Bacterial infection

Your prostatitis could be caused by bacteria. If you ever had acute prostatitis with fever, it was probably bacterial (and most likely quickly brought under control with antibiotics).

In the beginning….there was bacterial infection.

That is to say, the original theory about the cause of prostatitis was that it is caused by bacterial infection. Now, of course, we know that some prostatitis has nothing, or little, to do with bacteria. Exactly how important bacterial infection is in causing prostatitis is a subject of great debate on every level, from patient discussion to scientific research.

The reason there can be any controversy is because of the logic of how one tests for bacteria. Generally speaking, a negative test for bacteria just means the test did not find any. They may be there, hiding from the testing method, the wrong test may have been used, the testing method may not have been sensitive enough, or the test may not have been read properly. Also, until the advent of multiple-drug-resistant bacteria, antibiotics have been so effective that after a long course of antibiotics, many doctors presume that there cannot be any bacteria left.

Then there’s the next question: if bacteria are shown to be present, does that mean that they are causing your symptoms? Will eliminating your bacteria mean the end of your problems, and your pain and other symptoms?

Which leads to another big question. How does one get rid of bacteria? Are there antibiotics that work on your bacteria? Do the antibiotics cause serious side effects? Are your bacteria resistant to antibiotics? Or as a recent study suggests, do some bacteria have mechanisms to survive antibiotics?

In the last 30 years, with the wide availability of powerful antibiotics, doctors in many clinical settings have not honed their ability to diagnosis specific bacterial infections. Why bother? Just prescribe a powerful broad-spectrum antibiotic and watch the patient get better. This reliance on antibiotics goes to such an extent that doctors will prescribe antibiotics, which themselves have risks, even though the doctor doesn’t think your problem is caused by bacteria.