurethral surgery, catheterization or phimosis.
Most prostate gland infections are due to bacteria. Rarely, viral and fungal prostatitis may occur although it is more often associated with immunocompromised states. Bacterial prostatitis is less common than other non-infectious causes. in acute prostatitis, usually the same bacteria that are involved in urinary tract infections may also infect the prostate. this includes E.coli, enterococci and staphylococci. with chronic prostatitis, however, the are a host of microorganisms that may also play a role in infection, including Klebsiella spp, Enterobacter spp, staphylococci, Pseudomonas spp and enterococci.
The microorganisms gain entry into the prostatic tissue through multiple routes. The most common is when microorganisms enter through the penile urethra and spread up the urinary tract. this is known as an ascending urethral infection. Microorganisms in the urine may also enter the prostatitic ducts, against the regular flow of urine. this is known as reflux of infected urine. in acute prostatitis, these routes of transmission are usually responsible.
Bacterial prostatitis may also arise through direct infiltration of the rectal bacteria. Lymphatic spread of the rectal bacteria and hematogenous spread of bacteria through the blood stream from distant sites may also be responsible.
The symptoms of acute bacterial prostatitis are usually intense while in chronic cases, the presentation may be mild or even asymptomatic.
The risk of developing a prostatitic abscess exists especially with acute bacterial prostatitis and may require drainage.
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