bacteria is the cause of symptoms of chronic bacterial prostatitis (CBP). CBP is a recurrent urinary tract infection due to the same organism, which persists in the prostatic fluid, and has an associated symptom complex.

The prostatitis symptom complex is very common. Approximately half of all men develop prostatitis symptoms at some time in their lives.

organisms, Chlamydia trachomatis, Ureaplasma urealyticum, Mycoplasma hominis) can cause prostatitis.

The normal prostate measures 3 cm by 4 cm by 2 cm in length, width, and depth, respectively. The prostate is divided into 3 distinct zones, central, transitional, and peripheral zones. These 3 zones fuse into a single glandular structure that completely surrounds the urethra. It is enclosed by a capsule composed of collagen, elastin, and smooth muscle.

Antibiotics depend on passive diffusion to enter the epithelial prostatic glandular acini. Because antibiotics do not penetrate the prostate easily and no active transport mechanism exists that antibiotics can enter the prostatic ducts. Therefore, The epithelial cells do not allow the free passage of antibiotics unless they meet certain criteria, ie, un-ionized, lipid-soluble.

Prostatic fluid is acidic with pH of 6.4 compared to plasma pH of 7.4 and this is another inhibiting factor, thus creating a pH gradient further inhibiting diffusion of acidic antibiotics into the prostatic fluid. Therefore, the best antibiotics for use in prostatitis have high dissociation constants, are basic instead of acidic.

The prostate has the highest level of zinc concentration of any organ, men with CBP have low prostatic zinc levels and normal serum zinc levels. Interestingly, oral zinc supplement does not increase the prostatic zinc levels in men with CBP.

Symptoms

Patients also can have irritative or obstructive urologic symptoms such as frequency, decreased force of the urinary stream, nocturia, urgency, dysuria, and postvoid dribbling.

Genitourinary pain occurs in the penile tip, testicles, rectum, perineal area, lower abdomen, and back.

Other symptoms include ejaculatory pain, hematospermia, a clear-to-milky urethral discharge, and sexual dysfunction.

Causes: Causative organisms include following:

• Klebsiella pneumoniae

• Pseudomonas aeruginosa

• Staphylococcus species

• Proteus species

• Escherichia coli

Prostatitis, Bacterial
Urethritis
Urethral Strictures
Nonbacterial Prostatitis
Acute prostatitis