Prostatitis is not one condition. Scientists have identified four types, and only two of them involve bacteria. The most common type is not an infection at all, which is why antibiotics so often fail to fix it.
The most common type of prostatitis is not an infection, which is why antibiotics often do nothing for it.
The prostate sits below the bladder and wraps around the urethra. It can become inflamed for several different reasons, and bacteria are only one of them.
Here are the four types, what separates them, and the one question that changes your treatment more than any other.
The Four Types, and Which Two Involve Bacteria
NIDDK is precise about this. Scientists have identified four types of prostatitis. Two are bacterial. Two are not.
That split is the whole article. Get it right and the treatment follows. Get it wrong and you can spend years on the wrong medicine.
- Type 1. Acute bacterial prostatitis. A true infection that starts suddenly with severe symptoms. Fever, chills, low back pain and painful urination. Johns Hopkins calls it the least common type. It is the one that needs treatment right away, and severe cases may need a hospital stay.
- Type 2. Chronic bacterial prostatitis. Also a real infection, but it keeps coming back. Johns Hopkins describes it as fairly uncommon and hard to treat. Symptoms are milder than the acute form and they recur.
- Type 3. Chronic prostatitis or chronic pelvic pain syndrome. The most common type, and the reason this article exists. NIDDK calls it the most common and least understood form. It is not a bacterial infection.
- Type 4. Asymptomatic inflammatory prostatitis. Inflammation with no symptoms at all. NIDDK says men with this type do not have symptoms, it causes no complications, and it does not need treatment. It is usually found by accident.
Notice what the list does. It puts an infection and a pain syndrome under one word, and then hands you the same prescription pad for both.
That is where most of the wasted years come from.
Why the Common Type Does Not Respond to Antibiotics
Type 3 is not caused by bacteria. Cleveland Clinic confirms it is the most common type, and NIDDK states its exact cause is unknown, with researchers believing a microorganism, though not a bacterial infection, may be involved.
So the drug has nothing to kill.
NIDDK puts it plainly. Antibiotics will not help treat nonbacterial prostatitis, though a urologist may prescribe them at least initially, until a bacterial infection can be ruled out.
One trial course while your doctor rules things out is reasonable medicine. A third or fourth course after a clean urine culture is not, and it is worth asking about.
Although antibiotics will not help treat nonbacterial prostatitis, a urologist may prescribe them, at least initially, until the urologist can rule out a bacterial infection.
Take the four types with you
One printable sheet: the four types, the questions that sort them, and the antibiotic conversation worth having. Free, unlocked right here.
Enter your email to unlock your plan
Your 1-page prostatitis plan, unlocked right here.
Your plan is ready
Download or print it below. Save it anywhere.
⬇ Download your plan (PDF)When Antibiotics Are Exactly Right, and For How Long
For the two bacterial types, antibiotics are not optional. They are the treatment, and the course is longer than most people expect.
NIDDK says urologists usually prescribe oral antibiotics for at least two weeks for acute bacterial prostatitis. Because the infection may come back, some urologists recommend six to eight weeks.
Fever and chills alongside severe pain point to the acute bacterial type. Johns Hopkins Medicine says it often starts suddenly and it is important to get treatment right away.
That is the one situation where speed matters more than sorting out which type you have.
Three Prostatitis Beliefs Worth Dropping Today
Three corrections worth carrying into the appointment.
Prostatitis is an early sign of prostate cancer. Johns Hopkins says it plainly. Prostatitis is inflammation of the prostate gland and it is not cancer. It is a separate condition with a separate workup. It can raise your PSA, though, so tell whoever reads that number that you have it.
It is an older man's problem. The opposite is closer to true. NIDDK says prostatitis is the most common urinary tract problem for men younger than age 50. It drops to third place after 50.
The right antibiotic will eventually cure it. For type 3, there is no cure to reach. Johns Hopkins says symptoms may get better and then come back without warning, providers do not know why, and there is no cure, but you can manage the symptoms. Managing it well beats chasing a cure that is not there.
To your health,
Ageless Coach
Age Strong. Live Long.
This article is education, not medical advice. Fever and chills with severe pelvic pain, or being unable to pass urine, needs same day care rather than a search engine.