Prostatitis is a clinical term loosely used to describe a constellation of symptoms which commonly occurs in young and middle-aged men. The complaints vary but consist mainly of sensation of chronic perineal fullness, low back pain or dysuria, sometimes associated with a slight urethral discarge. Usually there is no fever or major constitutional illness. The symptoms are often temporarily relieved but sometimes exacerbated following ejaculation or rectal massage of the prostate. The etiology in unknown.

It also permits definition of bacterial prostatis which may be asymptomatic, but in which clear evidence of larger numbers of bacteria are found in the prostatic fluid than can be accounted for by urethral contamination or from bacteriuria. The organisms are the same as those found in other urinary infections, e.g., Esch. Coli most commonly, followed by Enterobacter, Klebsiella, Proteus, and group D streptococci.

Bacterial prostatis is important in the male with recurrent urinary tract infection because of the potential of bacteria in the prostatic focus to reinfect the urinary tract. This is of particular concern since it is quite difficult to eradicate bacteria which colonize the prostate. The bacteria often are introduced into the prostate following urethral instrumentation and complicate the care of the patient after the foreign body is removed.

Acute bacterial prostatitis is a more fulminant process in which there are fever and acute perineal and low back pain, often accompanied by gram negative or enterococcal bacteremia. Occasionally the Staphylococcus may produce microabscesses in the prostate as part of generalized bacteremia. This condition may be complicated by bacteril epididymitis and require surgical drainage as well as antimicrobial therapy. It may occur spontaneously or as part of a general urinary infection or following indwelling urethral catheterization. Tuberculosis and deep fungal infections such as blastomycosis, coccidioidomycosis and cryptococcosis may also infect the prostate and epididymis.