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Chronic bacterial prostatitis (CBP)
Chronic bacterial prostatitis (CBP) is another uncommon form of prostatitis, characterized by recurrent infection of the prostate. It usually is associated with some underlying defect in the prostate that serves as a focal point for persistent bacterial infection. Antibiotics may not cure the infection; surgery may be required.
CBP What are the causes and risks of the condition? increased alkalinity of the prostatic fluid; there is some evidence that this condition leads to decreased fertility, as sperm do not tolerate such an environment.
• What are the causes and risks?
• What are the signs and symptoms ?
• How is this condition diagnosed?
• What are the treatments?
What are the causes and risks of the condition?
As in cases of CBP, the initial bacterial infection may be caused by bacteria traveling up the urethra and reflux of infected urine into the prostatic ducts. This can be brought on by the use of a urinary catheter, enlargement of the patient’s prostate, a bladder infection or bacteria acquired by engaging in anal intercourse.
What characterizes CBP from ABP, however, is the recurrent nature of the infection. This usually results from an underlying defect in the prostate which provides a host environment for the bacteria. This may be calculi — stones caused by hardened salts or prostatic secretions that block portions of the gland — or minute pools of stagnant, difficult-to-sterilize urine trapped in the bladder by enlarged or inflamed portions of the prostate. Until the defect is fixed, the infection will linger. The usual course of antibiotics prescribed for ABP may knock the infection down for a time, only to have it rebound.
What are the signs and symptoms of the condition?
The symptoms of CBP are similar to those of ABP: rapid onset, chills, fever, pain in the lower back and genital area, body aches, burning or painful urination, increased urinary frequency and urgency, often at night, and occasionally visible blood in the urine. The most distinguishing feature of CBP is its high incidence of recurring bladder infections.
How is this condition diagnosed?
A diagnosis of CBP typically is made when the patient returns frequently after treatment for ABP, complaining of renewed discomfort and recurrent infection.
What are the treatments?
CBP requires a longer course of antibiotic treatment-typically four to 12 weeks. Antibiotics prescribed include ciprofloxacin, trimethoprim, sulfamethoxazole, carbenicillin, tetracycline, doxycycline and erythromycin. About 60% of CBP cases respond to this treatment.
If this is unsuccessful, a 4 to 12-month, low-dose course of antimicrobal treatment may be recommended. Alternative treatments involving direct injection of antimicrobal agents into the prostate and low-dose suppressive antibacterial therapy also have been tried, without conspicuous success.
The most persistent cases of CBP may require surgery to correct the underlying prostate or urinary tract defect responsible for reinfection. Transurethral resection of the prostate (TURP) may be necessary.
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