Prostatitis. Sorting out the different causes.

Both acute and chronic bacterial prostatitis are generally caused by gram-negative organisms. However, acute infections are seen in younger men and cause fever, difficulty in voiding, low back and perineal pain, and other systemic symptoms. Chronic infections are more often seen in older men and may or may not be associated with symptoms of prostatitis. Nonbacterial prostatitis is the most common type. Patients have symptoms and signs of prostatitis, but infecting organisms cannot be demonstrated. Studies attempting to identify a causative organism have not been conclusive. Prostatodynia is a complex of symptoms similar to prostatitis that occurs without objective findings that definitely implicate the prostate gland. Bladder disorders such as internal sphincter dyssynergia, tension myalgia of the pelvic floor, or, at times, stress and emotional problems may be associated. Management depends on the precipitating factor.