Sexuality and prostatitis: a hypothesis.

Pathways of entry of pathogenic organisms into the prostate may include hematogenous dissemination from distant foci of infection, extension via lymphatics, transmission via infected urine from kidneys, or retrograde entry via the urethra. The last route of entry seems to account for most episodes of prostatitis. Indirect evidence from studies of patients with prostatitis points to retrograde entry of bacteria via the urethra following oral, anal, or genital intercourse or masturbatory practices as a major means of induction of prostatitis. Evidence is based upon similarity of organisms recovered from various orifices to those in the prostate, apparent low incidence of prostatitis in asexual males, and appearance in the prostate of bacteria which reside in the distal urethra. Definitive studies are necessary to prove this hypothesis; emphasis must be placed on correct diagnosis of prostatitis.